Neuropsychological characteristics of Gulf War illness: A meta-analysis

Patricia A Janulewicz, Maxine H Krengel, Alexis Maule, Roberta F White, Joanna Cirillo, Emily Sisson, Timothy Heeren, Kimberly Sullivan, Patricia A Janulewicz, Maxine H Krengel, Alexis Maule, Roberta F White, Joanna Cirillo, Emily Sisson, Timothy Heeren, Kimberly Sullivan

Abstract

Objective: Gulf War illness (GWI) is a disorder related to military service in the 1991 GW. Prominent symptoms include fatigue, pain and cognitive problems. These symptoms were reported by GW Veterans (GWV) immediately after the war and were eventually incorporated into case definitions of GWI. Neuropsychological function in GW veterans has been studied both among deployed GWV and in GWV diagnosed with GWI. Results have been inconsistent between and across GW populations. The purpose of the present investigation was to better characterize neuropsychological function in this veteran population.

Methods: Meta-analysis techniques were applied to published studies on neuropsychological performance in GWV to identify domains of dysfunction in deployed vs. non-deployed GW-era veterans and symptomatic vs. non-symptomatic GWVs.

Results: Significantly decreased performance was found in three functional domains: attention and executive function, visuospatial skills and learning/memory.

Conclusions: These findings document the cognitive decrements associated with GW service, validate current GWI case definitions using cognitive criteria, and identify test measures for use in GWI research assessing GWI treatment trial efficacy.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Search strategy for meta-analysis on…
Fig 1. Search strategy for meta-analysis on neuropsychological performance in Gulf War veterans.
From: Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(7): e1000097. doi:10.1371/journal.pmed1000097. For more information, visitwww.prisma-statement.org.
Fig 2. Group A, forest plot for…
Fig 2. Group A, forest plot for block design subtest: Deployed Gulf War veterans compared to non-deployed Gulf-era veterans.
Fig 3. Fig 3a Group B, forest…
Fig 3. Fig 3a Group B, forest plot for block design subtest: Symptomatic versus non-symptomatic Gulf War veterans and Fig 3b Group B forest plot for Continuous Performance Test (CPT) subtest: Symptomatic versus non-symptomatic Gulf War veterans.

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