Autonomic dysfunction in veterans with Gulf War illness (1068.19)

Abstract

Gulf War Illness (GWI) is a complex, idiopathic condition affecting Veterans deployed during the first Gulf War. Common symptoms reported in Veterans with GWI include but are not limited to chronic fatigue, diffuse muscle pain, gastrointestinal disorders, as well as autonomic dysfunction. While the cause of GWI is not known, there is evidence that autonomic dysfunction may be an important element underlying GWI and the associated disability. In this study Veterans with and without GWI (as defined by Kansas screening) underwent autonomic function testing, including transcranial Doppler in the middle (MCA) and anterior cerebral artery (ACA) as well as blood pressure during multiple tests (orthostatic challenge, hyper/ hypocapnia, cold pressor). Our results show that the autoregulation index (ARI) for both MCA (Control 3.5 ± 0.58 vs GWI 2.1 ± 0.48) and ACA (Control 3.7 ± 0.67 vs GWI 2.6 ± 0.50) are both lower in GWI Veterans vs. Non‐GWI vets; suggesting autonomic impairment in GWI individuals. Blood pressure nadirs did not change between groups (Control 9.9 ± 0.30s vs GWI 10.1 ± 0.32s); however, there was a difference when comparing nadirs from MCA mean blood velocity (7.6 ± 0.61s vs 8.9 ± 0.51s) between groups, further illustrating autonomic dysfunction in GWI Veterans. Our findings suggest a level of autonomic impairment in Veterans with GWI, and further studies should be performed to determine if interventions can ameliorate autonomic impairment in this group of individuals.Grant Funding Source: Department of Veterans Affairs and Office of Public Health