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Pattern of Cognitive Function in Regisrty Gulf War Veterans: A Preliminary Study

Lange, G. Tiersky, L., DeLuca, J., Scharer, J., Policastro, T.,
Fiedler, N., Natelson, B.H.

Center for Environmental Hazards Research, East Orange, NJ; EOHSI,
Piscataway, NJ; Kessler Medical Rehabilitation Research and Education
Corporation, West Orange, NJ

Background: Complaints of Gulf War Veterans suffering from medically unexplained symptoms labeled Gulf War Illness (GWI) include chronic fatigue and cognitive difficulties, symptoms also commonly reported by civilians with fatiguing illnesses. The cognitive impairment most often found in civilians with fatiguing illness, is a subtle, but debilitating inability to process, manipulate, and encode multiple pieces of information simultaneously. The purpose of this study was to examine the pattern of cognitive functioning in Registry Persian Gulf Veterans. It is hypothesized that since the illness pattern so closely resembles that of civilians with fatiguing illness, the cognitive impairment in Gulf War Veterans with a major complaint of chronic fatigue may be similar to that of civilians with fatiguing illness, that is complex attentional and working memory functions will be most severely affected.

Methods: The following criteria were used to select Persian Gulf Veterans with GWI (PGV-F) for this study: 1) presenting with fatigue as a major complaint, 2) fulfilling clinical case definitions for Chronic Fatigue Syndrome, Idiopathic Chronic Fatigue, and/or Multiple Chemical Sensitivity. Sixty-seven Registry PGVs were examined; 44 PGV-F and 23 did not report any health problems since the Gulf War (PGV-H). All subjects were assessed neuropsychologically across several cognitive domains with a standardized test battery. PGV-F and PGV-H group means on neuropsychological tasks, as well as the amount and frequency of alcohol use were compared using planned univariate analysis of variance.

Results: Amount and frequency of alcohol use was similar for both PGV-F and PGV-H. However, on the average, PGV-F tended to consume less alcohol during the year prior to intake than the PGV-H group. Neuropsychologically, group performances differed on a the WAIS-R Digit Span Forward task, a simple attention test, and a number of complex attention/information processing tasks, such as WAIS-R Digit Span Backwards subtest, the NES Complex Performance Test, and the PASAT. Scores on the Trail Making Test B, a test of executive functioning, were also significantly worse in PGV-F compared to PGV-H. A strong trend toward statistically significant differences were observed on all measures assessing visual-perceptual functioning. PGV-F did not manifest learning or memory problems in either the verbal or visual domains. Likewise, fine motor function as assessed by the Grooved Pegboard Test was not different between groups.

Conclusion: Persian Gulf Veterans with GWI show evidence of subtle cognitive impairment in the areas of simple attention, complex attention/information processing, and possibly visual perceptual. Difficulties in processing, manipulating and encoding of complex information in PGVs with GWI is similar to that documented in civilians with fatiguing illness.

KEYWORDS: Gulf War Illness, Cognitive Function, Fatiguing Illness

New Jersey Center for Environmental Hazards Research, Department of Veterans Affairs, East Orange, New Jersey

Return to Psychological and Neuropsychological Outcomes

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