HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Haley, R. W. Articles by Fleckenstein, J. L. Search for Related Content PubMed PubMed Citation Articles by Haley, R. W. Articles by Fleckenstein, J. L.

Brain Abnormalities in Gulf War Syndrome: Evaluation with ¹H MR Spectroscopy¹

¹ From the Depts of Internal Medicine, Section of Epidemiology (R.W.H., W.W.M.), Radiology (G.G.M., M.A.D., J.L.F.), and Psychiatry (F.P.), University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd, Dallas, TX 75390-8874, and Dallas Veterans Affairs Medical Center, Tex (F.P.). From the 1999 RSNA scientific assembly. Received Nov 8, 1999; revision requested Jan 7, 2000; revision received Jan 28; accepted Mar 13. Supported by the U.S. Army Medical Research and Materiel Command under cooperative agreement no. DAMD17-97-2-7025; by U.S. Public Health Service grant M01-RR00633; by a grant from the Perot Foundation; and by a grant from Philips Medical Systems of North America. Address correspondence to R.W.H.

View larger version (132K): [in a new window]   Figure 1a. Regions localized during MR spectroscopic evaluation. (a) Coronal and (b) transverse T1-weighted scout images show the position chosen for the left basal ganglia (box). A similar location was chosen for the right basal ganglia (not shown). (c) Coronal and (d) sagittal T1-weighted scout images show the position chosen for the pons (box). Parameters for a-d are repetition time, 20 msec; echo time, 5 msec; flip angle, 60°.

View larger version (124K): [in a new window]   Figure 1b. Regions localized during MR spectroscopic evaluation. (a) Coronal and (b) transverse T1-weighted scout images show the position chosen for the left basal ganglia (box). A similar location was chosen for the right basal ganglia (not shown). (c) Coronal and (d) sagittal T1-weighted scout images show the position chosen for the pons (box). Parameters for a-d are repetition time, 20 msec; echo time, 5 msec; flip angle, 60°.

View larger version (126K): [in a new window]   Figure 1c. Regions localized during MR spectroscopic evaluation. (a) Coronal and (b) transverse T1-weighted scout images show the position chosen for the left basal ganglia (box). A similar location was chosen for the right basal ganglia (not shown). (c) Coronal and (d) sagittal T1-weighted scout images show the position chosen for the pons (box). Parameters for a-d are repetition time, 20 msec; echo time, 5 msec; flip angle, 60°.

View larger version (143K): [in a new window]   Figure 1d. Regions localized during MR spectroscopic evaluation. (a) Coronal and (b) transverse T1-weighted scout images show the position chosen for the left basal ganglia (box). A similar location was chosen for the right basal ganglia (not shown). (c) Coronal and (d) sagittal T1-weighted scout images show the position chosen for the pons (box). Parameters for a-d are repetition time, 20 msec; echo time, 5 msec; flip angle, 60°.

View larger version (19K): [in a new window]   Figure 2. Representative 1H MR spectra (echo time, 272 msec) from the right basal ganglia of a Gulf War veteran with syndrome 2 (right) compared with that from a well control veteran of the same age (left). The areas under the three major peaks indicate the signal intensities (concentrations) of Cho, Cr, and NAA in the brain volume of interest. The model spectra (top), mathematically fit to the original spectra (bottom), are scaled to equal heights of the Cr peaks to facilitate comparison of the NAA/Cr and Cho/Cr ratios of the two subjects. The ill veteran (top right) has greatly reduced neuronal mass (NAA/Cr ratio) and glial mass (Cho/Cr ratio) compared with those ratios in the control subject (top left).

View larger version (40K): [in a new window]   Figure 3. Mean (± SEM) metabolite ratios in the basal ganglia and pons of veterans with Gulf War syndromes 1-3 (Syn 1-Syn 3) and a replication sample of veterans with syndrome 2 from an independent veteran population (Syn 2 R), compared with an age-sex-education-matched group of well veterans (Controls). The NAA/Cr ratios in the basal ganglia (upper left) are significantly lower than that in the control group for the Gulf War veteran sample with syndrome 2 and for the veterans of the replication sample with syndrome 2, and there is a similar, though nonsignificant, trend for those with syndrome 1. The NAA/Cr ratios in the pons (upper right) are significantly lower than that in the control group for the veterans with syndromes 2 and 3 and in the replication sample with syndrome 2, but not in those with syndrome 1. The Cho/Cr ratios in basal ganglia (lower left) are lower than that in the control group for syndrome 1 and the replication sample but not for syndromes 2 and 3. The Cho/Cr ratios in the pons (lower right) tended to be lower than that in the control group for all syndrome groups, but none was statistically significant. For the basal ganglia, the P value is for a difference from the control group in both left and right basal ganglia (group effect), controlling for hemisphere effect and the group-by-hemisphere interaction by repeated-measures ANOVA. For the pons, the P value came from a t test of the difference from the control group.