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Gulf War Veterans


Introduction

Nearly 700,000 men and women served in the Persian Gulf during Operation Desert Shield and Operation Desert Storm in the early 1990s. VA researchers are conducting studies to better understand and treat health problems experienced by some Veterans who served during the Gulf War.

A prominent condition affecting Gulf War Veterans is a cluster of medically unexplained chronic symptoms that can include fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, skin problems, and memory impairment. VA refers to these illnesses as chronic multisymptom illness, medically unexplained illnesses, and Gulf War Veterans' illnesses—all commonly known as Gulf War illness (GWI).

According to a 2020 Department of Defense report, GWI is estimated to affect 175,000 to 250,000 Veterans of the nearly 700,000 troops who were deployed to the Gulf War theater of operations from 1990 to 1991. GWI affects Veterans who served in the Army and the Marine Corps at higher rates than those who served in the Navy and Air Force, and enlisted personnel are affected more than others. GWI rates also differ by where Veterans were located during deployment, with the highest rates among troops who served in areas that were close to combat.

According to a 2016 study by VA researchers, based on data collected 20  years after the war, Gulf War-era Veterans who were deployed to the Gulf continued to report poorer health than Veterans who served during the same period but were not deployed.

VA has determined that nine infectious diseases are related to military service in the Southwest Asia theater of operations during the first Gulf War and Afghanistan. They include malaria, brucellosis, campylobacter jejuni, coxiella burnetii (Q fever), mycobacterium tuberculosis, nontyphoid salmonella, shigella, visceral leishmaniasis, and West Nile virus. A fuller description of these diseases can be found here.

In addition, VA presumes certain chronic, unexplained symptoms existing for six months or more are related to Gulf War service without regard to cause. These “presumptive” illnesses must have appeared during active duty in the Southwest Asia theater of military operations by Dec. 31, 2021, and must be at least 10% disabling. The illnesses include chronic fatigue syndrome, fibromyalgia, functional gastrointestinal disorders, and other undiagnosed illnesses. A fuller description of these diseases can be found here.

VA has established several registries to help scientists better understand and treat health problems experienced by Gulf War Veterans:

The Gulf War Registry Health Exam alerts Veterans to possible long-term health problems that may be related to environmental exposures during their military service. The registry data helps VA understand and respond to these health problems more effectively. All Veterans who served in the Gulf during Operation Desert Shield, Operation Desert Storm, Operation Iraqi Freedom, or Operation New Dawn are eligible for the exam, which is separate from VA's disability compensation process. Veterans do not need to be enrolled in VA health care to take part.

Veterans can also sign up for VA’s Airborne Hazards and Open Burn Pit Registry, where they can report exposures to airborne hazards such as smoke from burn pits, oil-well fires, or pollution during deployment, as well as other health concerns.

The VA Gulf War Era Cohort and Biorepository was established to learn more about health conditions affecting Veterans who served in the U.S. military between 1990 and 1991. Members of the GWI Cohort, which includes 1,275 men and women who served during the Gulf War era, have completed a health survey and provided blood samples for DNA analysis. Participants do not need to receive their health care through VA.

For more information on VA's efforts on behalf of Gulf War Veterans, particularly in the areas of epidemiology and surveillance, visit the Gulf War Veterans' Illnesses section of the VA Office of Public Health website.

Current Funded Studies

The following is a partial list of projects related to the Gulf War that are funded by the VA Office of Research and Development (ORD). To see a full list of all ORD-funded projects on the topic, go to the Funded Projects page and type "Gulf War" into the search bar at the top of the table.

For those interested in joining a VA-sponsored clinical trial, click here and follow the instructions.

 Project 
 Title ↓
 PI 
 Service 
I01CX001480-01 A Randomized, Double-blind Placebo-controlled Phase III Trial of Coenzyme Q10 in Gulf War Illness Klimas, Nancy Clinical Science R&D
IK2CX001679-01A1 Acute exercise tolerance among Veterans with Gulf War Illness Lindheimer III, Jacob Clinical Science R&D
I01BX004740-01A1 Advancing Non-Invasive Diagnostics and Treatments of Deployment-Related Chronic Lung Disease in Gulf War Veterans Osterholzer, John Biomedical Laboratory R&D
I01CX000798-05 An investigation of the relationship between toxicant exposures during Gulf War deployment and prodromal Parkinson's disease. Chao, Linda Clinical Science R&D
I01CX001569-01A1 Biomarker Candidates in Gulf War Veterans: A 10-year Follow-up Investigation Marx, Christine Clinical Science R&D
First 5 of 22 projects matching "Gulf War". For the full list search for "Gulf War" in study titles here.

