Journal of the International Neuropsychological Society

Research Articles

Neuropsychological functioning of U.S. Gulf War veterans 10 years after the war

ROSEMARY TOOMEYa1a2a3a4 c1, RENEE ALPERNa5, JENNIFER J. VASTERLINGa6a7, DEWLEEN G. BAKERa8a9, DOMENIC J. REDAa5, MICHAEL J. LYONSa1a2a3a4, WILLIAM G. HENDERSONa5, HAN K. KANGa10, SETH A. EISENa11a12a13 and FRANCES M. MURPHYa14a15

a1 Research Service, Boston VA Healthcare System, Boston, Massachusetts

a2 The Massachusetts Mental Health Center Public Academic Psychiatry Division of the Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, Department of Psychiatry, Boston, Massachusetts

a3 Harvard Institute of Psychiatric Epidemiology and Genetics, Boston, Massachusetts

a4 Psychology Department, Boston University, Boston, Massachusetts

a5 Cooperative Studies Program Coordinating Center, Hines Veterans Affairs Hospital, Hines, Illinois. (W.G.H. is currently at the University of Colorado Health Outcomes Program and the Department of Preventive Medicine and Biometrics, Aurora, Colorado.)

a6 VA South Central (VISN 16) Mental Illness Research, Education, and Clinical Center, New Orleans Veterans Affairs Medical Center, New Orleans, Louisiana

a7 Department of Psychiatry and Neurology, Tulane University School of Medicine, New Orleans, Louisiana. (Author is currently at the Psychology Service and VA National Center for PTSD, VA Boston Healthcare System and Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts.)

a8 Psychiatry Department, University of Cincinnati, Cincinnati, Ohio

a9 Psychiatry Service, Cincinnati VA Medical Center (Author is currently at Psychiatry Service, San Diego VA Healthcare System, San Diego, California, and the University of California, San Diego, California.)

a10 Environmental Epidemiology Service, Department of Veterans Affairs, Washington D.C.

a11 Medical and Research Services, St. Louis Department of Veterans Affairs Medical Center, St. Louis, Missouri.

a12 Department of Internal Medicine, Division of General Medical Sciences, Washington University School of Medicine, St. Louis, Missouri.

a13 Health Services Research and Development, Veterans Administration, Washington, D.C.

a14 Veterans Health Administration, U.S. Department of Veterans Affairs, Washington, D.C.

a15 Uniformed Services University of the Health Sciences, Washington, D.C.

Abstract

Many U.S. Gulf War-era veterans complained of poor cognition following the war. This study assessed neuropsychological functioning in veterans 10 years after the war through objective tests. 2189 Gulf War-era veterans (1061 deployed, 1128 non-deployed) were examined at 1 of 16 U.S. Veterans Affairs medical centers. Outcomes included neuropsychological domains derived from factor analysis and individual test scores. Deployed veterans performed significantly worse than non-deployed veterans on 2 of 8 factors (motor speed & sustained attention, analysis not corrected for multiple comparisons) and on 4 of 27 individual test variables (Trails A & B, California Verbal Learning Test – List B, and Continuous Performance Test sensitivity, with only Trails B surviving Bonferroni correction). Within deployed veterans, Khamisiyah exposure was negatively correlated with motor speed after controlling for emotional distress. Depressive symptoms and self-reported exposure to toxicants were independently and significantly associated with worse sustained attention. Other factors were also associated with self-reported exposures. The findings were not a result of differential effort across groups. Gulf War deployment is associated with subtle declines of motor speed and sustained attention, despite overall intact neuropsychological functioning. Evidence suggests that toxicant exposures influence both these functions, and depressive symptoms also influence attention. (JINS, 2009, 15, 717–729.)

(Received April 27 2006)

(Reviewed May 20 2009)

(Accepted May 26 2009)

Correspondence:

c1 Correspondence and reprint requests: Rosemary Toomey, Ph.D., Psychology Department, Boston University, 648 Beacon Street, 6th Floor, Boston, MA. 02215. E-mail: rosemary_toomey@hms.harvard.edu

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