Examination of Neuroimaging, Cognitive Functioning, and Plasma Markers in a Longitudinal Cohort of Gulf War Deployed Veterans: The Fort Devens Cohort
Abstract
Over the last 25 years, many Veterans who were deployed to the Gulf War (GW) have continued to report chronic health symptoms of unknown cause. Our research team first began following a cohort of Veterans who returned from deployment in 1991 through Ft. Devens, MA. This group was initially called the Ft. Devens Operation Desert Storm Reunion survey participants, and over time they have been known as the Ft. Devens Cohort (FDC). The participants first filled out questionnaires pertaining to their mood and reintegration status, but it became clear after speaking with many of these Veterans that not only were they ill, but they were reporting chronic or worsening health concerns and that more extensive health symptom and exposure surveys needed to be done. At that time (in the late 1990s), we began to see smaller groups of individuals to complete in-person evaluations, including environmental exposure questionnaires, memory and attention testing, and MRI (magnetic resonance imaging) brain scans (Time 3). Our goal was to more adequately document problems in memory/thinking abilities and to get a better idea about what individuals were exposed to in the Gulf region, including toxic chemicals such as chemical sprays, anti-nerve gas pills (PB), and sarin nerve gas. Our participants reported that joint pain, headaches, memory and attention difficulties, skin rash, gastrointestinal difficulties, and sleep problems were the most commonly reported chronic symptoms. It was also documented that toxicant exposures such as sarin gas was significantly correlated with slowed motor speed (reaction times) and visuospatial functioning on cognitive testing. At that same time period, our team conducted in-person cognitive, mood and exposure assessments on GW Veterans who were referred for neuropsychological clinics for cognitive concerns. This 200-member treatment-seeking GW Veteran cohort (known as the TSC) performed more poorly on measures of attention, visual memory, visuospatial functioning, and mood than non-deployed-era Veterans. In addition, MRI brain imaging findings on a subset of 54 of these individuals showed TSC participants reporting more chronic health symptoms had less total brain white matter. Follow-up studies of the FDC in the early 2000s found that individuals who encountered chemical odors during their GW deployment were 6 times more likely to meet criteria for severe chronic multi-symptom illness (CMI) of Fukuda et al., while those who consumed more than 20 anti-nerve gas (PB) pills during deployment were 2 to 4 times more likely to meet CMI criteria. Dr. Maxine Krengel currently leads the latest FDC resurvey effort where 600 participants are expected to participate and rates current of CMI and Kansas GWI criteria are being determined. In addition, 200 FDC participants are taking part in a study to assess genetic susceptibility to environmental exposures and one oxidative stress marker (PON1). We have also found that about two-thirds of GW Veteran respondents have a self-reported history of mild concussion or traumatic brain injury (mTBI). Results from this latest study show that toxic exposures and TBI significantly correlate with the criteria for CMI/GWI. Further, those who reported experiencing multiple TBIs reported significantly more health symptoms during the past month than those reporting a single TBI. We are now proposing a follow-up in-person study to reassess memory and attention and other cognitive functions in 150 FDC/TSC Veterans. In addition, we are proposing to use previously unavailable neuroimaging markers (MRS) of oxidative stress in the brain (GSH) that we will compare with blood markers. Oxidative stress has been found to occur after TBI and exposures to GW toxic chemicals. We aim to compare current cognitive functioning and MRI brain volumes to prior testing done with our FDC cohort and to determine current biological markers (MRI, MRS, blood) to aid in devising a diagnostic test for GW
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 31, 2017
- Source ID
- W81XWH1610695
Entities
People
- Kimberly Sullivan
Organizations
- Boston University Medical Campus
- United States Army