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MRI Finds 2 Distinct Kinds Of Gulf War Illness

June 19, 2013
Written by: , Filed in: Diagnostic Imaging, Neuroradiology
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What exactly is Gulf War illness? A group of researchers at Georgetown University in Washington used functional MRI to scan the brains of 28 Gulf War veterans diagnosed with the illness and, in a surprise, discovered that it seems to be at least two different disorders, both with neurological roots.

Said Rakib U. Rayhan, lead author of an article about the research published Friday in PLOS ONE:

Our findings help explain and validate what these veterans have long said about their illness.

Rayhan was quoted in a Georgetown news release.

By some estimates, nearly 30 percent of the military personnel who served in Operation Desert Storm, the war against Iraq in 1990–91, report such symptoms as cognitive impairment, fatigue, and chronic pain. The diffuse nature of the symptoms and the variance in their occurrence among sufferers have led to debates about the cause, or even the existence, of what has come to be called Gulf War illness. Many veterans have blamed exposure to toxic chemicals. Many medical professionals have attributed the symptoms to combat stress.

Exacerbation of symptoms following exercise seems to be a common complaint. So the Georgetown researchers scanned—once before a bicycle exercise stress test and again an hour after exercise—the brains of 28 Gulf War veterans who met a set of criteria developed in 1998 by the Centers for Disease Control and Prevention to classify the illness. The researchers also scanned 10 control subjects.

Among 18 of the Gulf War illness patients, pain levels increased after the exercise. fMRI scans showed a loss of brain matter in regions associated with pain regulation. During pre-exercise cognitive tests, that group showed an increased use of the basal ganglia. That’s a compensatory strategy often employed by brains suffering from neurodegenerative disorders.

The other 10 patients manifested substantial increases in heart rate. Scans showed atrophy in the brain stem, which regulates heart rate. Scans also showed compensatory use, but this time of the cerebellum.

After exercise, both groups lost the ability to employ their respective compensatory brain strategies. None of the members of the control group showed changes in cognition, brain structure, or exercise-induced symptoms.

“The use of other brain areas to compensate for a damaged area is seen in other disorders, such as Alzheimer’s disease,” said Rayhan, “which is why we believe our data show that these veterans are suffering from central nervous system dysfunction.”

Some experts contacted by the New York Times were skeptical, noting among other things the small size of the study. John Bailar, MD, PhD, an emeritus professor at the University of Chicago who studied Gulf War illness in 1996, said in an e-mail:

I am not questioning whether a substantial proportion of veterans of Desert Storm have symptoms related to their service. I am questioning whether those symptoms have any cause other than the stress of war itself.

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