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dc.contributor.authorJanulewicz, Patriciaen_US
dc.contributor.authorKrengel, Maxineen_US
dc.contributor.authorQuinn, Emilyen_US
dc.contributor.authorHeeren, Timothyen_US
dc.contributor.authorToomey, Rosemaryen_US
dc.contributor.authorKilliany, Ronalden_US
dc.contributor.authorZundel, Claraen_US
dc.contributor.authorAjama, Joyen_US
dc.contributor.authorO'Callaghan, Jamesen_US
dc.contributor.authorSteele, Leaen_US
dc.contributor.authorKlimas, Nancyen_US
dc.contributor.authorSullivan, Kimberlyen_US
dc.date.accessioned2020-05-07T14:29:40Z
dc.date.available2020-05-07T14:29:40Z
dc.date.issued2018-11-01
dc.identifierhttp://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000451306300008&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=6e74115fe3da270499c3d65c9b17d654
dc.identifier.citationPatricia Janulewicz, Maxine Krengel, Emily Quinn, Timothy Heeren, Rosemary Toomey, Ronald Killiany, Clara Zundel, Joy Ajama, James O'Callaghan, Lea Steele, Nancy Klimas, Kimberly Sullivan. 2018. "The Multiple Hit Hypothesis for Gulf War Illness: Self-Reported Chemical/Biological Weapons Exposure and Mild Traumatic Brain Injury." BRAIN SCIENCES, Volume 8, Issue 11. https://doi.org/10.3390/brainsci8110198
dc.identifier.issn2076-3425
dc.identifier.urihttps://hdl.handle.net/2144/40653
dc.description.abstractThe Gulf War Illness Consortium (GWIC) was designed to identify objective biomarkers of Gulf War Illness (GWI) in 1991 Gulf War veterans. The symptoms of GWI include fatigue, pain, cognitive problems, gastrointestinal, respiratory, and skin problems. Neurotoxicant exposures during deployment, such as pesticides, sarin, and pyridostigmine bromide pills have been identified as contributors to GWI. We have also found an association between mild traumatic brain injury (mTBI) and increased rates of GWI. However, the combined impact of these physical and chemical exposures has not yet been explored in GWI. The objective of this study was to examine both self-reported mTBI and exposure to chemical/biological weapons (CBW) as a multiple or two hit model for increased risk of GWI and other chronic health conditions. The study population included 125 Gulf War (GW) veterans from the Boston GWIC. Exposure to CBW was reported in 47.2% of the study population, and 35.2% reported sustaining a mTBI during the war. Results confirmed that those with both exposures (mTBI and CBW) had higher rates of comorbid chronic health conditions while rates of GWI were equivalent for mTBI and CBW or mTBI alone. The timing of exposure to mTBI was found to be strikingly different between those with GWI and those without it. Correspondingly, 42.3% of GWI cases reported experiencing a mTBI during military service while none of the controls did (p = 0.0002). Rates of mTBI before and after the war did not differ between the cases and controls. In addition, 54% of cases compared to 14.3% of controls (p = <0.001) reported being exposed to CBW during military service. The current study examined the relation of the separate and combined effects of exposure to mTBI and CBW in 1991 GW veterans. The findings from this study suggest that both exposure to mTBI and CBW are associated with the development of GWI and multiple chronic health conditions and that combined exposure appears to lead to higher risk of chronic health effects.en_US
dc.description.sponsorshipThis work was supported by the Congressionally Directed Medical Research Program (CDMRP) through the Gulf War Illness Research Program (GWIRP) under Award No. W81XWH-13-2-0072 to Kimberly Sullivan. (W81XWH-13-2-0072 - Congressionally Directed Medical Research Program (CDMRP) through the Gulf War Illness Research Program (GWIRP))en_US
dc.format.extent14 pages.en_US
dc.languageEnglish
dc.language.isoen_US
dc.publisherMDPIen_US
dc.relation.ispartofBrain Sciences
dc.rightsThis is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.en_US
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/.
dc.subjectScience & technologyen_US
dc.subjectLife sciences & biomedicineen_US
dc.subjectNeurosciencesen_US
dc.subjectNeurosciences & neurologyen_US
dc.subjectGulf War illnessen_US
dc.subjectGulf Waren_US
dc.subjectMild traumatic brain injuryen_US
dc.subjectChemical weaponsen_US
dc.subjectNeurotoxicant exposuresen_US
dc.subjectMultisymptom illnessen_US
dc.subjectCyclosarin exposureen_US
dc.subjectRisk-factorsen_US
dc.subjectVeteransen_US
dc.subjectSymptomsen_US
dc.subjectEtiologyen_US
dc.subjectHistoryen_US
dc.subjectSarinen_US
dc.subjectSenseen_US
dc.subjectPsychologyen_US
dc.subjectCognitive sciencesen_US
dc.titleThe multiple hit hypothesis for Gulf War illness: self-reported chemical/biological weapons exposure and mild traumatic brain injuryen_US
dc.typeArticleen_US
dc.description.versionPublished versionen_US
dc.identifier.doi10.3390/brainsci8110198
pubs.elements-sourceweb-of-scienceen_US
pubs.notesEmbargo: Not knownen_US
pubs.organisational-groupBoston Universityen_US
pubs.organisational-groupBoston University, Administrationen_US
pubs.organisational-groupBoston University, College of Arts & Sciencesen_US
pubs.organisational-groupBoston University, College of Arts & Sciences, Department of Psychological & Brain Sciencesen_US
pubs.organisational-groupBoston University, School of Medicineen_US
pubs.organisational-groupBoston University, School of Public Healthen_US
pubs.publication-statusPublisheden_US
dc.identifier.mycv406421


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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Except where otherwise noted, this item's license is described as This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.