BACKGROUND Gulf War Illness (GWI) is a condition that affects about 30 % of veterans who served in the 1990-91 Persian Gulf War. Given its broad symptomatic manifestation, including chronic pain, fatigue, neurological, gastrointestinal, respiratory, and skin problems, it is of interest to examine whether GWI is associated with changes in the brain. Existing neuroimaging studies, however, have been limited by small sample sizes, inconsistent GWI diagnosis criteria, and potential comorbidity confounds. OBJECTIVES Using a large cohort of US veterans with GWI, we assessed regional brain volumes for their associations with GWI, and quantified the relationships between any regional volumetric changes and GWI symptoms. METHODS Structural magnetic resonance imaging (MRI) scans from 111 veterans with GWI (Age = 49 ± 6, 88 % Male) and 59 healthy controls (age = 51 ± 9, 78 % male) were collected at the California War Related Illness and Injury Study Center (WRIISC-CA) and from a multicenter study of the Parkinson's Progression Marker Initiative (PPMI), respectively. Individual MRI volumes were segmented and parcellated using FreeSurfer. Regional volumes of 19 subcortical, 68 cortical, and 3 brainstem structures were evaluated in the GWI cohort relative to healthy controls. The relationships between regional volumes and GWI symptoms were also assessed. RESULTS We found significant subcortical atrophy, but no cortical differences, in the GWI group relative to controls, with the largest effect detected in the brainstem, followed by the ventral diencephalon and the thalamus. In a subsample of 58 veterans with GWI who completed the Chronic Fatigue Scale (CFS) inventory of Centers for Disease Control and Prevention (CDC), smaller brainstem volumes were significantly correlated with increased severities of fatigue and depressive symptoms. CONCLUSION The findings suggest that brainstem volume may be selectively affected by GWI, and that the resulting atrophy could in turn mediate or moderate GWI-related symptoms such as fatigue and depression. Consequently, the brain stem should be carefully considered in future research focusing on GWI pathology.

中文翻译：

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海湾战争疾病的脑干萎缩症。

背景技术海湾战争疾病（GWI）是一种疾病，它影响到在1990-91年波斯湾战争中服役的退伍军人中约30％。鉴于其广泛的症状表现，包括慢性疼痛，疲劳，神经系统，胃肠道，呼吸道和皮肤问题，研究GWI是否与大脑变化有关很有意义。但是，现有的神经影像学研究受到样本量小，GWI诊断标准不一致以及潜在的合并症混杂症的限制。目的使用大量美国退伍军人与GWI进行队列研究，我们评估了他们与GWI的关联的区域脑容量，并量化了任何区域容量变化与GWI症状之间的关系。方法采用GWI方法对111名退伍军人进行结构磁共振成像（MRI）扫描（年龄= 49±6，在加利福尼亚战争相关疾病和伤害研究中心（WRIISC-CA）以及帕金森氏病进展标记倡议（PPMI）的多中心研究中收集了88％的男性）和59名健康对照（年龄= 51±9、78％的男性）。 ， 分别。使用FreeSurfer分割并分割各个MRI体积。相对于健康对照组，在GWI队列中评估了19个皮质下皮质，68个皮质和3个脑干结构的区域体积。还评估了区域容量与GWI症状之间的关系。结果我们发现，相对于对照组，GWI组的皮质下萎缩明显，但没有皮质差异，在脑干中发现最大的效果，其次是腹侧中脑和丘脑。在完成疾病控制和预防中心（CDC）的慢性疲劳量表（CFS）清单的58名GWI退伍军人的子样本中，较小的脑干量与严重程度的疲劳和抑郁症状显着相关。结论研究结果表明，脑干体积可能受到GWI的选择性影响，并且所导致的萎缩可能反过来介导或缓解GWI相关症状，例如疲劳和抑郁。因此，在未来针对GWI病理学的研究中应仔细考虑脑干。并且由此导致的萎缩反过来又可以介导或缓解GWI相关症状，例如疲劳和抑郁。因此，在未来针对GWI病理学的研究中应仔细考虑脑干。并且由此导致的萎缩反过来又可以介导或缓解GWI相关症状，例如疲劳和抑郁。因此，在未来针对GWI病理学的研究中应仔细考虑脑干。