Fibromyalgia & Chronic Pain LIFE Summer 2013, Issue 9 - Page 5

NEW STUDY REVEALS TWO SUBGROUPS IN GULF WAR ILLNESS by Rae Marie Gleason A new scientific study, β€œExercise Challenges in Gulf War Illness Reveals Two Subgroups with Altered Brain Structure and Function” was published on June 14, 2013, in PLOS ONE, an international, peer-reviewed, open-access, online publication. Gulf War Illness (GWI) is a condition that includes symptoms such as cognitive impairment, autonomic dysfunction, debilitating fatigue and chronic widespread pain. A defining feature of GWI is post-exertional malaise, an intensification of symptoms following physical and/or mental effort. This study looked at 28 Gulf War veterans and 10 controls. The 1990 American College of Rheumatology Fibromyalgia Diagnostic Criteria was applied to all of the participants and revealed that 68% of the Gulf War veterans had at least 11 of 18 tender points, confirming a fibromyalgia (FM) diagnosis. All the participants underwent fMRI scans before and after two exercise stress tests to examine serial changes in pain, autonomic function, and working memory. Responses to the exercise portion of the study revealed two clinical GWI subgroups. One subgroup (n=10) presented with orthostatic tachycardia (moving from lying flat to an upright position causes an abnormally large increase in heart rate). This phenotype correlated with brainstem atrophy (shrinkage). The second subgroup (n=18) developed exercise induced hyperalgesia, an increased sensitivity to pain that was associated with cortical atrophy and baseline working memory compensation in the basal ganglia area of the brain. The control group did not demonstrate any alterations in cognition, brain structure, or symptoms. Until now GWI research was done under the assumption that all of the veterans had identical conditions. This incorrect conclusion has probably hindered scientific discovery of more effective treatments for this condition. Because two GWI groups have been identified, future research will better define study participants enabling scientists to test more appropriate treatments for specific patient complaints. As an example, if a study is specific to pain treatment, researchers will now be able to differentiate the orthostatic tachycardia (heart rate) group from the pain group, allowing elimination of the heart rate participants from the study. This will result in a more robust data analysis for scientists to better measure the success of a particular pain treatment. Q‘”Ν…΅”₯́ΡΙΥ”™½ΘΡ‘”₯ΉΙ•…Ν•‘•…ΙЁɅєΙ½ΥΐμΡ‘”Α…ΙΡ₯₯Α…ΉΡ́έ₯Ρ ₯ΉΙ•…Ν•Ν•ΉΝ₯Ρ₯Ω₯ΡδΡΌΑ…₯Έέ₯±°‰”•±₯΅₯Ή…Ρ•°…±±½έ₯Ήœ™½Θ„΅½Ι”½‘”΄()Ν₯Ω”‘…Ρ„…Ή…±εΝ₯́₯Έ‘•Ρ•Ι΅₯Ή₯ΉœΡΙ•…Ρ΅•ΉΠ•™™•Ρ₯Ω•Ή•ΝΜΈ%ΉΡ•Ι•ΝΡ₯Ή±δ°Ρ‘”½Ι₯₯Ή…°‘εΑ½Ρ‘•Ν₯́₯ΈΡ‘”]$ΝΡΥ‘δΑΙ½Α½Ν•Ρ‘…ЁΝΡΙ•Ν́ѕΝΡ́ݽձ…±Ρ•ΘΝε΅ΑΡ½΅Μ₯ΈΡ‘”Ω•Ρ•Ι…ΉΜ‰ΥЁΉ½Π½ΉΡΙ½±Μ…Ή₯‘•ΉΡ₯™δΥΉ‘•Ι±ε₯Ήœ•ΉΡΙ…°΅•‘…Ή₯́͡…ΉΙ•₯½ΉΜ½˜‘εΝ™ΥΉΡ₯½ΈΈQ‘”Ι•Ν•…ɍ‘•Ί‘₯Ή½Π…ΉΡ₯₯Α…Ρ”‘₯͍ɕє‘…Ή•Μ₯Ή‘₯…Ρ₯ΉœΡέΌ]$ΝΥ‰Ι½ΥΑΜΈQ‘•₯ȁ™₯Ή‘₯ΉΜΑΙ½΅ΑΡ•™ΥΙΡ‘•Θ…Ή…±εΝ₯́₯ΉΡΌ•α•Ι₯Ν”΅₯Ή‘Ս•Νε΅ΑΡ½΅Μ…ΉΡ‘”Ι•±…Ρ₯½ΉΝ‘₯ΐΡΌΝΡΙՍΡΥΙ…°…Ή™ΥΉΡ₯½Ή…°‰Ι…₯ΈΑ…Ι…΅•Ρ•ΙΜΈ1₯Ή­₯Ήœ±₯Ή₯…°΅…Ι­•ΊѼ…±Ρ•Ι…Ρ₯½ΉΜ₯ΈΡ‘”‰Ι…₯Έ•αΡ•Ή‘•Ρ‘•₯ȁչ‘•ΙΝΡ…Ή‘₯Ήœ½˜Ρ‘”ΥΉ‘•Ι±ε₯Ήœ΅•‘…Ή₯́͡₯Έ]$ΈM₯Ή”€Ψά”½˜Ρ‘”]$ΝΡΥ‘δΑ…ΙΡ₯₯Α…ΉΡ́ݕɔ‘₯…Ή½Ν•έ₯Ρ 4°Ρ‘•Ι”₯́„½½‘…Ή”Ρ‘…Ёё₯́ΝΡΥ‘δέ₯±°‰”Ι•Α±₯…Ρ•™½ΘΡ‘₯́Α…Ρ₯•ΉΠΙ½ΥΐΈA•Ι‘…Ά͍₯•ΉΡ₯ΝΡ́έ₯±°‰”‰•Ρѕȁ…‰±”ΡΌ₯‘•ΉΡ₯™δΑ…₯ΈΩΜΈ‘•…ΙЁɅє™₯‰Ι½΅ε…±₯„Α…Ρ₯•ΉΡ́ѼΙ•…Ρ”½Θ₯‘•ΉΡ₯™δ‰•ΡѕȁΡΙ•…Ρ΅•ΉΡ́™½ΘΝΥ‰Ι½ΥΆ½˜Α•½Α±”έ₯Ρ Ρ‘₯́½Ή‘₯Ρ₯½ΈΈA…₯Έ…Ή™…Ρ₯Υ”…Ι”Ρ‘”΅…©½ΘΝε΅ΑΡ½΅Μ½˜™₯‰Ι½΅ε…±₯„°ΝΌ₯Ё΅…­•ΜΝ•ΉΝ”Ρ‘…Ёё”½Ή±ΥΝ₯½ΉΜ½˜Ρ‘₯́]$ΝΡՑ䁡₯‘Ё…±ΝΌ½ΙΙ•±…Ρ”₯Έ‰•Ρѕȁɕ͕…ɍ ½Υэ½΅•Μ₯ΈΡ‘”Ν₯•ΉΡ₯™₯ŒΝΡՑ䁽˜™₯‰Ι½΅ε…±₯„Έ()MΥ΅΅•Θ€ΘΐΔ́₯‰Ι½΅ε…±₯„€˜ ‘Ι½Ή₯ŒA…₯Έ()1₯™—Š€ΧŠ((0