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Research Advisory Committee on Gulf War Veterans' Illnesses

The Research Advisory Committee on Gulf War Veteran's Illnesses makes recommendations to the Secretary of Veterans Affairs on proposed research and strategies related to understanding and treating the health consequences of military service in the Southwest Asia theater of operations during the 1990-1991 Gulf War. To learn more about RAC reports and activities, follow this link.



Selected Major Accomplishments

  • 1995: Initiated the Longitudinal Health Study of Gulf War-era Veterans
  • 2012: Developed the first Gulf War research strategic plan
  • 2016: Published follow-up results for the second wave of the Longitudinal Health Study
  • 2017: Found evidence that Veterans with GWI might have greater mitochondrial DNA damage than Veterans without GWI
  • 2020: Held a Joint VA/DOD GWI state of the science conference to coincide with the 30-year anniversary of Operation Desert Shield
  • 2021: Found that toxic exposures during the Gulf War may cause changes in the hippocampus, contributing to memory problems

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New, Ongoing, and Published Research

VA researchers are learning about conditions affecting Gulf War Veterans and identifying the best ways to diagnose and treat them. Their efforts are guided by a strategic plan for Gulf War research developed with input from leading scientists, researchers, physicians, and Veterans themselves.

The plan was developed in 2012 and updated in 2015 in response to a call from the National Academy of Medicine for a renewed and better-focused effort in Gulf War research. It comprehensively addresses a range of issues related to Gulf War research and emphasizes the need for effective treatment for Veterans.

VA investigators are conducting research in many areas important to Gulf War Veterans. These include studies on pain, autoimmune disease, neurodegenerative disease, sleep disorders, gastrointestinal disorders, respiratory problems, and other chronic diseases.

➤ Longitudinal study of Gulf War Veterans

VA's Longitudinal Health Study of Gulf War Era Veterans is one of the largest studies to examine the health of Veterans who served during the Gulf War. The study aims to compare changes in health over time for deployed and non-deployed Veterans from the Gulf War era. Approximately 30,000 Veterans took part in the original study.

The initial report was published in 2000. In comparison to non-deployed Veterans, Gulf War Veterans had a higher prevalence of functional impairment, health care utilization, symptoms, and medical conditions. They also rated their overall health status, including mental, physical, and social well-being, less highly than Veterans who did not serve in the Gulf.

VA researchers published follow-up studies in 2011 and 2016. They found that almost 20 years later, Gulf War Veterans who served in the region continued to report poorer health outcomes—both physical and mental—than their counterparts who were not deployed to the Gulf. However, researchers noted that Veterans from that era, as a group, have multiple health conditions and a high body mass index, which could contribute to poorer health.

In 2021, VA researchers published a third follow-up to the Gulf War era Longitudinal Health Study—including more than 6,300 Veterans who participated in all three surveys. The team found that Veterans who deployed to the Gulf continued to report an increase in chronic disease. Not only were these Veterans more likely to report health problems than their non-deployed peers, but they also reported problems earlier.

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➤ Reported GWI symptoms

Symptoms persist 25 years later—A 2021 study led by researchers at the Durham VA Medical Center supported findings from the Longitudinal Health Study of Gulf War Era Veterans. It found that multisymptom illnesses are sustained even decades after deployment to the Persian Gulf. The research team surveyed more than 1,000 members of the Gulf War Era Cohort and Biorepository and found that 84% had GWI using the Centers for Disease Control criteria. Using the Kansas Gulf War criteria, 40% of study participants had GWI.

Compared with non-deployed Veterans, those who deployed to the Gulf had higher odds of having GWI symptoms. The researchers found that differences in symptoms between deployed and non-deployed Veterans diminished over time. The team believes that GWI definitions need to be updated to take age-related conditions into account.

