![]() This is an important question because there have been reports from veterans in recent conflicts of symptoms that share similarities with CMI experienced by Gulf War era veterans. What remains unclear is whether the latest generation of veterans who served in Iraq and Afghanistan in the wars that followed the terrorist attacks of Septemalso faced hazardous exposures, and whether those exposures resulted in CMI. Thus, while a clear etiological link has not been firmly established, it is reasonable to speculate that the exposures that took place during the 1990–1991 Gulf War may have contributed to CMI. Interestingly, farmers exposed to high levels of pesticides experience a similar constellation of symptoms (e.g., cognitive and movement problems) as do veterans with CMI. In veterans, exposure to sarin gas is associated with reduced gray matter, white matter, and hippocampus volume however, there are mixed results with respect to neuropsychological functioning. Further, animal models of the effects of sarin gas, a chemical weapon, indicate that exposure results in neuropsychological problems such as memory loss. Research demonstrates a dose-response relationship between pyridostigmine bromide and CMI. In addition to pesticide exposure, pyridostigmine bromide pills were frequently used by Gulf War service members as a prophylactic against nerve gas exposure and are also associated with CMI symptoms. Pesticide exposures have been linked to CMI symptoms across multiple samples of Gulf War veterans and a dose-response association exists between exposure and CMI symptoms. Although a clear etiology has yet to be discovered, research into the potential causes of CMI have focused on exposure to DEET, flea collars with pesticide, pyridostigmine bromide, nerve agents, and chemical weapons. Research consistently demonstrates that CMI is not induced by general stress and cannot be classified as a psychosomatic disorder. This cluster of symptoms has been referred to as “Gulf War Syndrome,” “Gulf War Veterans’ illnesses,” “Gulf War illness” (GWI), or simply “chronic multi-symptom illness” (CMI). This same constellation of symptoms is found in veterans who deployed to the Gulf and were exposed to chemical hazards, but not in same-era veterans who served elsewhere. These symptoms affect 1990–1991 Gulf War veterans at significantly higher rates than non-deployed veteran comparison groups from the same era. ![]() Multiple studies describe a consistent profile of protracted symptoms that include chronic headache, widespread pain, mood disturbances, respiratory problems, persistent and unexplained fatigue, memory problems and other cognitive difficulties, gastrointestinal disturbances and skin rashes. ![]() ![]() Since their return from military service in the 1990–1991 Gulf War, a substantial minority of veterans have been affected by a complex of persistent and disabling symptoms that are not explained by well-established medical or psychiatric diagnoses. ![]()
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