THURSDAY, March 21 (HealthDay News) -- Many of the soldiers who
served in the first Gulf War suffer a poorly understood collection
of symptoms known as Gulf War illness, and now a small study has
identified brain changes in these vets that may give hints for
developing a test for diagnosing the condition.
Around 25 percent of the nearly 700,000 U.S. troops that were
deployed to countries including Iraq, Kuwait and Saudi Arabia began
experiencing a range of physical and mental health problems during
or shortly after their tour that persist to this day. Common
symptoms are widespread pain; fatigue; mood and memory disruptions;
and gastrointestinal, respiratory and skin problems.
New research suggests that structural changes in the white
matter of the brains of these vets could be at least partly to
blame for their symptoms. White matter is made up of a network of
nerve fibers or axons, which are the long projections on nerve
cells that connect and transmit signals between the gray matter
regions that carry out the brain's many functions.
Denise Nichols was a nurse in the U.S. Air Force and worked with
an aeromedical evacuation team for six months during the war. While
still in theater, she developed bumps on her arms and had
alternating constipation and diarrhea. Shortly after returning in
1991, her eyesight worsened and she developed intense muscle
fatigue and memory problems that made it hard for her to help her
daughter with her math homework.
"I'm not working anymore because of it; I just could not do it," said Nichols, now 62. In addition to working as a military and civilian nurse, Nichols used to teach nursing and has helped conduct research on Gulf War illness and participated in studies including the current one. "There's people much worse who have cancers and heart problems, and pulmonary embolism has now started surfacing," she said.
"It's frustrating because VA hospitals have not taught their doctors [how to handle the illness]," Nichols said. VA doctors diagnosed her with post-traumatic stress disorder (PTSD). "I told them I didn't have PTSD, but they were giving us PTSD from having to deal with them," she said.
Lead researcher Rakib Rayhan put it this way: "This study can
help us move past the controversy in the past decade that Gulf War
illness is not real or that vets would be called crazy. Gulf War
duties have caused some changes that are not found in normal
Rayhan and his colleagues performed an advanced form of MRI for
visualizing white matter on 31 vets who experienced Gulf War
illness, along with 20 vets and civilians who did not experience
the syndrome. Although the researchers focused on white matter in
the current study, they are also investigating gray matter regions,
said Rayhan, a researcher at Georgetown University Medical Center
in Washington, D.C.
The results were published March 20 in the journal
The images suggested that there was loss of structural integrity
in several white-matter areas in vets with Gulf War illness,
particularly in a region that connects gray-matter areas involved
in the perception of pain and fatigue, Rayhan said. The researchers
observed more disorganization in this area in vets who reported
more severe pain and fatigue, and who had a lower threshold for
pain in a test that applied pressure to 18 points on the body.
Dr. Robert Haley, director of epidemiology at the University of
Texas Southwestern, in Dallas, said the study is very important,
and the first to use this type of MRI to examine Gulf War
The findings agree with previous research that found that
white-matter regions in the brains of Gulf War vets were smaller
than in controls using conventional MRI, said Haley, who was not
involved in the research.
Other research by Haley and his colleagues has identified
functional differences in some of the gray-matter regions in Gulf
War vets. Damage to both white- and gray-matter regions could be
involved in Gulf War illness, Haley said, adding that the current
study helps make the case that the physiological damage is not
limited to the gray matter.
The changes in white matter seen in the current study, however,
have to be shown in other groups of vets in other studies, Haley
said. A downside of the current study is that all of the vets with
Gulf War illness also met the criteria for having chronic fatigue
syndrome and half of them qualified as having fibromyalgia, a
chronic widespread pain disorder. So it is possible that the
changes in white matter noted in this study were related to these
conditions and not Gulf War illness.
But teasing apart the brain changes associated with these
conditions could be challenging, Rayhan said, because of the
overlap in their symptoms. For example, if you meet the criteria
for chronic fatigue syndrome and fibromyalgia and you were in the
military in 1990 or '91, your doctor could decide that you have
Gulf War illness, he said.
To diagnose Gulf War illness, doctors generally look for at
least moderately severe symptoms in the following areas: fatigue;
pain; mood and cognition; and gastrointestinal, respiratory and
If the differences reported in this study can be supported by
other studies, it could open doors for diagnostic testing based on
this type of MRI, Haley said. It is a simple, fast test that does
not involve radiation, he said.
Such a test would help vets get out of the "your word against
theirs" challenge in getting services from VA systems, which
includes not only medical treatment, but also benefits for their
families, Haley said. Veterans of the recent wars in Iraq and
Afghanistan also are in need of a diagnostic test for mild
traumatic brain injury in cases where they cannot prove the injury
based on having endured an explosion or lost consciousness, he
The more researchers understand the brain damage that is
underlying Gulf War illness, the further along they will be in
developing treatments, Haley said.
Although it is fairly well agreed upon that Gulf War illness is
caused by exposure to chemicals, and the likely culprits are
chemicals in nerve gas and the pesticides used to protect troops
from mosquitoes and other insects, treatments have been elusive,
You can get more information on Gulf War illness from the
of Veterans Affairs.
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