Deployed women Veterans report multiple GWI symptoms—A 2020 study, conducted by VA, DOD, and other institutions, found that 40% of Gulf War-deployed women Veterans reported more than 20 GWI symptoms—nearly twice the rate of Gulf War-era women Veterans who were not deployed. The study used data from the VA Cooperative Studies Program #585 GWECB. Study participants who were deployed were more likely to report cognitive, neurological, mood, and respiratory symptoms than their non-deployed counterparts.

About two-thirds of the women Veterans in the study reported difficulty remembering new information and trouble concentrating. In addition, 39% reported difficulty breathing or shortness of breath. More than half also reported a low tolerance for heat and cold. Researchers recommended additional research to identify specific biological markers of GWI and find effective treatments that may be gender specific.

Post-exertional malaise (PEM) inconsistent in Veterans with GWI—In a 2020 study, VA researchers found that GWI Veterans with PEM perceived exercise as more painful and fatiguing, compared with the control group. Researchers at the William S. Middleton Memorial Veterans Hospital in Madison, Wisconsin, and the VA War Related Illness and Injury Study Center in New Jersey examined PEM following an exercise challenge in 39 Veterans with GWI and 28 controls. Researchers found that not all study participants with GWI reported PEM 24 hours after exercise. The team believes more research is needed to determine how much exercise worsens GWI symptoms.

Post-exertional malaise (PEM) is a debilitating symptom of GWI. People with PEM find their symptoms of pain and fatigue become worse after even minor physical or mental exertion. Many Veterans with GWI experience this condition.

Increased rates of respiratory illnesses in Gulf War Veterans—Veterans who deployed during the Gulf War had a small but significant higher prevalence of respiratory illnesses, compared with non-deployed Veterans from the same era, found a 2020 study by VA’s Post-Deployment Health Services (now known as Health Outcomes Military Exposures [HOME]). Researchers looked at 10-year outcomes for more than 360,000 Veterans who deployed during the Gulf War and more than 320,000 Veterans who did not deploy. Deployed Veterans had higher rates of chronic bronchitis, emphysema, chronic airway obstruction, and chronic obstructive pulmonary disease. The difference was small, but still significant. The results show that Gulf War Veterans should continue to be monitored for long-term respiratory health consequences of airborne hazards, say the researchers.

Health symptom frequency for GWI—In a study published in 2018, a team of researchers from the VA Boston Health Care System, the U.S. Army Research Institute of Environmental Medicine, and Boston University School of Medicine looked at 21 peer-reviewed studies from 1990 to 2017 that reported health symptom frequencies in deployed and non-deployed Gulf War Veterans.

They found that deployed Veterans had higher odds of experiencing all 56 reported symptoms. The odds of reporting irritability, detachment, muscle weakness, diarrhea, and rashes were more than three times higher among deployed Gulf War Veterans, compared with those who did not deploy to the region. Checking for these symptoms is important when assessing the health status of Gulf War Veterans, according to the researchers.

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➤ Biomarkers of GWI

Inflammation—In 2016, researchers at the VA Minneapolis Health Care System and the University of Minnesota developed a panel of blood markers that was able to verify a GWI diagnosis with 90% accuracy. The study found that four types of blood cells were present in higher numbers in GWI Veterans. It also discovered that serum proteins associated with inflammation were significantly different in GWI Veterans. The researchers believe that chronic inflammation in the body may be a component of GWI.

Participants in the study included 85 Gulf War Veterans. The researchers found that blood samples that showed significantly higher levels of lymphocytes, monocytes, and C-reactive protein could correctly diagnose GWI 90% of the time, when the probability of having GWI was greater than 70%.

The team is analyzing results from a clinical trial that closed in October 2020 to test whether an existing anti-inflammatory drug will improve quality of life for Veterans with GWI.

Human leucocyte antigen—The human leukocyte antigen (HLA) system is a group of genes that encode proteins that regulate the immune system in humans.

In 2015, a research team from the Minneapolis VA Health Care System and the University of Minnesota found the composition of HLA in Veterans with GWI was different from those without the illness. The researchers concluded that Veterans with GWI had reduced levels of protection from HLA and were therefore more susceptible to the illness.

In 2016, a follow-up study found sharp differences in brain function between healthy and ill Gulf War Veterans in the cerebellum and the frontal cortex—areas of the brain which control movement and higher mental processes such as decision making. These differences are excellent predictors of GWI, according to the study authors.

Another 2016 study by the same team found that HLA affects what is called “neural synchrony,” which is important for cognitive functions including attention, memory, and communication between nerves and muscles. Past studies have shown that cognitively healthy people display similar patterns of synchrony, while abnormal synchrony is linked to PTSD and other disorders. Eighty-one Gulf War Veterans underwent a magnetoencephalography scan to assess the strength of brain synchronicity. The study found evidence of symptom-related interactions between HLA genes and brain function.

A 2017 study by the group found that the HLA allele DRB1*13:02 plays a protective role against brain atrophy in Gulf War Veterans. (Alleles are alternative forms of a gene that arise by mutation.) The team hypothesizes that this allele can successfully eliminate external antigens that cause brain atrophy in GWI.

Genetic study and biorepository—VA is undertaking a genetic study of Gulf War Veterans that will include collecting survey data and banking blood in a biorepository to better understand genetic influences on GWI and how Veterans respond to treatment.

Study participants are followed over their life spans and agree to donate their brain and other body tissues at the time of their death.

Researchers say the medical, lifestyle, and exposure data they collect will provide valuable clues to the health challenges faced by Veterans of the Gulf War and other conflicts.

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➤ Pain in Gulf War Veterans

Chronic pain affects thinking in Gulf War Vets—Pain places greater stress on the thinking of Gulf War Veterans with chronic pain, relative to their Gulf War peers without chronic pain, according to a 2021 study. VA researchers at the William S. Middleton Memorial Veterans Hospital in Madison, Wisconsin, analyzed neural processing in Gulf War Veterans with chronic musculoskeletal pain. The team used magnetic resonance imaging (MRI) to assess study participants with chronic pain and healthy Gulf War Veteran controls as they completed cognitive testing while exposed to pain stimuli.

The imaging showed that Gulf War Veterans with chronic pain required more neural resources to sustain cognitive performance during pain stimuli, compared to the healthy controls. According to the researchers, the results suggest Gulf War Veterans with chronic pain may have abnormal pain processing.

Structural damage linked to musculoskeletal pain in Gulf War Veterans—Chronic musculoskeletal pain affects around 25% of Veterans who were deployed during the Persian Gulf War (1990–1991). A 2017 study at the William S. Middleton Memorial Veterans Hospital  showed that structural damage in the brain may be linked to chronic musculoskeletal pain.

The research team used MRI to determine that study participants with chronic pain had widespread disruptions in the structure of their white matter across several regions of the brain. White matter is tissue deep within the brain that contains nerve fibers. The study linked poorer white matter health to greater pain and fatigue in Gulf War Veterans with chronic musculoskeletal pain. Poorer white matter health was also linked to higher levels of depression, although to a lesser extent.

Veterans with GWI and GI complaints are hypersensitive to pain—Somatic pain is an unpleasant sensation that happens when pain receptors in tissues, like the skin or bones, are activated. A 2018 study at the Malcom Randall VA Medical Center in Gainesville, Florida, and other institutions looked for evidence of heightened somatic pain sensitivity in 138 Gulf War Veterans. The Veterans were divided into three groups—Veterans with GWI and gastrointestinal (GI) symptoms, Veterans with GWI and no GI symptoms, and a control group. Study participants underwent three types of pain stimuli—cold, heat, and ischemia (blood flow restriction using a tourniquet).

Researchers found that Veterans with both GWI and GI symptoms generally had a lower threshold for pain than those without GI symptoms. The researchers believe that this information can be used to develop more effective therapies  to address pain in Veterans deployed to future conflicts.

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➤ Toxic exposures during Gulf War service

Toxic exposures change hippocampus—Toxic exposures in an animal model altered gene expression in the hippocampus brain region, causing memory problems, according to a 2021 study led by researchers with the VA New Jersey Health Care System. Military personnel deployed during the Gulf War were exposed to many toxic chemicals—typically some combination of insecticides, insect repellents, nerve agents, and anti-toxins. Approximately 30% of deployed Gulf War Veterans report a variety of health issues including problems with memory.

Researchers simulated Gulf War conditions by exposing mice to three chemicals: two insecticides and an anti-sarin prophylactic. This resulted in inflammation and acute changes in gene expression in the mice's hippocampal tissue. According to the team, these results suggest that exposure to these toxic substances could cause chronic brain degeneration and could explain how GWI develops.

