http://www.forbes.com/forbeslife/health/feeds/hscout/2007/05/01/hscout604165.html
Vets From First Gulf War Show Brain Differences
05.01.07, 12:00 AM ET
TUESDAY, May 1 (HealthDay News) -- Veterans of the first Gulf War who
developed numerous health complaints have areas of the brain that are
measurably smaller than those of healthier vets, a new study found.
The results of the U.S. government-funded study are preliminary but
provide some of the first hard evidence that veterans from the
1990-1991 conflict are suffering from a real neurological illness,
researchers say.
"Right now, for Gulf War veterans, there is a discounting of there
being any physical basis for what might be wrong with them. But I
think that what is really important about this brain imaging research
is that it suggests that we really need to take their symptoms
seriously, that there is a clear neurological basis for their
complaints," said study lead researcher Roberta White of Boston
University School of Public Health.
Another expert with a long history of research into so-called Gulf War
syndrome was more cautious.
"These findings are intriguing, but they do not prove that veterans of
the first Gulf War were harmed by wartime chemical exposure," said Dr.
Daniel Clauw, professor of medicine and director of the Chronic Pain
and Fatigue Research Center at the University of Michigan, in Ann
Arbor.
The study was expected to be presented Tuesday at the annual meeting
of the American Academy of Neurology, in Boston.
U.S. and British veterans of the first Gulf War have long complained
of a wide array of physical and mental symptoms, which many blame on
exposure to biowarfare agents such as toxic pesticides and sarin gas.
"Back when the vets first started returning from the war, they were
complaining of symptoms that affected the central nervous symptom, or
suggested effects on the central nervous system," White said. Those
symptoms included mood swings, personality changes, disordered sleep,
joint pain, headaches, skin conditions, chronic fatigue and other
effects.
But, it has been tough for experts to pinpoint any "objective
evidence" -- for example, anatomical anomalies -- supporting the
existence of an identifiable neurological condition, White said.
But recent advances in brain imaging are helping that effort.
In its study, which is ongoing, White's team took detailed MRI images
of the brains of 36 veterans of the first Iraq conflict. Half of the
veterans have complained of five or more symptoms -- out of a list of
20 -- attributed to Gulf War syndrome, while the other half have
listed less than five symptoms.
The brain scans revealed key differences between the two groups.
First, the cortex -- the covering of the brain, highly involved in
learning -- was about 5 percent smaller in those veterans with a
higher number of symptoms compared with those with a lower number of
symptoms. And a second area of the brain, called the rostral anterior
cingulated gyrus -- important to emotion, motivation and memory -- was
6 percent smaller on average in the more symptomatic vets, according
to the study.
These finds are preliminary and do not confirm that wartime exposures
changed the veterans' brains, only that differences exist, White said.
However, the brain differences may be relevant to reported symptoms
"because [veterans] complain of fatigue, of changes in their cognitive
efficiency, and memory problems," she noted. "We actually have
objective evidence that memory performances were worse among the high-
symptom complainers and that correlates with the findings in the
cingulated gyrus," White added.
Those symptoms also correlate with exposures to a variety of toxins
present in the first Iraq conflict, White said. "Things like
pesticides, sarin -- chemical warfare agents of the kind that they
used in the Gulf -- those kinds of substances do cause these kinds of
effects on brain function," she said. However, she added that "much
less is known about more subtle effects on brain structure of these
chemicals, because they have not been studied in this way."
Another expert in Gulf War syndrome agreed that it's impossible at
this point to conclude that wartime exposures led to changes in
veterans' brains.
For example, "we know that many psychiatric disorders, such as
depression and post-traumatic stress disorder, cause cognitive
problems. And we know that these two can be associated with changes in
brain function and metabolism," said Dr. Simon Wessely, a professor of
psychiatry at the King's Center for Military Health Research at King's
College London.
Until White's group can get a larger number of study subjects and
tease out these possible confounding causes, scientists shouldn't get
"too excited" about the findings, he said.
"The symptoms of Gulf War illness are very common in people who have
not been to the Gulf," Wessely noted. "I would be more interested in
comparing Gulf [veterans] vs. civilians with the same symptoms before
I jumped to any conclusions about any relation to Gulf War exposures,"
he said.
Clauw seconded that thought.
"Recent, similar studies have shown decreases in brain volumes in
individuals in the general population with chronic pain conditions
such as low back pain and fibromyalgia," he said. "Future studies need
to compare the results of brain scans of Gulf War veterans with
individuals with chronic pain and other symptoms who were not deployed
to the Gulf War, before concluding that any changes are due to wartime
exposures."
White agreed that it's still too early to draw any definite
conclusions. She said the study, which was funded by the U.S.
Department of Veterans Affairs, should wrap up by this fall.
"These are preliminary findings, and, with more subjects, we might
learn more about which parts of the brain are more affected," she
said. Still, she added, "I think this is a very important next chapter
in looking at the first Gulf War."
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I think they ought to also investigate vaccinations and/or
innoculations that were imposed on the troops during the First Gulf
War for possible causative links.