Intranasal Insulin: A Novel Treatment for Gulf War Multisymptom Illness.

摘要

Following their deployment to the 1991 Gulf War, many veterans (GWV) reported a constellation of unexplained health symptoms; common among them were attention and memory difficulties, fatigue, joint pain, headaches, gastrointestinal complaints, and mood and sleep problems (Proctor et al., 1998; Sullivan et al., 2003). Despite the passage of time, the symptom complex persists for many veterans. Indeed, it is estimated that at least 25 percent of GWV (nearly 170,000 veterans) have a persistent form of chronic multisymptom illness (CMI) (Kang et al., 2009; Gulf War Research Advisory Committee (RAC), 2008; IOM, 2010). GW deployed veterans are also developing significantly more chronic diseases such as diabetes, hypertension, arthritis, and coronary heart disease than their non-deployed veteran peers (Toomey et al., 2009; Chao et al., 2010; Chao et al., 2011; Li et al., 2011) putting these individuals at risk for accelerated aging-related diseases of the peripheral and central nervous system (CNS). Over the years it has been found that cognitive complaints have been particularly troublesome to GWV. Recent studies have shown a slowing of response speed that affects mental flexibility across multiple cognitive domains (memory, attention, visuospatial functions) especially on tests that were timed and computerized and where small differences in cognitive reaction times could be measured (Anger et al., 1999; RAC, 2008; Krengel and Sullivan, 2008; Toomey et al., 2009; Chao et al., 2011). Recent studies also have suggested that the response inhibition deficits shown in GWV may reflect executive system dysfunction (Tillman et al., 2010) as reflected by slower motor responses across multiple cognitive domains (RAC, 2008). To date, there are no treatments that have been shown to substantially improve cognitive impairments or health symptoms of GWVs. Thus, it is of paramount importance to identify effective, safe, and tolerable treatments for Gulf War CMI.