Exposure to sarin and cyclosarin—In 1991, the demolition of a munition depot in Khamisiyah, Iraq, caused U.S. soldiers to be exposed to low levels of two chemical agents, sarin and cyclosarin, which were carried downwind in a smoke plume. VA researchers in San Francisco used MRI scans to identify brain differences between Veterans who were exposed to those agents and those who were not, in a 2011 study.

MRI data showed reduced gray matter and white matter in the brains of exposed Veterans. During testing, exposed Veterans committed more errors of omission and tended to have slower responses than unexposed Veterans. The researchers said the findings "confirmed previous reports ... of central nervous system pathology in Gulf War Veterans with suspected exposure to low levels of [sarin and cyclosarin] two decades after exposure."

A 2014 follow-up study at the site added evidence of differences in the hippocampus—an area of the brain crucial for learning and memory—in those Gulf War Veterans with suspected exposure, and a 2015 study found that exposure to sarin and cyclosarin may result in a "reorganization" of the brain's white matter, resulting in possible behavioral changes.

Most recently, a 2017 study by the research team found that the smaller hippocampus volume in Veterans exposed to sarin and cyclosarin was associated with lower scores on a test of verbal learning and memory, 25 years after toxic exposure. Scores on the memory test were also lower for Veterans with higher estimated exposure levels and for those with self-reported memory difficulties.

Toxic exposure increases likelihood of GWI in women—Women Gulf War Veterans exposed to pesticides, oil well fires, and pyridostigmine bromide pills (an anti-nerve gas medication) were significantly more likely to meet criteria for GWI than women Veterans without toxic exposures, found a study by VA Boston researchers and colleagues. The researchers surveyed 202 women Veterans who deployed during the Gulf War. Self-reported exposure to toxic substances increased participants’ likelihood of meeting GWI criteria. Results also suggest that women exposed to particular toxic substances may benefit from more targeted treatment strategies based on how they were exposed, according to the researchers.

Chemical exposure could cause muscle weakness in GWI—Exposure to chemicals linked to GWI can lead to muscle atrophy and loss of function, found a study led by a VA San Diego researcher. Exposure to chemicals used to protect against insects and nerve gases is suspected as a cause of GWI. Researchers exposed rats to three common chemical protectants used during the Gulf War—pyridostigmine, permethrin, and DEET—in equivalent doses to what would have been experienced by service members. Rats exposed to the chemicals had lower limb strength and muscle weight, compared with controls. Metabolic pathways that promote skeletal muscle growth were altered in exposed rats. The effects of these chemical on muscle growth may account for Gulf War illness symptoms, say the researchers.

Effects of depleted uranium—The United States military uses depleted uranium (DU) in tank armor and some bullets designed to penetrate enemy armored vehicles. It began using DU on a large scale during the Gulf War. DU is 40% less radioactive than natural uranium, but has the same chemical toxicity. Fragments from armor-piercing rounds can become embedded in service members' bodies.

In 2017, researchers with the Baltimore VA Medical Center and the University of Maryland evaluated 36 Veterans known to have been exposed to DU during the Gulf War, through embedded bullet fragments. They found that 25 years after exposure, Veterans showed no uranium-related health effects.

Veterans with embedded uranium fragments showed elevated concentrations of uranium in their urine and a DU isotopic signature. Veterans exposed to uranium through inhalation had lower uranium concentrations in their urine and a natural isotopic signature. Because embedded DU fragments continue to expose Veterans to radiation, the researchers recommended that they continue to receive health surveillance.

A 2018 study by the same team found lung functioning was the same, on average, for Veterans with both high and low concentrations of uranium in their urine.

➤ Treatments for GWI

Psychotherapy for insomnia improves GWI symptoms—In a 2021 study, researchers with VA and the University of California, San Francisco, found that cognitive behavioral therapy for insomnia (CBT-I), when administered to Veterans with GWI by telephone, improved insomnia symptoms and sleep quality. CBT-I is a short, structured, and evidence-based approach to combating insomnia.

