Abstract
This review paper summarizes the accumulation of research investigating neuropsychological outcomes in veterans with Gulf War illness (GWI). Earlier research focused on Gulf War veterans (GW) who were deployed versus non-deployed, as well as those who were symptomatic versus asymptomatic, or compared neuropsychological test results to published norms. Further research became more sophisticated, investigating specific GWI criteria, as well as the result of neurotoxicant exposure and the relationship to possible neurocognitive outcomes. As the early research supported both psychological and physiological effects on GWI; current research as summarized in this literature review supports the presence of neuropsychological deficits, particularly in the domains of attention, executive functioning, memory, and motor functioning related to chemical exposures that can be exacerbated by comorbid mood-related conditions. The same test battery has not been used consistently making it difficult to compare results among studies. Therefore, researchers created a resource to provide recommendations for the recently listed Neuropsychological Tests for Common Data Elements (CDEs) for use in all future GWI studies. Future research is necessary to further understand patterns of neuropsychological test data and how these decrements may relate to immunological or other biological markers, and the impact of trauma from physical and psychological stressors. In conclusion, there is consistent evidence that GWI is characterized by neuropsychological decrements – with future research these findings may aid in the diagnosis and assessment of treatment trial efficacy of GW veterans.
Highlights
PTSD symptoms severity correlated with greater deficits in a wide array of neuropsychological measures in GW deployed veterans (Partial R2 = 0.02–0.10) – CBW exposure and PTSD severity in GWVs associated with deficits in sustained attention (Partial R2 = 0.0004–0.0015), motor speed/motor coordination (0.0000–0.0007)
Neuropsychological research in GWI has improved in methodology but continues to leave questions regarding the etiology and cognitive difficulties in veterans
It is imperative that these measures are adapted for use in imaging studies to understand the functional and structural underpinnings of cognitive impairments and changes over time in this aging group of veterans who are at higher risk for chronic medical conditions (Zundel et al, 2019)
Summary
Concluded that methodological issues limited the ability to understand the data. Recommended that future studies include more sophisticated cohort comparisons, including exposure data. The Research Advisory Committee on Gulf War Veteran’s Illnesses [RAC-GWVI] (2008) review concluded that symptomatic veterans had subtle “sub-clinical” CNS damage This included deficits in attention, executive function, memory, visuospatial skills, psychomotor functioning, and mood. Chao (2017) concluded that subjective memory complaints are sensitive to neuropsychological deficits and, as subjective memory complaints are linked to dementia risk, a necessary component of GW neuropsychological assessment These three studies did not show consistency in regard to objective tests (Table 3). Given the discrepancy between subjective complaints and objective test performance, more validation research is needed with tests sensitive to memory impairment in GW veterans as delineated in the CDE protocol (Table 1) None of these studies used the same subjective question of memory functioning making comparisons with objective measures difficult. The model of mood-related issues included indices of trait anxiety, subjective
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
