Abnormal brain response to cholinergic challenge in chronic encephalopathy from the 1991 Gulf War

Psychiatry Res. 2009 Mar 31;171(3):207-20. Epub 2009 Feb 20.

Abnormal brain response to cholinergic challenge in chronic encephalopathy from the 1991 Gulf War.

Haley RW, Spence JS, Carmack PS, Gunst RF, Schucany WR, Petty F, Devous MD Sr, Bonte FJ, Trivedi MH. Epidemiology Division, Departments of Internal Medicine and Clinical Science, University of Texas Southwestern Medical Center, Dallas, TX, USA. Robert.Haley@UTSouthwestern.edu

Several case definitions of chronic illness in veterans of the 1991 Persian Gulf War have been linked epidemiologically with environmental exposure to cholinesterase-inhibiting chemicals, which cause chronic changes in cholinergic receptors in animal models. Twenty-one chronically ill Gulf War veterans (5 with symptom complex 1, 11 with complex 2, and 5 with complex 3) and 17 age-, sex- and education-matched controls, underwent an 99mTc-HMPAO-SPECT brain scan following infusion of saline and >48 h later a second scan following infusion of physostigmine in saline. From each SPECT image mean normalized regional cerebral blood flow (nrCBF) from 39 small blocks of correlated voxels were extracted with geostatistical spatial modeling from eight deep gray matter structures in each hemisphere. Baseline nrCBF in symptom complex 2 was lower than controls throughout deep structures. The change in nrCBF after physostigmine (challenge minus baseline) was negative in complexes 1 and 3 and controls but positive in complex 2 in some structures. Since effects were opposite in different groups, no finding typified the entire patient sample. A hold-out discriminant model of nrCBF from 17 deep brain blocks predicted membership in the clinical groups with sensitivity of 0.95 and specificity of 0.82. Gulf War-associated chronic encephalopathy in a subset of veterans may be due to neuronal dysfunction, including abnormal cholinergic response, in deep brain structures.

PMID: 19230625 [PubMed - indexed for MEDLINE]

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written by kaz1311, April 05, 2010

HI, MY HUSBAND WAS IN THE FIRST GULF WAR,HE IS NOW IN HOSPITAL AGAIN,THIS TIME ILLER THAN EVER. HE HAS SOME LESIONS ON/IN HIS BRAIN THAT THE CONSULTANTS CANT EXPLAIN.IT IS ALL VERY BIZARRE REALLY BUT UNTIL THEY CAN DIAGNOSE HIM,THEY CANT BEGIN TO TREAT HIM,AND HE IS DETERIORATING EACH WEEK. HE AS HAD TWO BIOPSYS WHICH HAVE TAKEN ABNORMAL CELLS AWAY BOTH TIME,FROM DIFFERENT AREAS OF HIS BRAIN (THIS THING IS SPREADING) BUT THEY CANT RECOGNISE WHAT IT IS,ALTHOUGH THEY DO SAY ITS NOT CANCER.. I WAS WONDERING IF YOUR STUDY HAS FOUND ANYONE ELSE WITH COMPLEX BRAIN LESIONS.IF SO I WOULD BE GRATEFUL OF ANY INFORMATION YOU COULD HELP ME WITH,TO GIVE TO THE DRS LOOKING AFTER MY HUSBAND.THEY TELL ME THAT IT IS PUZZLING SO MANY IN THE HOSPITAL,SO I AM JUST LOOKING FOR CLUES IF THERE ARE ANY OUT THERE! THE HOSPITAL CONSULTANTS ARE GOING TO CONTACT M.O.D TO ASK ABOUT THE INJECTIONS THEY HAD IN THE 1ST GULF WAR,BUT AS ALOT OF PEOPLE REALISE NOW-THEY ARE NOT AS FORTHCOMING WITH INFO AS THEY SHOULD BE...SADLY. PLEASE HELP IF YOU CAN GIVE ME ANY HELP WITH ANYTHING YOU CAN,STEVE GAVE 15 YEARS TO THE ARMY AND WE HAVE A GRANDCHILD ON THE WAY SOON,I WANT HIM TO BE AROUND TO SEE HIM! I APPRECIATE ANYTHING YOU CAN GIVE ME THAT MAY BE OF SOME INTEREST TO THE DRS. THANK YOU KAREN LOWE - karen lowe

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