gulf war illness

Gulf War Veterans Continue to Experience Cognitive Effects of Toxic Chemical Exposures

A new analysis provides comprehensive evidence that these cognitive decrements were associated with specific exposures to chemical weapons, pesticides, anti-nerve gas pills, and oil well fires during the war.

One out of every three veterans who served in the 1990–1991 Gulf War have experienced chronic health issues following their exposure to toxic chemicals during the war. Many GW veterans continue to suffer from these symptoms, known as Gulf War Illness (GWI), which comprise a complex variety of debilitating issues, including extreme fatigue, chronic pain, and cognitive impairment.

Previous studies have assessed common GWI symptoms associated with cognitive difficulties, but most of these studies have focused on small groups of veterans and produced inconsistent results. 

A new study led by a School of Public Health researcher has expanded this cognitive analysis among a much larger, more representative cohort of GW veterans. 

Published in the journal Environmental Health, the new analysis found that veterans with GWI showed significantly poorer attention, executive functioning, learning, and short-and-long term verbal memory on objective test measures than veterans who did not have GWI. This additional evidence confirms and builds upon prior results of the adverse neurotoxic effects of the Gulf War, and can help researchers more accurately identify cognitive measures that can inform future treatments and hopefully prevent further cognitive decline among this population.

“The results of our study clearly confirm that Gulf War veterans continue to suffer from cognitive problems affecting their memory, attention and executive functioning as a result of their toxic wounds from the war,” says study lead and corresponding author Kimberly Sullivan, research associate professor of environmental health sciences. “This work should make it easier for our veterans to get benefits and validation for their illness, and allows us to target treatments more appropriately for their specific cognitive problems.”

For the study, Sullivan and colleagues utilized several large datasets of cognitive health information among 411 GW veterans, obtained through the Boston Biorepository, Recruitment, and Integrative Network (BBRAIN), a four-site recruitment and 10-site data-mining project that serves as a repository and critical resource for GWI researchers. Sullivan is principal investigator of the repository, which launched in 2019 and houses previous and newly collected biological specimens and clinical survey and brain imaging data from veterans with and without GWI.

In addition to poorer cognitive measures of attention, executive functioning, and verbal memory among veterans with GWI, the researchers found that GW veterans with exposures to acetylcholinesterase-inhibiting pesticides and nerve gas agents had worse performance on executive function tasks, and veterans with exposure to oil well fires had worse performance on verbal memory. Compared to healthy GW veterans, GWI veterans exposed to pyridostigmine bromide anti-nerve gas pills had better verbal memory, but worse performance on attention tasks.

These findings not only help inform future research and treatment, they also validate decades of “hidden” suffering among many of these veterans.

“One big problem is that these toxic wounds are not as readily seen as other war injuries and can make veterans feel like they are suffering from invisible wounds, and not being taken seriously for their ailments,” Sullivan says. “It’s our responsibility to take care of veterans who went to war and came back sick. It’s important to recognize their service, validate their illness, and get them the help that they need. It’s the very least that we can do.” 

Study recruitment

Sullivan is currently recruiting for two diet-related treatment studies that aim to alleviate these cognitive effects and other health problems resulting from the Gulf War, with the hope that this knowledge can also inform treatments for veterans with similar toxic wounds from other wars. 

One study involves the dietary antioxidant supplement n-acetylcysteine, which Sullivan says has been shown to reduce oxidative stress and reduce inflammation that are likely related to the cognitive and other chronic symptoms of GWI. The multi-site project is in collaboration with Nova Southeastern University and other institutions participating in the Gulf War Illness Clinical Trials and Interventions Consortium.

The second study, in collaboration with American University researchers, is examining a special diet that reduces signaling of excitatory chemical messengers that may be associated with GWI symptoms. The study is based in Boston, Washington, DC, and Miami and follows a smaller pilot study of this diet that showed improvement in these symptoms. 

Gulf War veterans who are interested in participating in either of these studies, or in the ongoing one-visit BBRAIN repository study, can fill out this Brief Screening Agreement or contact the research team at 617-358-2230 or bbrain@bu.edu.