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Gulf War Syndrome Update: |
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Gulf War Syndrome Update March 2012:
Gulf War Illness
(GWI) is a complex, poorly understood illness characterized
by many symptoms, including fatigue after exertion, sleep
and mood problems, difficulty concentrating, difficulty
thinking and finding words, and musculoskeletal pain.
Individuals often present with many symptoms, some of them
severe and disabling, and with additional medical diagnoses,
including chronic fatigue syndrome, fibromyalgia, irritable
bowel syndrome, digestive complaints, and mood-related
psychiatric disorders, such as depression, posttraumatic
stress disorder, and other anxiety disorders.
More than
100,000 veterans of the first Gulf War (Operation Desert
Shield/Storm, 1990-1991) out of 700,000 US service personnel
deployed to the Persian Gulf have presented with medical
complaints through programs established to address the
problem, which came to be called chronic multisymptom
illness (CMI). Groups of veterans in the United Kingdom,
Canada, and Australia were identified with similar problems.
The veterans have received treatment directed at their
symptoms, but at 5- and 10-year follow-ups, many reported
their symptoms remained, some of them severe and disabling.
Clearly, an effective treatment for these conditions would
be of great benefit to those who were injured during their
military service.
The cause of CMI is unknown, and the
symptoms can not be explained by physical and laboratory
examinations. Several factors have been considered,
including exposure to vaccines, chemicals likely to be
encountered in combat (chemical weapons, smoke, pesticides)
and stress related to military service, deployment, and
combat. After investigation by the Centers for Disease
Control (CDCP), researchers suspect that the symptoms
reflect a range of injuries to the nervous system. It may be
that the factors that led to these injuries were not
specific to the Persian Gulf region, and that veterans of
the current war in Iraq and Afghanistan, as well as active
duty personnel, are exposed to similar stressors and will
benefit from an investigation of CMI and its treatment.
The
goal of this study is to help identify whether acupuncture
is an effective treatment for Gulf War Syndrome. Acupuncture
is likely to be helpful in treating GWI because it has
already been used successfully to reduce many of its key
symptoms - fatigue, irritability, anxiety, insomnia, and
pain. Acupuncture treatment is designed to treat each
individual's symptoms making it very well suited for
treating the varied symptoms of GWI. Veterans will receive
care that is directed specifically at their most distressing
symptom.
Though the specific etiology of CMI is unknown,
acupuncture's analgesic and anti-inflammatory effects are
likely to be helpful. Acupuncture seems to work, in part, on
peripheral nerves near the site of injury, in the brain,
central nervous system, and on the endocrine system, in ways
that promote the body's own efforts to reduce pain and heal
even chronic injuries. Numerous studies have shown
acupuncture is well tolerated by patients, safe, and
cost-effective compared to routine care. Acupuncture will be
provided by licensed acupuncturists with at least 5 years of
clinical experience, who have received 20-hours of training
related to symptoms of GWI.
The investigators plan to
recruit patients through the Department of Veterans Affairs
(VA) who report they have symptoms of GWI. Through
questionnaires, physician assessment and medical histories,
the investigators will measure the severity of symptoms
before beginning treatment, after 2 months, and after
treatment is completed. One group of patients will receive
acupuncture evaluation and treatment twice per week for 2
months, followed by once per week for 4 months. A second
group, for comparison purposes, will continue whatever
treatment they received from their physicians, and will be
offered acupuncture after waiting for 2 months. Based on
previous acupuncture research on fatigue, stress, and pain,
the investigators expect this length of treatment will be
enough for patients to receive significant benefit. The
investigators also plan to collect samples of blood and
saliva from our volunteers that will help identify possible
disease mechanisms for the illness and track the effects of
treatment.
How
Does Trauma Affect Sleep
According to the National Center for PTSD,
roughly 60% of men and 50% of women will experience
at least one traumatic event during their lifetimes.
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