Cook awarded grant to examine perplexing illness
in Gulf War veterans
By Houa Lee
Many veterans of the Gulf War, which took place from 1990-91, suffer from a complex and chronic illness that can cause pain, fatigue and cognitive problems.
UW–Madison’s Dane B. Cook notes that prior research into Gulf War Illness (GWI) has mainly focused on various individual physiological systems in an effort to find answers to this ailment that is poorly understood.
But thanks to a recent grant he received from the Department of Veterans Affairs, Cook hopes to more closely examine how these various systems are effected together as they relate to GWI. The hope is that this research can identify the mechanisms involved in GWI, and in the long run help veterans better deal with the range of issues caused by the illness, for which there are currently no confirmed effective treatments.
Cook, a professor with the Department of Kinesiology and a research physiologist with the Department of Veterans Affairs, explains that much of the research that has been done to date on GWI has categorized and looked at the types and severity of symptoms experienced by veterans. Some studies have looked separately at the immune system, for example, while others have examined things like heart rate, blood pressure regulation and how the brain is operating.
“But none of them have looked at how these separate but related physiological systems interact,” says Cook, who has spent the past decade studying the psychobiological mechanisms of pain and fatigue, and how exercise can help understand and treat these phenomena.
For the next four years, Cook will more closely study GWI by working collaboratively with researchers at the War Related Illness and Injury Study Center in East Orange, New Jersey.
Unlike with healthy individuals, prior research has shown that patients with chronic multi-symptom illness, like GWI, have a worsening of symptoms when they exercise — a condition called post-exertion malaise. To accomplish their goals, Cook and colleagues will use acute exercise to stress these physiological systems and importantly test how they interact and whether these interactions are responsible for the veterans’ symptoms.
Cook and his team hypothesize that dysfunction across multiple physiological systems interact to produce and maintain the symptoms of GWI.
“I expect we’re going to see changes in how the autonomic nervous system regulates blood pressure and heart rate,” says Cook. “We’re going to see up-regulation in pro-inflammatory cytokines – proteins that can cause fatigue and pain. And we’re going to see that these systems are communicating with one another. These communications are going to help explain why that veteran became more sick when he tried to exercise.”
In order to study this complex issue, Cook and his colleagues will also utilize neuroimaging experiments using functional magnetic resonance imaging (fMRI). This process will also allow the researchers to explore neural responses related to pain, fatigue and exercise.
Cook hopes this research will significantly enhance our understanding of GWI and will begin to determine the physiological systems that are most impaired. He says the findings from this research will help us better understand not only ailments inflicting Gulf War veterans, but also disorders affecting veterans from our current and future affairs.
“It would be better if we thought more proactively about veteran health,” says Cook. “If this (our research) can do a tiny part to drive that, then that would be great. But that’s not the purpose of this research. The purpose of this research is to understand the pathophysiology of today’s Gulf War veterans and use this information to guide future treatments for the men and women who have selflessly served this country.”