Article: Brain studies show chronic fatigue syndrome and Gulf War illness are distinct conditions

Andy

Andy

Retired committee member
Gulf War Illness (GWI) and chronic fatigue syndrome (CFS) share symptoms of disabling fatigue, pain, systemic hyperalgesia (tenderness), negative emotion, sleep and cognitive dysfunction that are made worse after mild exertion (postexertional malaise). Now, neuroscientists at Georgetown University Medical Center have evidence, derived from human brain studies, that GWI and CFS are two distinct disorders that affect the brain in opposing ways.

The findings, presented in two related studies at the annual meeting of the Society for Neuroscience (SFN) in Chicago, offer a new perspective on neurotoxicity and suggest that methods to effectively diagnose and treat these disorders could be developed, says the studies' senior author, James Baraniuk, MD, a Georgetown professor of medicine.
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https://medicalxpress.com/news/2019-10-brain-chronic-fatigue-syndrome-gulf.html
 
Gulf War Illness (GWI) and chronic fatigue syndrome (CFS) share symptoms of disabling fatigue, pain, systemic hyperalgesia (tenderness), negative emotion, sleep and cognitive dysfunction that are made worse after mild exertion (postexertional malaise).
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With so many similar symptoms, it makes one wonder if some Gulf War Illness patients might actually have ME/CFS. I don't think there's any reason to believe that being a Gulf War veteran would lower one's risk of getting CFS, but a history of Gulf War service no doubt increases your odds of getting a GWI diagnosis. I'm just thinking of the case where a Gulf War veteran happens to develop CFS and it's mistaken for GWI due to his/her military service.

By contrast, I'd be surprised if one could get a GWI diagnosis without being a Gulf War veteran.
 
Forbin said:
I don't think there's any reason to believe that being a Gulf War veteran would lower one's risk of getting CFS
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Chances are higher that those people with childhood CFS (diagnosed or not) will not get into the military, so if there is a genetic component to the chance that somebody will develop CFS then military personnel are less likely to - I have no stats at all to back that up, it just seems that it would be logical.
 
Andy said:
Chances are higher that those people with childhood CFS (diagnosed or not) will not get into the military, so if there is a genetic component to the chance that somebody will develop CFS then military personnel are less likely to - I have no stats at all to back that up, it just seems that it would be logical.
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Good point! It's easy to forget that adult percentages, such as the .422% obtained by Jason, don't, so far as I know, exclude adults who became sick as children.

ETA:

It seems like children have better CFS recovery rates than adults. Even so, those who recover still might be less likely to enter military service.
 
Not surprising Baraniuk oversaw this given his historical overlapping emphasis. I kind of like that he doesn't hold back when he labels ME/CFS and GWS "diseases of the brain." He joins Natelson in this regard, if I recall correctly. I personally would have preferred if he opined "diseases that effect the brain."

Still treading dangerous ground. I found the "negative emotion" and PTSD references disturbing. I'd be curious to know more about what they are actually doing with these fMRI tests, during the tests, to evoke responses.

The article gets some things wrong, too, like PEM primarily follows physical exertion. Maybe for the larger subset, but this is still misleading.

All-in-all, a good piece. Mixed signals, though.
 
Prior research by Baraniuk on differences between ME and GWI: https://www.nature.com/articles/s41598-017-15383-9.

