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Evidence of Hippocampal Structural Alterations in Gulf War Veterans With Predicted Exposure to the Khamisiyah Plume

Chao, Linda L. PhD; Raymond, Morgan R. BS; Leo, Cynthia K. BA; Abadjian, Linda R. PhD

Journal of Occupational and Environmental Medicine: October 2017 - Volume 59 - Issue 10 - p 923–929
doi: 10.1097/JOM.0000000000001082

Objectives: To replicate and expand our previous findings of smaller hippocampal volumes in Gulf War (GW) veterans with predicted exposure to the Khamisiyah plume.

Methods: Total hippocampal and hippocampal subfield volumes were quantified from 3 Tesla magnetic resonance images in 113 GW veterans, 62 of whom had predicted exposure as per the Department of Defense exposure models.

Results: Veterans with predicted exposure had smaller total hippocampal and CA3/dentate gyrus volumes compared with unexposed veterans, even after accounting for potentially confounding genetic and clinical variables. Among veterans with predicted exposure, memory performance was positively correlated with hippocampal volume and negatively correlated with estimated exposure levels and self-reported memory difficulties.

Conclusions: These results replicate and extend our previous finding that low-level exposure to chemical nerve agents from the Khamisiyah pit demolition has detrimental, lasting effects on brain structure and function.

Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center (Dr Chao, Ms Raymond, Ms Leo, Dr Abadjian); Department of Radiology and Biomedical Imaging (Dr Chao); and Department of Psychiatry (Dr Chao), University of California, San Francisco, San Francisco, California.

Address correspondence to: Linda L. Chao, PhD, 4150 Clement Street, 114M, San Francisco, CA 94121 (

This study was supported by VA grant No. CX000798 entitled “Longitudinal Assessment of Gulf War Veterans with Suspected Sarin Exposure.”

The authors have no conflicts of interest to report.

Copyright © 2017 by the American College of Occupational and Environmental Medicine