Enrichment of Data Collection for the Boston Biorepository and Integrative Network for GWI: The Non-Exclusionary Wave (NEW BBRAIN) Cohort
Abstract
Gulf War Illness (GWI) is a chronic debilitating disorder characterized by symptoms including fatigue, joint pain, memory and concentration problems, headaches and gastrointestinal problems. It is thought to affect approximately 30% of the 697,000 Veterans who served in the 1991 Gulf War. Despite significant research over the years, GWI remains a disorder primarily diagnosed by self-report of symptoms making clear diagnosis, treatment development, and access to benefits and care difficult for many GW (GW) Veterans. Our research group is currently filling this need in the GWI research community by overseeing the Boston Biorepository, Recruitment and Innovative Network (BBRAIN) for GWI consortia to more quickly identify objective biomarkers and potential targeted or personalized treatment strategies for Veterans with GWI. To distinguish our BBRAIN cohort, we have been utilizing the Kansas GWI exclusion criteria, the gold standard of inclusion and exclusion measurement in GWI research. However, we have found that the Kansas exclusionary criteria excludes over half of all potential Veterans that have been screened to date and has excluded over 200 Veterans from our prior GWI consortium because of comorbid (additional) conditions such as diabetes, heart disease, head injury that in theory could otherwise account for their symptoms of GWI. This group of Veterans who are frequently excluded from studies and treatment trials due to their often more complicated health conditions will compose our third comparison group of Veterans. This Non-Exclusionary Wave (NEW BBRAIN) cohort will meet the Kansas symptom criteria but will also have comorbidities that would otherwise exclude them from participation according to the current Kansas exclusionary criteria. This NEW BBRAIN cohort will help clarify whether or not comorbid diagnosed conditions are related to more severe and progressive subtypes of GWI that could result in neurodegenerative and/or other age-related disorders. Unfortunately, this group has largely been left behind in most current GWI research and our goal is to address this issue. Our research group is taking a team approach to solving the mystery of GWI with the implementation of the BBRAIN consortia and the proposed addition of the NEW BBRAIN cohort. We are actively adding to a large multi-site dataset with cognitive, brain imaging, health symptom data, and biorepository blood and saliva sample specimens that we are making available to the whole GWI research community. The NEW BBRAIN cohort will follow the same methods as our BBRAIN study where online demographic, exposure, and health outcome surveys will be completed; and cognitive assessments, heart-rate variability, and sleep metrics and biomarkers including blood, DNA, RNA, stool, urine will be collected and stored for sharing within the biorepository. A brief neurological examination and a test for changes in smell that may be related to neurologic disease will be added. In addition, all BBRAIN participants (GWI symptoms only, GWI with exclusions, GW controls) will complete online health symptom and chronic medical conditions surveys to assess health changes since their last visit. This will allow us to capture any difference in risk of chronic conditions due to deployment and not simply a result of comorbidities and lifestyle choices. By making all of these data and samples available in the repository, we can greatly hasten our ongoing studies and those of other researchers in the field who we will share these samples and data with. This study will also help to determine more targeted treatments for all Veterans with GWI rather than those who only have GWI symptoms and no other chronic conditions. This is imperative as Veterans continue to age and many of the sickest Veterans are now excluded from studies when they may be the most at risk and the most in need of treatment trials. The current Kansas and other GWI case criteria were created more than 20 years ag
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 28, 2022
- Source ID
- W81XWH2210398
Entities
People
- Kimberly Sullivan
Organizations
- Boston University Medical Campus
- United States Army