Link Between Pain, Brain Disruption in Gulf War Veterans

by U.S. Medicine

April 14, 2018

MADISON, WI — Chronic musculoskeletal pain (CMP) affects about one-fourth of the 700,000 veterans deployed during the Persian Gulf War in 1990-1991. A study in the journal Pain pointed out that the cause of their pain is unknown, and no efficacious treatments exist.1

The study team, led by researchers from the William S. Middleton Memorial Veterans Hospital in Madison, noted that a small body of literature suggests that brain abnormalities exist in Gulf War Veterans (GV), yet relationships between brain abnormalities and disease symptoms remain largely unexplored.

The purpose, according to the researchers, was to compare white matter (WM) integrity between GVCMP and matched, healthy veteran controls (GVCO). Relationships then were determined between cerebral WM integrity and symptoms.

For the study, 30 GVCMP and 31 controls completed magnetic resonance imaging with diffusion tensor imaging. Results indicated that GVCMP had greater pain symptoms and mood disturbance and lower quality of life and physical function compared with GVCO (P < 0.05). In addition, GVCMP had lower WM integrity across several brain regions implicated in chronic pain (P < 0.05) including the middle and inferior frontal gyrus, corpus callosum, corona radiata, precentral gyrus, external capsule and posterior thalamic radiation.

For GVCMP, WM integrity was associated with pain and mood symptoms in widespread brain areas that were found to be different between groups (P < 0.05).

“Results indicate widespread WM microstructure disruption across brain regions implicated in pain processing and modulation in chronic pain,” study authors concluded. “The observed relationships between WM microstructure and symptoms encourage the testing of treatments designed to improve the brain health of affected veterans.”

1Van Riper SM, Alexander AL, Koltyn KF, Stegner AJ, et. al. Cerebral white matter structure is disrupted in Gulf War veterans with chronic musculoskeletal pain. Pain. 2017 Dec;158(12):2364-2375. doi: 0.1097/j.pain.0000000000001038. PubMed PMID: 28796115.

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