#DesertStorm30: Gulf War illness

Nearly 700,000 men and women served in the Persian Gulf during Operation Desert Shield and Operation Desert Storm in the early 1990s.

Now, three decades later, as many as a third of that population are affected by a cluster of medically unexplained chronic symptoms that have plagued them following their return from deployment. The symptoms can include fatigue, headaches, joint pain, indigestion, bowel discomfort, insomnia, dizziness, respiratory disorders, skin problems and memory impairment. VA clinicians and researchers often call this condition “Gulf War illness” in medical literature.

VA researchers have been conducting various types of studies to better understand Gulf War illness (GWI), for which there are no proven treatments. The following is a sampling of the diverse nature of these studies.

Clinical trials

Deployed Gulf War Veterans experienced environmental and toxic exposures involving smoke, chemicals and other substances that are known to cause an excess of free radicals in the body’s cells, a scenario known as oxidative stress. Excess oxidative stress can damage cells, proteins, and DNA, contributing to an early onset of aging-related ailments. Exploratory studies using methods that support cell functioning and prevent or repair stress mediators suggest a role for targeted strategies, such as the coenzyme Q10, also known as CoQ10. The primary goal of this double-blind, Phase 3 trial is to determine if a treatment with ubiquinol, a form of CoQ10, is effective in increasing physical function and improving the quality of life for Veterans with Gulf War illness.

An ammunition specialist carries a 105mm armor-piercing, discarding sabot round, to be used in an M-1 Abrams main battle tank, during Operation Desert Shield.

Biomedical research

The U.S. military considered the drugs that were intended to protect soldiers from a chemical attack and from insects to be safe at the doses administered. But those drugs combined, together with the stress of war, may have contributed to the development and persistence of Gulf War illness years later. Neurological symptoms of GWI include cognitive impairment, attention deficits, depression, and anxiety. These symptoms have been linked to abnormal immune function and chronic inflammation in GWI patients. Dr. Alpaslan Dedeoglu of the VA Boston Healthcare System and his team have provided evidence that an inflammatory process occurs in the brain using a mouse model of Gulf War illness. He’s now leading a study into whether GWI can be treated with fingolimod, an anti-inflammatory drug used for patients with multiple sclerosis. If successful, this project will provide data for comprehensive clinical trials for treating Gulf War illness using an anti-inflammatory strategy.

Rehabilitation

Veterans with GWI are at risk of developing chronic physical health conditions. Exercise is a cost-effective way to reduce the risk of many chronic ailments. But a major challenge for Veterans with Gulf War illness is that symptoms can worsen when one tries to become physically active, a phenomenon known as post exertion malaise (PEM). This study is measuring the link between aerobic exercise intensity and PEM. The researchers hope to take a first step toward providing a proven exercise plan for Veterans with Gulf War illness.

This study about the health experiences and treatment of Gulf War Veterans with chronic multi-symptom illness is expected to yield major insight into the features of effective care models and treatments, as well as satisfaction with care. “It will also create a rich, ongoing resource that can inform VA’s effort to improve customer service and care for Gulf War Veterans, including a specific focus on those with multi-symptom illness and their caregivers,” the researchers write. This research will identify better illness-specific health measures and promising therapeutic approaches that are appropriate to VA settings. Finally, the goal is to alert Veterans to be more engaged with the health system and VA research and policy processes, and to improve Gulf War Veteran communication with VA care providers.

Epidemiological research 

One of the most telling VA epidemiological studies on the health of Gulf War Veterans is a 2016 study by researchers in VA Post-Deployment Health Services. The study, based on data that were collected about 20 years after the Gulf War in 2012, found that Gulf War Veterans continue to report poorer health than those who served at the same time but did not deploy to the Persian Gulf. The study found that as many as 300,000 Veterans, or nearly 44% of those who took part in the Gulf War, self-reported that they have Gulf War illness, based on the latest data.

Observational

The Department of Defense estimates that more than 41,000 Veterans were likely overexposed to pesticides during the Persian Gulf War. In addition to pesticides, Gulf War Veterans were potentially exposed to many other chemicals and toxicants during the conflict. Research suggests a possible link between chemical exposures and Parkinson’s disease, a neurodegenerative disorder that short-circuits the body’s motor system. The researchers for this study are investigating the link between toxic exposures during Gulf War deployment and prodromal Parkinson’s disease, which is when a person shows early signs of the health condition. The study includes 140 Gulf War Veterans with high levels of exposure to deployment-related chemicals. They are taking part in a series of experiments over a four-year period that are expected to provide important information on the long-term consequences of Gulf War illness in relation to aging and neurodegenerative diseases, particularly Parkinson’s.

Registry enrollment

Veterans of Operation Desert Shield and Operation Desert Storm are highly encouraged to enroll in two distinct and important VA clinical registries: the Gulf War Registry and the Airborne Hazards and Open Burn Pit Registry. All Gulf War Vets are eligible to take part in both. The Airborne Hazards and Open Burn Pit Registry includes an online questionnaire and an optional health exam at a VA medical center. Gulf War Veterans can contact their local environmental health coordinator to schedule an Airborne Hazards and Open Burn Pit Registry health exam and to enroll in the Gulf War Registry.

Learn more about the burn pit registry in this Borne the Battle benefits breakdown.