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Article

Brain–Immune Interactions as the Basis of Gulf War Illness: Clinical Assessment and Deployment Profile of 1990–1991 Gulf War Veterans in the Gulf War Illness Consortium (GWIC) Multisite Case-Control Study

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Veterans Health Research Program, Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA
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Institute for Neuroimmune Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
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Department of Veterans Affairs, Miami VA Healthcare System, Miami, FL 33125, USA
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Department of Neurology, Boston University School of Medicine, Boston, MA 02118, USA
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Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
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Department of Psychological and Brain Sciences, Boston University College of Arts and Sciences, Boston, MA 02215, USA
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Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
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Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA
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H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX 77030, USA
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Discipline of Pharmacology, School of Biomedicine, University of Adelaide, Adelaide, SA 5005, Australia
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Authors to whom correspondence should be addressed.
Academic Editor: Isabelle M. Rosso
Brain Sci. 2021, 11(9), 1132; https://doi.org/10.3390/brainsci11091132
Received: 19 July 2021 / Revised: 20 August 2021 / Accepted: 24 August 2021 / Published: 26 August 2021
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. View Full-Text
Keywords: Gulf War illness; brain–immune interactions; military exposures; pesticides; traumatic brain injury; case-control study Gulf War illness; brain–immune interactions; military exposures; pesticides; traumatic brain injury; case-control study
MDPI and ACS Style

Steele, L.; Klimas, N.; Krengel, M.; Quinn, E.; Toomey, R.; Little, D.; Abreu, M.; Aenlle, K.; Killiany, R.; Koo, B.-B.; Janulewicz, P.; Heeren, T.; Clark, A.N.; Ajama, J.; Cirillo, J.; Buentello, G.; Lerma, V.; Coller, J.K.; Sullivan, K. Brain–Immune Interactions as the Basis of Gulf War Illness: Clinical Assessment and Deployment Profile of 1990–1991 Gulf War Veterans in the Gulf War Illness Consortium (GWIC) Multisite Case-Control Study. Brain Sci. 2021, 11, 1132. https://doi.org/10.3390/brainsci11091132

AMA Style

Steele L, Klimas N, Krengel M, Quinn E, Toomey R, Little D, Abreu M, Aenlle K, Killiany R, Koo B-B, Janulewicz P, Heeren T, Clark AN, Ajama J, Cirillo J, Buentello G, Lerma V, Coller JK, Sullivan K. Brain–Immune Interactions as the Basis of Gulf War Illness: Clinical Assessment and Deployment Profile of 1990–1991 Gulf War Veterans in the Gulf War Illness Consortium (GWIC) Multisite Case-Control Study. Brain Sciences. 2021; 11(9):1132. https://doi.org/10.3390/brainsci11091132

Chicago/Turabian Style

Steele, Lea, Nancy Klimas, Maxine Krengel, Emily Quinn, Rosemary Toomey, Deborah Little, Maria Abreu, Kristina Aenlle, Ronald Killiany, Bang-Bon Koo, Patricia Janulewicz, Timothy Heeren, Allison N. Clark, Joy Ajama, Joanna Cirillo, Gerardo Buentello, Vanesa Lerma, Janet K. Coller, and Kimberly Sullivan. 2021. "Brain–Immune Interactions as the Basis of Gulf War Illness: Clinical Assessment and Deployment Profile of 1990–1991 Gulf War Veterans in the Gulf War Illness Consortium (GWIC) Multisite Case-Control Study" Brain Sciences 11, no. 9: 1132. https://doi.org/10.3390/brainsci11091132

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