TABLE 4-6 Nervous System Diseases

Study

Design

Population

Outcomes

Results

Adjustments

Comments

Peripheral Neuropathy and Myopathy

Davis et al., 2004 (Vol. 4)

Cross-sectional, prevalence, medical evaluation, exposure-specific component

1047 deployed veterans vs 1121 nondeployed veterans; 240 Khamisiyah-exposed deployed veterans vs 807 non-Khamisiyah-exposed deployed veterans

Distal symmetric polyneuropathy identified by nerve-conduction studya

Deployed vs nondeployed veterans: OR 0.65 (95% CI 0.33-1.28); Khamisiyah-exposed veterans vs non-Khamisiyah-exposed veterans: OR 1.04 (95% CI 0.25-4.37)

Excludes coexisting conditionsb

Low participation rate: 53% in deployed veterans, 39% in nondeployed veterans

Rose et al., 2004; Sharief et al., 2002 (Vol. 4)

Case-control

49 symptomatic deployed UK veterans vs 26 healthy deployed UK veterans, 13 symptomatic Bosnia deployed veterans, 22 symptomatic Gulf War-era veterans

Nerve-conduction studies, quantitative sensory and autonomic testing, concentric needle and single-fiber, electromyography, ischemic forearm exercise test, subanaerobic bicycle exercise test, muscle biopsy

No significant differences between symptomatic deployed and nondeployed veterans, except deployed veterans had increased lactate production in bicycle exercise test

 

Positive finding from bicycle test could reflect mitochondrial damage or inactivity resulting from ill health

Kelsall et al., 2005 (Update)

Cross-sectional survey

1382 Australian male GWVs, 1376 nondeployed male era veterans frequency matched by age and service type (Same study population as Kelsall et al., 2004a,b)

Self-reported neurologic symptoms corroborated during neurological examination; SF-12; modified NIS

Lower limb neurological type symptoms and signs: OR 1.6 (95% CI 1.0-2.7) Neuropathy Score: GWV (2.0, sd = 4.3) vs controls (2.0, sd = 4.7) RoM 1.1 (95% CI 0.9-1.3) Association of neurological symptoms in self-reported nonexposed compared to exposed: PB (RoM 1.5, 95% CI 1.2-1.8)

Antibiological warfare

Age, rank, service type, current marital status, highest level of education, alcohol consumption, and history of diabetes

Exposure data self-reported; response rate 80.5% for deployed, 56.8% for nondeployed



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