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Neuropsychological functioning of U.S. Gulf War veterans 10 years after the war

Published online by Cambridge University Press:  01 September 2009

ROSEMARY TOOMEY ,
RENEE ALPERN ,
JENNIFER J. VASTERLING ,
DEWLEEN G. BAKER ,
DOMENIC J. REDA ,
MICHAEL J. LYONS ,
WILLIAM G. HENDERSON ,
HAN K. KANG ,
SETH A. EISEN  and
FRANCES M. MURPHY
ROSEMARY TOOMEY*
Affiliation:
Research Service, Boston VA Healthcare System, Boston, Massachusetts The Massachusetts Mental Health Center Public Academic Psychiatry Division of the Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, Department of Psychiatry, Boston, Massachusetts Harvard Institute of Psychiatric Epidemiology and Genetics, Boston, Massachusetts Psychology Department, Boston University, Boston, Massachusetts
RENEE ALPERN
Affiliation:
Cooperative Studies Program Coordinating Center, Hines Veterans Affairs Hospital, Hines, Illinois. (W.G.H. is currently at the University of Colorado Health Outcomes Program and the Department of Preventive Medicine and Biometrics, Aurora, Colorado.)
JENNIFER J. VASTERLING
Affiliation:
VA South Central (VISN 16) Mental Illness Research, Education, and Clinical Center, New Orleans Veterans Affairs Medical Center, New Orleans, Louisiana Department of Psychiatry and Neurology, Tulane University School of Medicine, New Orleans, Louisiana. (Author is currently at the Psychology Service and VA National Center for PTSD, VA Boston Healthcare System and Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts.)
DEWLEEN G. BAKER
Affiliation:
Psychiatry Department, University of Cincinnati, Cincinnati, Ohio Psychiatry Service, Cincinnati VA Medical Center (Author is currently at Psychiatry Service, San Diego VA Healthcare System, San Diego, California, and the University of California, San Diego, California.)
DOMENIC J. REDA
Affiliation:
Cooperative Studies Program Coordinating Center, Hines Veterans Affairs Hospital, Hines, Illinois. (W.G.H. is currently at the University of Colorado Health Outcomes Program and the Department of Preventive Medicine and Biometrics, Aurora, Colorado.)
MICHAEL J. LYONS
Affiliation:
Research Service, Boston VA Healthcare System, Boston, Massachusetts The Massachusetts Mental Health Center Public Academic Psychiatry Division of the Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, Department of Psychiatry, Boston, Massachusetts Harvard Institute of Psychiatric Epidemiology and Genetics, Boston, Massachusetts Psychology Department, Boston University, Boston, Massachusetts
WILLIAM G. HENDERSON
Affiliation:
Cooperative Studies Program Coordinating Center, Hines Veterans Affairs Hospital, Hines, Illinois. (W.G.H. is currently at the University of Colorado Health Outcomes Program and the Department of Preventive Medicine and Biometrics, Aurora, Colorado.)
HAN K. KANG
Affiliation:
Environmental Epidemiology Service, Department of Veterans Affairs, Washington D.C.
SETH A. EISEN
Affiliation:
Medical and Research Services, St. Louis Department of Veterans Affairs Medical Center, St. Louis, Missouri. Department of Internal Medicine, Division of General Medical Sciences, Washington University School of Medicine, St. Louis, Missouri. Health Services Research and Development, Veterans Administration, Washington, D.C.
FRANCES M. MURPHY
Affiliation:
Veterans Health Administration, U.S. Department of Veterans Affairs, Washington, D.C. Uniformed Services University of the Health Sciences, Washington, D.C.
*
*Correspondence and reprint requests: Rosemary Toomey, Ph.D., Psychology Department, Boston University, 648 Beacon Street, 6th Floor, Boston, MA. 02215. E-mail: rosemary_toomey@hms.harvard.edu
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Abstract

Many U.S. Gulf War-era veterans complained of poor cognition following the war. This study assessed neuropsychological functioning in veterans 10 years after the war through objective tests. 2189 Gulf War-era veterans (1061 deployed, 1128 non-deployed) were examined at 1 of 16 U.S. Veterans Affairs medical centers. Outcomes included neuropsychological domains derived from factor analysis and individual test scores. Deployed veterans performed significantly worse than non-deployed veterans on 2 of 8 factors (motor speed & sustained attention, analysis not corrected for multiple comparisons) and on 4 of 27 individual test variables (Trails A & B, California Verbal Learning Test – List B, and Continuous Performance Test sensitivity, with only Trails B surviving Bonferroni correction). Within deployed veterans, Khamisiyah exposure was negatively correlated with motor speed after controlling for emotional distress. Depressive symptoms and self-reported exposure to toxicants were independently and significantly associated with worse sustained attention. Other factors were also associated with self-reported exposures. The findings were not a result of differential effort across groups. Gulf War deployment is associated with subtle declines of motor speed and sustained attention, despite overall intact neuropsychological functioning. Evidence suggests that toxicant exposures influence both these functions, and depressive symptoms also influence attention. (JINS, 2009, 15, 717–729.)

Keywords

CognitionPsychological testsNeurotoxicity syndromesEnvironmental medicineMental disordersPsychological stress
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 15 , Issue 5 , September 2009 , pp. 717 - 729
Copyright
Copyright © The International Neuropsychological Society 2009

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