Exercise – induced changes in cerebrospinal fluid miRNAs in Gulf War Illness, Chronic Fatigue Syndrome and sedentary control subjects
Gulf War Illness (GWI) and Chronic Fatigue Syndrome (CFS) have similar profiles of pain, fatigue, cognitive dysfunction and exertional exhaustion. Post-exertional malaise suggests exercise alters central nervous system functions. Lumbar punctures were performed in GWI, CFS and control subjects after (i) overnight rest (nonexercise) or (ii) submaximal bicycle exercise. Exercise induced postural tachycardia in one third of GWI subjects (Stress Test Activated Reversible Tachycardia, START). The remainder were Stress Test Originated Phantom Perception (STOPP) subjects. MicroRNAs (miRNA) in cerebrospinal fluid were amplified by quantitative PCR. Levels were equivalent between nonexercise GWI (n = 22), CFS (n = 43) and control (n = 22) groups. After exercise, START (n = 22) had significantly lower miR-22-3p than control (n = 15) and STOPP (n = 42), but higher miR-9-3p than STOPP. All post-exercise groups had significantly reduced miR-328 and miR-608 compared to nonexercise groups; these may be markers of exercise effects on the brain. Six miRNAs were significantly elevated and 12 diminished in post-exercise START, STOPP and control compared to nonexercise groups. CFS had 12 diminished miRNAs after exercise. Despite symptom overlap of CFS, GWI and other illnesses in their differential diagnosis, exercise-induced miRNA patterns in cerebrospinal fluid indicated distinct mechanisms for post-exertional malaise in CFS and START and STOPP phenotypes of GWI.
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Dr. Klimas has also done research using tests that were able to distinguish patients with ME/CFS from patients with Gulf War Illness and also from controls.

But don't ask me to explain it!

I know there's a thread on the forum somewhere but not up to searching at the moment. But I do have the link to this video

 
Forbin said:
I'd be surprised if one could get a GWI diagnosis without being a Gulf War veteran.
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Yes, I believe this difficulty has been discussed as some of them haven't been to the Gulf, yet still appear to have GWI. A rename was discussed, parallels were drawn to diagnoses given in other wars (some of which were likely PTSD, so not all the same thing). I'm not up to locating the papers right now.
 
beverlyhills said:
Most GWI patients are men of diverse race and have normal BMIs. Soldiers would have 10-20% the the risk of a random person. [responding to whether some GWI patients might have ME/CFS]
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I don't follow. ME patients are of diverse race/ethnicity. (Even if mainly well-off white middle aged women are getting diagnosed, we know from population-based studies that everyone gets ME, including in other countries. Military doctors are maybe a bit less biased in diagnosis, however, and GWI probably has different stigmas, rather than having ME's "bored/stressed housewife/working woman" stigma.)

The BMIs of ME patients are all over the place, from normal to high to underweight. (Most people I see in studies or pictures of look pretty normal.)

Being a soldier would be correlated with normal BMI (can't be too high as you have to stay in shape: can't be too low or you might not pass the strength and endurance testing).

Being a soldier is correlated with being a man. Women are definitely soldiers but it's still quite a bit less common (in the US, anyway).

While getting diagnosed with ME is correlated with being a woman, men do get it. We aren't sure the sex ratio of who has it, because most people with ME aren't diagnosed and our data is not good enough.
 
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I would like to see the published study. Wondering whether this reflects greater effort to maintain the same performance post-exercise.
 
Veterans study suggest two sub-types of Gulf War illness
Georgetown University Medical Center
WASHINGTON -- Brain imaging of veterans with Gulf War illness show varying abnormalities after moderate exercise that can be categorized into two distinct groups -- an outcome that suggests a more complex illness that previously thought.

Researchers at Georgetown University Medical Center, using functional magnetic resonance imaging (fMRI), have shown the Gulf War Illness patients have one of two different of kinds of changes after exercise when compared with healthy patients. The results clarify that Gulf War illness (GWI) leads to measurable physiological changes in the brain, suggesting multiple strategies for future treatments of Gulf War illness patients.

GWI affects about 25% to 30% of veterans from the 1990-1991 Persian Gulf War. Cognitive and memory problems (often described as "brain fog"), pain, and fatigue following mild to moderate exertion are similar to myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS).
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In a study published December 12 in the journal Brain Communications (10.1093/braincomms/fcz039), researchers in the laboratory of James Baraniuk, MD, professor of medicine at Georgetown University Medical Center, imaged the brains of veterans with Gulf War illness before and after moderate exercise. The following day, the groups had a second stress test and a memory test during brain imaging.

