Gulf War Illness, Chronic Fatigue Syndrome Share Many Symptoms, But Are Distinct Illnesses, Study Suggests

The study has shown that the two illnesses produce distinctly different, abnormal patterns of brain activity after moderate exercise.

Researchers at Georgetown University Medical Center have published their findings in the journal Brain Communications, which suggest that Gulf War illness (GWI) and chronic fatigue syndrome (CFS) are two different illnesses, which need different treatments.

The study has shown that the two illnesses produce distinctly different, abnormal patterns of brain activity after moderate exercise.

Gulf War syndrome continues to be a medical mystery. Almost one-third of the 700,000 US and Allied soldiers who participated in the 1990-1991 Persian Gulf War suffered from unusual array of symptoms, including fatigue, muscle pain, “brain fog”, headaches, cognitive problems, insomnia, and digestive problems.

Chronic fatigue syndrome (CFS) (sometimes called myalgic encephalomyelitis)  CFS affects 0.2-2% of the U.S. population, GWI is a multi-symptom illness that affects about 25% to 30% of the approximately 700,000 military personnel who participated in the 1990-1991 Persian Gulf War.

There are many common symptoms in these two illnesses. In both cases, people suffer from cognitive and memory problems. Pain and fatigue are also common in both illnesses.

Due to such common symptoms, many medical institutions in the US list CFS as a symptom of  Gulf War illness (GWI).

“Our results strongly suggest that GWI and CFS represent two distinct disorders of the brain and therefore CFS is not a symptom of GWI,” says Stuart Washington, Ph.D., a post-doctoral fellow and first author on the study. “Combining of two different disorders could lead to improper treatment of both.” Washington works in the laboratory of James Baraniuk, MD, professor of medicine at Georgetown.

Using functional magnetic resonance imaging (fMRI), researchers found that in the case of GWI, brain activities suffered greater loss.

Veterans with GWI showed a decrease in brain activity in the periaqueductal gray, a pain processing region within the brainstem, and in the cerebellum, a part of the brain responsible for fine motor control, cognition, pain, and emotion.

On the other hand, patients with CFS showed increased activity in the periaqueductal gray and in parts of the cerebral cortex related to maintaining vigilance and attention.

“Now that CFS and GWI have been shown to affect different regions of the brain, these regions can be more closely examined using neuroimaging and other techniques to further our understanding of the similarities and differences between the two illnesses,” says Baraniuk. “Once this new information is adopted broadly, diagnoses and treatments for both disorders should improve.”

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