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Week of 16 January 1998

Vol. I, No. 16

Feature Article

BU scientists awarded $1.8 million for Gulf War syndrome research

by Eric McHenry

The Centers for Disease Control and Prevention has awarded SPH scientists a $1.8 million grant to study Gulf War syndrome, an enigmatic illness supposedly suffered by veterans of the Persian Gulf War. One of the grant's purposes, the researchers say, is to help them determine whether such an affliction even exists.

"We are not truly confident there is a single entity called Gulf War syndrome," says Roberta White, School of Medicine professor of neurology and School of Public Health professor of environmental health. Rather, she says, Gulf War veterans seem to experience diverse and largely unrelated ailments. "We think that different people were exposed to different things in the Gulf, and they have various symptoms associated with their exposure. We suspect that the syndrome is actually a bunch of disparate reactions to environmental exposure there. What we're trying to do is ascertain whether specific environmental factors are associated with specific negative health outcomes.

"Our research certainly indicates that people deployed to the Gulf have more symptoms than other veterans from that era who were deployed to other places," she says, "but we can't find a set of symptoms that everyone has in common."

White and David Ozonoff, chair of the SPH department of environmental health, codirect the Environmental Hazards Center at the Boston VA Medical Center. They lead a research team whose efforts will be greatly enhanced by the grant. One of only two such awards nationwide, it is as large as the EHC's annual budget, White says.

Roberta White and David Ozonoff

SPH Professors Roberta White and David Ozonoff will use one of only two large national grants conferred by the Centers for Disease Control and Prevention to further their research on Gulf War-related illnesses. Photo by Vernon Doucette

In response to a report issued by the Presidential Advisory Committee on Gulf War Veterans' Illness, President Clinton announced the research allocation, along with other investigative and compensatory measures, in early November 1997. His action received national news coverage, and White has since been interviewed regarding the grant for a segment that aired on ABC's Good Morning America.

Gulf War syndrome has been the subject of a great deal of media attention in recent years. A paucity of obvious answers at the scientific level has made the issue a source of considerable speculation and controversy.

"We view our work as long-term science," Ozonoff says. "We haven't gone for the headlines. We've decided that what this field rather badly needs is some systematic good science that's aimed at answering some specific questions."

Ozonoff and White say the new money is earmarked for three specific areas of inquiry. One involves functional magnetic resonance imaging (MRI) of the brain. Researchers will examine a very specific group of veterans who report a high number of health problems, who suffer from post-traumatic stress disorder, or who attest to having had particular kinds of exposures.

MRI technology enables the scientists to watch their subjects' brains for activity associated with exposure to particular substances, says Karen Lindem, a MED postdoctoral fellow working with White on the grant. Her research includes "running paradigms," which involves having participating veterans perform specific tasks while in an MRI machine. Members of the research team then interpret the images produced.

"You need to extract the material that you're looking for," says Lindem, "because there's a great deal of information that comes from a functional MRI. The idea is to target the particular areas of the brain that we're interested in. It's quite labor-intensive."

The second area of study sponsored by the grant will be a specialized data analysis of symptom complaints recorded during previous research. The third will involve neuropsychological examinations of Gulf War veterans from Denmark.

"We've been doing a sister study with the University of Copenhagen on their Gulf War cohort," says White. "Part of this additional funding is to do central nervous system testing on those subjects."

"The Danish soldiers were part of the cleanup effort," adds Ozonoff. "They weren't involved in combat. They got there after it was over, so the issues of combat stress are not applicable. They provide a very nice comparison."

Although the CDC grant is a recent and significant development for Ozonoff and White, they point out that its purpose is to facilitate continuing research. Their work has already influenced the scientific community's understanding Gulf War-related illness.

"I think the fact that stress is not the explanation is a contri-bution that we've been able to make," says Ozonoff. "It continues to be talked about and to be the favored explanation in lots of quarters, but I don't see that as supportable any longer."

Also specious, White says, is the argument that health problems associated with Persian Gulf combat are for the most part psychosomatic. Scientists in the department of environmental health at SPH have been observing telling symptoms since long before the term Gulf War syndrome was coined and popularized.

"We have been prospectively following a cohort of people," she says, "who came back through New England, a group of about 3,000 people, ever since they returned. We have three samplings so far of their symptoms and their self-reported complaints. It does not look to us as though individuals have increased their complaints in the seven years since the war happened.

"These are not people suddenly developing the five symptoms they read about in the newspaper," she says.

"There aren't any easy answers," Ozonoff adds.