Perfusion deficit to cholinergic challenge in veterans with Gulf War Illness

Abstract

A highly plausible etiology for Gulf War Illness (GWI) is that the neural damage and cognitive deficits are associated with excessive exposure to cholinesterase-inhibiting cholinergic stimulants. Our previous SPECT study provided strong indication that cerebral blood flow (CBF) in veterans with GWI may be different from those of unaffected control veterans. The present study confirmed and extended previous findings that patients with GWI have abnormal response to an inhibitory cholinergic challenge, physostigmine infusion, when compared to age-gender-education matched control veterans. The MRI-based arterial spin labeling (ASL) and phase-contrast techniques have several key advantages over SPECT, including shorter experiment duration, complete non-invasiveness, and higher spatial and temporal resolutions, and therefore may provide a cost-effective biomarker for characterization of GWI.

Conflict of interest statement

Conflict of Interest statement

The authors declare that there are no conflicts of interest.

Copyright © 2010 Elsevier Inc. All rights reserved.

Figures

Figure 1

Experimental procedures for the physostigmine challenge.

Figure 2

Results of phase contrast MRI. (a) Illustration of the slice position in a representative subject. (b)–(d) show the raw image, magnitude image and phase image of the phase-contrast scan from the same subject, respectively. The manually drawn preliminary ROI (circle) is also displayed on the magnitude image (c). (e) Global CBF change due to cholinergic stimulation measured by phase-contrast MRI.

Figure 3

Regional CBF change due to cholinergic stimulation measured by standard resolution ASL MRI.

Figure 4

Comparison of baseline CBF across subject groups.