The impact of Gulf War specific neurotoxicant exposures on cardiac risk, neuropsychological functioning, and brain morphology more than 25 years post war

Gulf War (GW) veterans are a unique cohort of individuals who were exposed to numerous neurotoxicants in theater. These exposures include pyridostigmine bromide pills, pesticides, chemical warfare agents, vaccines, combustion byproducts from oil well fires, and solvent fumes from chemical agent resistant coating paint. After returning home from deployment, GW veterans began reporting a constellation of symptoms that encompassed multiple body systems and has since been collectively termed Gulf War Illness (GWI). Research immediately following the war has linked several of the neurotoxicant exposures to adverse health outcomes including cardiovascular, neuropsychological, and neuroanatomical effects. Over the years, GW research has transitioned to focusing on the illness as a whole and to investigating its potential biomarkers and mechanisms. Much of this research has compared veterans with and without GWI, however this grouping may be problematic given that veterans without GWI may have been exposed to the same neurotoxicants but present without symptoms or health effects or with symptoms below the threshold for current GWI diagnostic criteria. Additionally, some neurotoxicant exposures, without initially producing overt signs of toxicity, may produce delayed and persistent effects. As GW veterans begin to age, neurotoxicant exposures may exert delayed effects that may be different from symptoms initially experienced after the war. Therefore, it is of utmost importance to continue to characterize health effects from neurotoxicant exposures in GW veterans. This dissertation aims to investigate the effects of individual neurotoxicant exposures on cardiac risk, neuropsychological functioning, and brain morphology in GW veterans, nearly 30 years post-war. The first study examines the impact of these exposures on cardiac risk using the Framingham 10-year cardiovascular disease risk score, as well as the prevalence of cardiovascular and cerebrovascular medical conditions. The second study examines the impact of these exposures on neuropsychological and mood functioning, using an extensive battery of neuropsychological tests as well as the Profile of Mood States questionnaire. In the third study, the effects of these exposures on brain volumes of the Yeo functional networks are examined. The results of this dissertation will serve as a comprehensive update on GW veteran health regarding specific neurotoxicant exposures