Eighty-five Veterans with GWI and insomnia were randomly assigned to receive CBT-I or monitoring. The CBT-I group underwent eight weekly sessions administered over the phone by psychologists. Outcomes for GWI symptoms and insomnia were assessed before, during, and after treatment. Six months after the end of treatment, investigators found that CBT-I produced significant improvements in overall symptom severity when compared to the control group.

Existing drugs may help GWI—Researchers at the Dorn VA Medical Center in Columbia, South Carolina, and other institutions found that ribavirin, a broad-spectrum antiviral drug, may provide an effective treatment for GWI, in a 2019 study. An imbalance of the microorganisms that naturally occur in the gut has been implicated in GWI and other inflammatory diseases. Researchers performed genetic sequencing in mice that were exposed to Gulf War chemicals. They found these rodents had abnormal amounts of microorganisms in their gut. The mice were treated with two antimicrobial therapies: a combination of antibiotics and ribavirin. The mice who were treated with the antiviral drug showed a restored viral balance in the gut. The study shows evidence that antiviral drugs like ribavirin may form the basis of new therapies to treat GWI.

A 2021 study, which included a VA researcher, found that andrographolide, a commonly used herbal medicine in South Asia, may be able to restore the balance of microorganisms in the gut of people affected by GWI. Researchers used a mouse model of GWI to demonstrate that treatment with andrographolide increased beneficial bacteria and decreased harmful bacteria in the gut. The treatment also decreased inflammation in the gut and nervous system.

Curcumin may improve memory and mood in GWI—Curcumin is an antioxidant compound found in turmeric and other plants and is sold as an herbal supplement. A 2018 study at the Olin E. Teague VA Medical Center in Temple, Texas, and Texas A&M Health Science Center found that rats with simulated GWI had better cognitive and mood function after receiving curcumin, compared to placebo. The mice that  received curcumin for 30 days also had better neurogenesis (the growth and development of nerve tissue) and lower inflammation than those that  did not. The researchers hypothesize that changes in gene expression caused by curcumin could improve memory and mood symptoms related to GWI.

Treatment for brain inflammation—Neurological symptoms of GWI include cognitive impairment, attention deficits, depression, and anxiety. These symptoms have been linked to abnormal immune function and chronic brain inflammation in GWI patients. Researchers at the VA Boston Healthcare System are studying whether GWI in a mouse model can be treated with fingolimod, an anti-inflammatory drug now used for patients with multiple sclerosis. If the trial is successful, the project will provide data for comprehensive clinical trials for treating GWI using an anti-inflammatory strategy.

Grape juice may improve cognitive performance—An ingredient in Concord grape juice may improve cognitive function in Veterans with GWI, found a 2021 study by VA New Jersey researchers and colleagues. Concord grape juice contains high concentrations of polyphenols, molecules that have an antioxidant effect on the body. Researchers found high concentrations of several polyphenols in the blood of some study participants after they drank grape juice. They observed strong links between changes in cognitive function and changes in levels of two polyphenols. Larger clinical studies are needed to determine whether polyphenols can be part of treatment for the cognitive effects of GWI, according to the researchers.

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More on Our Website

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Selected Scientific Articles by Our Researchers

Acute gene expression changes in the mouse hippocampus following a combined Gulf War toxicant exposure. Murray KE, Delic V, Ratliff WA, Beck KD, Citron BA. Exposure to toxic substances that simulate Gulf War toxic exposure can cause chronic neurodegeneration. Life Sci. 2021 2021 Nov 1;284;119845.

Nociceptive stress interferes with neural processing of cognitive stimuli in Gulf War Veterans with chronic musculoskeletal pain. Lindheimer JB, Stegner AJ, Van Riper SM, Ninneman JV, Ellingson LD, Cook DB. Gulf War Veterans with chronic musculoskeletal pain require a greater amount of neural resources to sustain cognitive performance when they are stressed by pain. Life Sci. 2021 Aug 15;279:119653.

Cognitive behavioral therapy for insomnia in Veterans with Gulf War illness; results from a randomized controlled trial. Chao LL, Kanady JC, Crocker N, Straus LD, Hlavin J, Metzler TJ, Maguen S, Neylan TC. Cognitive behavioral therapy for insomnia delivered by telephone improves sleep and non-sleep symptoms of GWI. Life Sci. 2021 Aug. 15;279:119147.