There were no differences in fMRI scans between veterans before exercise. The veterans were then divided into those who had previously shown racing heart rates after standing up and those who did not. According to Stuart Washington, PhD, a post-doctoral fellow and lead author on the study, both groups of Gulf War illness veterans had differences in brain activity compared to healthy patients, but the type of abnormal brain activity was different between the groups.
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full article here:
https://www.eurekalert.org/pub_releases/2019-12/gumc-vss121019.php
 
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I wonder if there are some who have moved from one group to another. My daughter did not have OI issues until this year.
 
Free full text:

Exercise Alters Cerebellar and Cortical Activity Related to Working Memory in Phenotypes of Gulf War Illness
Stuart D Washington, Rakib U Rayhan, Richard Garner, Destie Provenzano, Kristina Zajur, Florencia Martinez Addiego, John W VanMeter, James N Baraniuk
Brain Communications, fcz039, https://doi.org/10.1093/braincomms/fcz039
Published:
12 December 2019
Article history

Abstract

Gulf War Illness (GWI) affects 25-32% of veterans from the 1990-1991 Persian Gulf War.

Post-exertional malaise with cognitive dysfunction, pain and fatigue following physical and/or mental effort is a defining feature of Gulf War Illness.

We modeled post-exertional malaise by assessing changes in functional magnetic resonance imaging at 3T during an N-Back working memory task performed prior to a submaximal bicycle stress test and after an identical stress test 24 hrs later.

Serial trends in postural changes in heart rate between supine and standing defined three subgroups of veterans with Gulf War Illness: Postural Orthostatic Tachycardia Syndrome (GWI-POTS, 15%, n = 11), Stress Test Associated Reversible Tachycardia (GWI-START, 31%, n = 23), and Stress Test Originated Phantom Perception (GWI-STOPP, no postural tachycardia, 54%, n = 46).

Before exercise, there were no differences in blood oxygenation level dependent activity during the N-Back task between control (n = 31), GWI-START, GWI-STOPP, and GWI-POTS subgroups.

Exercise had no effects on blood oxygenation level dependent activation in controls. GWI-START had post-exertional deactivation of cerebellar dentate nucleus and vermis regions associated with working memory. GWI-STOPP had significant activation of the anterior supplementary motor area that may be a component of the anterior salience network.

There was a trend for deactivation of the vermis in GWI-POTS after exercise.

These patterns of cognitive dysfunction were apparent in Gulf War Illness only after the exercise stressor.

Mechanisms linking the autonomic dysfunction of START and POTS to cerebellar activation, and STOPP to cortical sensorimotor alterations, remain unclear but may open new opportunities for understanding, diagnosing, and treating Gulf War Illness.
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https://academic.oup.com/braincomms...1093/braincomms/fcz039/5673581?searchresult=1
 
Another article
Brain Imaging of Veterans Suggests Gulf War Illness More Complex Than Previously Thought
Brain imaging of veterans with Gulf War illness show varying abnormalities after moderate exercise that can be categorized into two distinct groups — an outcome that suggests a more complex illness than previously thought.

Researchers at Georgetown University Medical Center, using functional magnetic resonance imaging (fMRI), have shown the Gulf War Illness patients have one of two different of kinds of changes after exercise when compared with healthy patients. The results clarify that Gulf War illness (GWI) leads to measurable physiological changes in the brain, suggesting multiple strategies for future treatments of Gulf War illness patients.

GWI affects about 25% to 30% of veterans from the 1990-1991 Persian Gulf War. Cognitive and memory problems (often described as “brain fog”), pain, and fatigue following mild to moderate exertion are similar to myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS).
Click to expand...
full article here:
https://scitechdaily.com/brain-imag...illness-more-complex-than-previously-thought/
 
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