Doctor: Blood Test May Be Next Step in Exploring Gulf War Illness

Posted in GUMC Stories

OCTOBER 31, 2015 – A Georgetown University Medical Center (GUMC) researcher who discovered the first physical evidence of Gulf War Illness, said at a panel discussion last week that the next step may be to develop a blood test for the illness.

“Eventually, Gulf War illness may be considered a disease like hepatitis – something that can be easily diagnosed and effectively treated,” said Dr. James Baraniuk, a GUMC professor of medicine. “It’s going to redefine psychiatry.”

While a great deal of additional research will be necessary, Baraniuk believes a blood test will be a reality one day.

Soldier’s Perspective 

The condition, which may affect as many as 200,000 military personnel who served in Operation Desert Storm and Desert Shield, is defined as a collection of vague symptoms that include headache, cognitive and gastrointestinal dysfunction, widespread pain and fatigue.

At the “Continuing Cura Personalis: Georgetown Discovery Paves the Way for Diagnosis and Treatment of Gulf War Illness,” panel discussion October 23, participants noted that unlike today’s military, Gulf War were not concerned with the possibility of exposure to hazardous elements.

“I think that the general soldier’s perspective is not one that’s occupied with occupational risk,” said Dr. Ryung Suh, associate professor of health systems administration at the School of Nursing & Health Studies and a GUMC adjunct assistant professor of microbiology. “These are really things that we didn’t think about in the Gulf War era.”

Suh graduated from the U.S. Military Academy at West Point days before Iraq invaded Kuwait in 1990 and later served in Operation Enduring Freedom. 

Significant Results

After talking to veterans claiming to suffer from Gulf War illness, Baraniuk found that many of them reported feeling exhausted after exercise.

He recruited participants for a study to see how the veterans’ brains were affected by exercise with functional MRI (fMRI) technology.

The veteran group had subtle, but significant changes in the white matter in their brains compared to the control group. Bicycle exercise similar to a cardiac stress test caused 10 of the 28 veterans to develop a very fast heart rate.

When the brains of the other 18 veterans were scanned, they showed increased blood flow in a critical “fine tuning” region of the brain that may explain why they have difficulties concentrating and solving problems. People in the control group did not have any changes in heart rate, brain stem or brain blood flow.

Baraniuk’s research didn’t identify a cause of Gulf War illness but it indicated that something biological was taking place in the veterans’ brains.

“Previously, scientists studying Gulf War illness were focused on defining a syndrome rather than trying to determine the pathophysiology,” said Dr. Victoria A. Cassano, president and CEO of Performance Medicine Consulting, LLC.

Viable Diagnosis 

“If we don’t know exactly what caused it, it is very easy to dismiss it as an illness,” said Cassano, a retired Navy occupational physician with 20 years of experience in Gulf War illness issues. “That’s why I think this research is so important – it ties everything together.”

Another GUMC panelist, James Giordano, chief of the Neuroethics Studies Program at the Pellegrino Center for Clinical Bioethics and professor of neurology, praised Baraniuk’s approach to research on Gulf War illness.

“There was initially some failure to recognize the gravitas of this illness,” said Giordano, who also served as a U.S. naval officer on active duty with the Marine Corps during Operation Desert Shield. “These represent viable diagnoses. Something is wrong with these people.”

Next Steps

Due to advances in epigenetics and technology, future directions for research on Gulf War illness may include an examination of the factors that may make some individuals more likely to develop the condition than others, Giordano said.

That will potentially lead to the identification of treatment options, he added.

As for those currently suffering from Gulf War illness, Suh said the VA allows for presumptive diagnoses, meaning that those who are symptomatic and served in the Persian Gulf are assumed to have Gulf War illness and receive disability benefits accordingly.

Presumptive diagnoses make sense because neuroscience is largely based on correlation, Giordano said.

“Although you’re taking a leap of faith, it’s a leap of faith that needs to be taken,” he explained.