WASHINGTON - The elusive "Gulf War syndrome" is genuine and appears to be caused by neurological damage from chemical exposures during the conflict, a team of Dallas researchers announced Wednesday.
In arguably the most sophisticated investigation of the issue so far, three reports from scientists at the University of Texas Southwestern Medical Center at Dallas conclude that the veterans studied have symptoms that may reflect injury to the brain and nervous system.
"Illness from the Persian Gulf War is real," said Dr. Robert Haley, chief of epidemiology at UT Southwestern.
The veterans' symptoms, including concentration problems, muscle weakness and chronic diarrhea, suggest that they are suffering from a rare condition caused by chemicals that inhibit a certain enzyme in nerve cells. The condition, which is called organophosphate-induced delayed polyneuropathy, or OPIDP, is known by toxicologists but not most general physicians, Dr. Haley said.
"This probably explains why no one explored this diagnosis earlier," he said.
The Dallas researchers' three studies of Gulf War syndrome will appear in the Jan. 15 Journal of the American Medical Association. A fourth study of Desert Storm veterans, from scientists at the University of Iowa and the U.S. Centers for Disease Control and Prevention, will appear in the same issue.
All four reports "shed important new light in helping to better characterize the perplexing symptoms of illnesses experienced by Gulf War veterans," Dr. Phil Fontanarosa, a senior editor of the journal, said Wednesday during a news conference releasing the research.
Veterans' groups said they hoped the study would spur further research and eventually lead to treatment.
"What Dr. Haley did today was a major gift to Gulf War vets," said American Legion spokesman Phil Budhan. "There's been a lot of anxiety and confusion about what happened in the gulf. We've always thought the answers were going to come from hard science . . . and what Dr. Haley's done is some of the best science we've seen to date."
Whether the studies will fundamentally alter the government's treatment of veterans remains a question.
Senate investigators, preparing for hearings on Thursday, said they consider Dr. Haley's findings significant.
A presidential advisory committee issued its findings Tuesday, heavily emphasizing the role of stress in Gulf War ailments. While not discounting stress as a factor, Dr. Haley said Wednesday that the ill veterans studied did not show signs of stress.
White House spokesman Mike McCurry said the researchers who presented their new findings Wednesday did not contradict the presidential panel's report.
"They were the first to say they had not found the causal link to those health effects, but that work needed to continue. And we'd welcome any of those who can come forward with research and continue the work," Mr. McCurry said at a news conference.
Aides to the presidential committee noted that their report had called for further research along the lines of Dr. Haley's work. Committee Chairwoman Joyce C. Lashof agreed that veterans may suffer from the interaction of numerous chemicals to which they were exposed.
"We would not have changed anything in our final report based on what these [JAMA] reports contain," said commission spokesman Gary Caruso.
Other scientists, while hailing the new findings as an important clue, cautioned that it is too early to declare the mystery solved.
"I think Dr. Haley deserves a tremendous amount of credit," said Dr. Robert Roswell, director of the Florida and Puerto Rico VA medical centers and executive director of the Persian Gulf veterans coordinating board. "But this shouldn't be viewed as the final answer."
For instance, he said, symptoms of OPIDP usually surface within weeks or months - not years - after exposure to chemicals.
The Dallas scientists focused on 249 members of 24th Reserve Naval Mobile Construction Battalion, all of whom completed extensive survey booklets.
The unit drew reservists from North and South Carolina, Tennessee, Georgia and Alabama into active duty during the Gulf War.
The scientists say they tried to make up for the weakness of other studies. For example, the survey avoided using ambiguous terms such as "fatigue" when asking about possible symptoms.
Also, 43 of the survey volunteers underwent objective neurological tests that could not be influenced by perceptions of their own illnesses.
The UT Southwestern research team identified not one, but three possible Gulf War syndromes, each of which may represent different degrees of severity of the same malady.
Syndrome 1, called impaired cognition, appeared to be associated with younger veterans and those who wore pet flea collars around their boots to discourage insects.
Syndrome 2, called confusion-ataxia, was more common in older veterans and those who reported being in a likely chemical weapons attack. Syndrome 2 had the most severe symptoms.
Syndrome 3, called arthro-myo-neuropathy, appeared to be more common in veterans who used government-issued insect repellent and in older veterans.
Up to one out of four veterans in the unit studied were suffering from at least one of the syndromes.
In a supporting study, Iowa researchers also found that Gulf War veterans reported more symptoms of illness than members of the military who served at the same time outside the gulf region.
Service members could have been exposed to a variety of chemicals, including pesticides, insect repellents and anti-nerve gas pills. Dr. Haley said Wednesday that previously published data from studies in animals indicate that although none of the agents individually would be responsible for the syndrome, the cocktail of chemicals could have these effects.
The bottom line is that the implication of a chemical combination "is probable but needs further testing," said Dr. Tom Kurt, a UT Southwestern toxicologist who worked with Dr. Haley. Jim Hom from the medical school also was an author on the papers. The research was funded by the Perot Foundation.
In an editorial published with the four studies, Dr. Philip Landrigan of the Mount Sinai School of Medicine in New York writes that the new studies "confirm what many physicians caring for Gulf War veterans already know, namely, that the illnesses in these men and women are quite real."
He praised the painstaking measures that the researchers took in trying to avoid skewing their results.
However, Dr. Landrigan pointed out on Wednesday that all researchers are investigating exposures that occurred six years ago and can't be measured now.
"In this particular instance, the trail is a bit cold," said Dr. Landrigan, who is also a member of the Presidential Advisory Committee on Gulf War Veterans' Illnesses.
Also, he said, less than half the members of the battalion participated in Dr. Haley's studies, and those who chose to volunteer may be different in some way from those who didn't.
In the end, Dr. Landrigan said, he hopes these studies will prompt more research that looks deeper at the question.
"We certainly have a responsibility to keep looking," he said.
Pentagon spokesman Jim Turner said the military had not yet drafted its response to the reports. Several Defense Department experts endorsed Dr. Landrigan's critique of the JAMA articles, Mr. Turner added.
Veterans who were studied said the report vindicated their long-standing belief that they suffered from more than psychological stress.
"We kind of suspected these things all along, but nobody believed us," said Jerry Jones, a disabled Navy Seabee who participated in the research. "We still have people thinking that we're malingerers, and it's all in our heads."
By Laura Beil and George Rodrigue / The Dallas Morning News
Staff writer Susan Feeney in Washington contributed to this report.
01/09/97
© 1996 The Dallas Morning News