Gulf War illness in the Gulf War Era Cohort and Biorepository: the Kansas and Centers for Disease Control definitions. Gifford, EJ, Vahey J, Hauser ER, Simms KJ, Efird JT, Dursa EK, Steele L, Helmer DA, Provenzale D. Veterans who deployed to the Gulf War show evidence of sustained, multi-symptom illness compared to non-deployed Gulf War era Veterans nearly 25 years later. Life Sci. 2021 Aug 1;278:119454.

Andrographolide attenuates gut-brain-axis associated pathology in Gulf War illness by modulating bacteriome-virome associated inflammation and microglia-neuron proinflammatory crosstalk. Saha P, Skidmore PT, Holland LA, Mondal A, Bose D, Seth RK, Sullivan K et al. Andrographolide may be able to restore gut microbiomes and viromes that have been altered by chronic multi-symptom illnesses like GWI. Brain Sci. 2021 Jul 9;11(7):905.

Prevalence and patterns of symptoms among female Veterans of the 1991 Gulf War Era; 25 years later. Sullivan K, Krengel M, Heboyan V, Schildroth S, Wilson C Iobst S, Klimas N, Coughlin SS. Twenty-five years after the Gulf War, female combat Veterans continue to report a wide variety of symptoms at a significantly higher excess frequency prevalence than other Gulf War-era women Veterans. J Womens Health (Larchmt). 2020 Jun;29(6):819-826.

Gut DNA virome diversity and its association with host bacteria regulate inflammatory phenotype and neuronal immunitoxicity in experimental Gulf War Illness. Seth RK, Maqsood R, Mondal A, Bose D, Kimono D, Holland LA, Lloyd PJ et al. Adjusting GI tracked viruses by repurposing existing FDA-approved antiviral drugs may be an effective treatment for GWI and its symptoms. Viruses. 2019 Oct 21;11(10):968.

Evidence for somatic hypersensitivity in Veterans with Gulf War illness and gastrointestinal symptoms. Zhou Q, Verne ML, Zhang B, Verne GN. Somatic hypersensitivity is found in Veterans with GWI and diarrhea and abdominal pain. It is positively correlated with abdominal pain ratings. Clin J Pain. 2018 Oct;34(10):944-949.

Motor unit number estimate and isometric hand grip strength in military Veterans with or without muscular complaints: reference values for longitudinal follow-up. Li M, Yao W, Sundahl C. This study established baselines for a longitudinal follow-up study of motor neuron function of troops deployed in the Gulf War. Mil Med. 2018 Sep 1;183(9-10):e399-e404.

Detecting chromosome condensation defects in Gulf War illness patients. Liu G, Ye CJ, Chowdhury SK, Abdallah BY, Horne SD, Nichols D, Heng HH. Some patients with GWI exhibited a high level of chromosomal condensation defects. Curr Genomics. 2018 Apr;19(3):200-206.

Impulse oscillometry measurement of distal airways obstruction in depleted uranium-exposed Gulf War Veterans. Hines SE, Barnes AH, Brown C, Gucer P, Oliver MS, Gaitens JM, Condon M, McDiarmid M. Veterans with high level exposure to depleted uranium have no higher levels of distal airways obstruction than those with low levels of exposure. Am J Ind Med. 2018 Apr;61(4):308-316

Curcumin treatment leads to better cognitive and mood function in a model of Gulf War illness with enhanced neurogenesis, and alleviation of inflammation and mitochondrial dysfunction in the hippocampus. Kodali M, Hattiangady B, Shetty GA, Bates A, Shuai B, Shetty AK. Curcumin may lead to better cognitive function and mood for those with GWI. Brain Behav Immun. 2018 Mar;69:499-514.

Meta-analysis of self-reported health symptoms in 1990-1991 Gulf War and Gulf War-era Veterans. Maule AL, Janulewicz PA, Sullivan KA, Krengel MH, Yee MK, McClean M, White RF. Higher odds of reporting mood-cognition, fatigue, musculoskeletal, gastrointestinal, and dermatological symptoms among Gulf War-deployed Veterans compared with Gulf War-era controls indicates those symptoms are important when assessing Gulf War Veteran health status. BMJ Open. 2018 Feb 13;8(2):e016086

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Gulf War Veterans Fact Sheet

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