BACKGROUND/RATIONALE:
Wars have long affected the health of veterans in multiple ways. Many soldiers who served during the 1990-1991 Gulf War (GW) developed a constellation of unexplained medical symptoms and neurocognitive difficulties (e.g., poor memory, reduced concentration, slowed psychomotor speed) that have been termed Gulf War Illness (GWI). While these difficulties are commonly reported, the extent to which they affect GW veterans who were deployed is unclear at this time. Understanding the cause and nature of these problems is of great importance to GW veterans because they interfere with their daily functioning and quality of life.

OBJECTIVE(S):
The main goal of this study is to better understand the neurocognitive health of Gulf War veterans. Most neurocognitive assessment studies of GW veterans have been on highly selected samples that present to referral programs, resulting in findings that cannot be generalized to the GW veteran population. In the current study, the primary objectives are to: 1) compare the neurocognitive differences and self-reported quality of life between population-based cases and controls; 2) compare traditional neuropsychological testing results of self-selected veterans with subjective cognitive complaints (archival cases) to population-based cases and controls; and 3) determine whether cognitive impairment is correlated with psychiatric distress in patients with GWI.

METHODS:
The current cohort study includes a random sample of 35 GW deployed cases that meet criteria for GWI as defined by the Center for Disease Control and 35 GW deployed controls. GW veterans with a history of central nervous system conditions, upper extremity dysfunction, psychosis, color blindness, and active substance abuse are excluded from the study. All subjects are asked to retake the GW veteran survey and complete a five- to six-hour neuropsychological evaluation. The latter consists of cognitive tests typically utilized at the DC Gulf War Referral Center. Testing takes place at VA medical centers located in the District of Columbia and West Virginia. Subject recruitment is ongoing. At present, thirty-seven subjects have completed a neuropsychological evaluation and three have been scheduled for testing. After data collection is complete, summary variables of cognitive tests will be compared using bivariate and multivariate analysis.

FINDINGS/RESULTS:
Major activities completed in the last 12 months include conducting GW veteran surveys, recruiting and screening subjects, collecting data (37 subjects enrolled, 3 subjects scheduled), scoring neuropsychological test batteries, compiling archival and current databases. It is anticipated that GW veterans who meet CDC criteria for GWI (cases) will score lower on cognitive, psychological, and quality of life measures in comparison to GW veterans who do not meet CDC criteria for GWI (controls). In addition, it is expected that the self-selected GW sample with multiple symptoms will have greater cognitive and psychiatric dysfunction than the population-based GW sample.

IMPACT:
The current study will provide GW veterans, the VA health care system, and the general public with a better understanding of the nature, progression, and treatment of Gulf War Illness. This will assist with improving the health status of GW veterans, decreasing healthcare expenditures, and guiding future deployment medical services.

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External Links for this Project

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PUBLICATIONS:

None at this time.

DRA: Military and Environmental Exposures
DRE: Epidemiology
Keywords: Adherence, Cognitive impairment, Gulf War I, Quality of life, Research method
MeSH Terms: none