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Neuropsychologic Assessment of a Population-based Sample of Gulf War Veterans

Wallin, Mitchell T. MD, MPH* †; Wilken, Jeffrey PhD* †; Alfaro, Mercedes H. PhD*; Rogers, Catherine PhD*; Mahan, Clare PhD; Chapman, Julie C. PsyD* †; Fratto, Timothy MA*; Sullivan, Cynthia PhD* †; Kang, Han DrPH* ‡; Kane, Robert PhD§

Cognitive and Behavioral Neurology: September 2009 - Volume 22 - Issue 3 - p 155-166
doi: 10.1097/WNN.0b013e3181b278e8
Original Studies

Objective: The objective of this project was to compare neuropsychologic performance and quality of life in a population-based sample of deployed Gulf War (GW) veterans with and without multisymptom complaints.

Background/Methods: The study participants were obtained from the 30,000 member population-based National Health Survey of GW-era veterans conducted in 1995. Cases (N=25) were deployed to the year 1990 and 1991 GW and met Center for Disease Control and Prevention criteria for multisymptom GW illness (GWI). Controls (N=16) were deployed to the 1990 and 1991 GW but did not meet Center for Disease Control and Prevention criteria for GWI.

Results: There were no significant differences in composite scores on the traditional and computerized neuropsychologic battery (automated neuropsychologic assessment metrics) between GW cases and controls using bivariate techniques. Multiple linear regression analyses controlling for demographic and clinical variables revealed composite automated neuropsychologic assessment metrics scores were associated with age (b=−7.8; P=0.084), and education (b=22.9; P=0.0012), but not GW case or control status (b=−63.9; P=0.22). Compared with controls, GW cases had significantly more impairment on the Personality Assessment Inventory and the short form-36.

Conclusions: Compared with GW controls, GW cases meeting criteria for GWI had preserved cognition function but had significant psychiatric symptoms and lower quality of life.

*War Related Illness and Injury Study Center, Veterans Affairs Health Administration

Department of Neurology, Georgetown University School of Medicine, Washington, DC

Environmental Epidemiology Service, Veterans Affairs Health Administration

§Veterans Affairs Maryland Health Care System, University of Maryland, Baltimore, MD

Supported by VA Health Services Research and Development Service Grant No.WRI01-176.

Reprints: Mitchell T. Wallin, MD, MPH, Department of Neurology, VA Medical Center, Neurology Service, No. 127, 50 Irving Street NW, Georgetown University, Washington, DC 20422 (e-mail:

Received for publication October 10, 2008

accepted April 19, 2009

© 2009 Lippincott Williams & Wilkins, Inc.