Abstract
The Boston University-based Gulf War Illness Consortium (GWIC) is a multidisciplinary initiative developed to provide detailed understanding of brain and immune alterations that underlie Gulf War illness (GWI), the persistent multisymptom disorder associated with military service in the 1990–1991 Gulf War. The core GWIC case-control clinical study conducted in-depth brain and immune evaluation of 269 Gulf War veterans (223 GWI cases, 46 controls) at three U.S. sites that included clinical assessments, brain imaging, neuropsychological testing, and analyses of a broad range of immune and immunogenetic parameters. GWI cases were similar to controls on most demographic, military, and deployment characteristics although on average were two years younger, with a higher proportion of enlisted personnel vs. officers. Results of physical evaluation and routine clinical lab tests were largely normal, with few differences between GWI cases and healthy controls. However, veterans with GWI scored significantly worse than controls on standardized assessments of general health, pain, fatigue, and sleep quality and had higher rates of diagnosed conditions that included hypertension, respiratory and sinus conditions, gastrointestinal conditions, and current or lifetime depression and post-traumatic stress disorder. Among multiple deployment experiences/exposures reported by veterans, multivariable logistic regression identified just two significant GWI risk factors: extended use of skin pesticides in theater (adjusted OR = 3.25, p = 0.005) and experiencing mild traumatic brain injury during deployment (OR = 7.39, p = 0.009). Gulf War experiences associated with intense stress or trauma (e.g., participation in ground combat) were not associated with GWI. Data and samples from the GWIC project are now stored in a repository for use by GWI researchers. Future reports will present detailed findings on brain structure and function, immune function, and association of neuroimmune measures with characteristics of GWI and Gulf War service.
Highlights
Data were collected for the Gulf War Illness Consortium (GWIC) case-control study between 2015 and 2020 at three clinical study sites: Boston University, the Miami Department of Veterans Affairs Medical
703 veterans were screened for study eligibility at the three GWIC sites
We describe the general health of GWIC participants, results of clinical evaluation and testing of GWIC cases and controls, and significant Gulf War illness (GWI) risk factors among veteran-reported wartime experiences and exposures
Summary
The 1990–1991 Persian Gulf War was among the most impressive military campaigns of the modern era. After the successful execution of the Gulf War, a substantial number of military personnel returned home with difficult health problems that were not explained by familiar medical or psychiatric diagnoses [2–4]. This condition, known as Gulf War illness (GWI), remains a serious problem for Gulf War veterans 30 years after the war [5–7]. A series of population studies identified a consistent profile of excess symptoms that affected up to one third of Gulf War veterans [8–11]. Clinical studies conducted in Gulf War veteran populations identified a series of neurological, immune and other pathobiological alterations that significantly distinguished GWI cases from healthy controls [18–25]. Studies using animal models to simulate the exposure experiences of Gulf War military personnel identified chronic and/or delayed neurological, inflammatory, and behavioral changes that were consistent with veterans’
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