title: Brain abnormalities in Gulf War syndrome: evaluation with 1H MR spectroscopy.
abstract: OBJECTIVE
  To test for neuronal brain damage in the basal ganglia and brainstem in Gulf War veterans by using magnetic resonance (MR) spectroscopy.
  
  
  METHODS
  Twenty-two Gulf War veterans with one of three factor analysis-derived syndromes (case patients); 18 well veterans matched for age, sex, and education level (control subjects); and six Gulf War veterans with syndrome 2 from a different population (replication sample) underwent long echo time (272 msec) proton (hydrogen 1) MR spectroscopy on a 4 x 2 x 2-cm voxel in the basal ganglia bilaterally and a 2 x 2 x 2-cm voxel in the pons. Syndromes 1-3 are described as "impaired cognition," "confusion-ataxia," and "central pain," respectively.
  
  
  RESULTS
  The N-acetylaspartate-to-creatine (NAA/Cr) ratio, which reflects functional neuronal mass, was significantly lower in the basal ganglia and brainstem of Gulf War veterans with the three syndromes than in those structures of the control subjects (P =.007). The finding was corroborated in the replication sample (P =.002). Veterans with syndrome 2 (the most severe clinically) had evidence of decreased NAA/Cr in both the basal ganglia and the brainstem; those with syndrome 1, in the basal ganglia only; and those with syndrome 3, in the brainstem only.
  
  
  CONCLUSIONS
  Veterans with different Gulf War syndromes have biochemical evidence of neuronal damage in different distributions in the basal ganglia and brainstem.
authors.affiliation: Dept. of Internal Medicine, Section of Epidemiology, University of Texas Southwestern Medical Center at Dallas, 75390-8874, USA.
authors.forename: R W
authors.initials: RW
authors.lastname: Haley
authors.forename: W W
authors.initials: WW
authors.lastname: Marshall
authors.forename: G G
authors.initials: GG
authors.lastname: McDonald
authors.forename: M A
authors.initials: MA
authors.lastname: Daugherty
authors.forename: F
authors.initials: F
authors.lastname: Petty
authors.forename: J L
authors.initials: JL
authors.lastname: Fleckenstein
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001921:Brain / Q000378:metabolism*; D016022:Case-Control Studies; D003401:Creatine / Q000378:metabolism; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods / Q000706:statistics & numerical data; D008875:Middle Aged; D009326:Naval Medicine; D018923:Persian Gulf Syndrome / Q000145:classification / Q000175:diagnosis* / Q000378:metabolism; D014481:United States; D014728:Veterans
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine