Poster Session C, Sunday, March 24, 5:00 – 7:00 pm, Pacific Concourse
Brainstem atrophy in Gulf War Illness
Yu Zhang1, Timothy Avery1,2, Andrei Vakhtin1,2, Danielle Mathersul1,2, J. Wesson Ashford1,2, Peter Bayley1,2, Ansgar Furst1,2; 1War Related Illness and Injury Study Center (WRIISC), VA Palo Alto Health Care System, 2Stanford University
Background: Gulf War illness (GWI) in veterans who served in the 1990-91 Persian Gulf War is manifested by multiple chronic symptoms, including pain, fatigue, neurological, gastrointestinal, respiratory, and skin problems. In this study, we assessed potential cortical and subcortical atrophy patterns associated with GWI and the relationship between regional atrophy and GWI symptoms using a large subjects’ cohort. Methods: Three-Tesla structural MRI scans from 111 GWI veterans (Age=49±6, 90% Male) and 59 healthy controls (Age=51±9, 63% Male) were collected at the California War Related Illness and Injury Study Center (WRIISC-CA) and Image Data Archive (LONI-IDA), respectively. Diagnoses of GWI were determined based on self-reports and clinical interviews, with all GWI veterans meeting both Fukuda/CDC and Kansas criteria for chronic multi-symptom illness. MRI images were segmented and parcellated using FreeSurfer v6.0. Volumes in 17 subcortical and 68 cortical regions and 3 brainstem sub-regions were measured and normalized by total intracranial volume. Results: Multivariate analyses revealed significant subcortical atrophy but no cortical differences in GWI relative to controls. Substantial atrophy in the brainstem (4% relative to controls, P=0.002) and the thalamus (P=0.02) was observed. In a subsample of 58 GWI veterans who completed the CDC Symptom Inventory, GWI veterans with smaller brainstems had marginally increased severities (P=0.06) of fatigue and depression symptoms when compared to GWI veterans with larger brainstems. Conclusion: The findings suggest that the brainstem is selectively affected in GWI and this in turn may moderate related symptoms such as fatigue and depression.
Topic Area: METHODS: Neuroimaging