Physiologic Effects of Stress in Gulf War Syndrome

摘要

Several expert panels have concluded that the constellation of overlapping symptoms characterizing POWI is not due to a single illness or cause. Rather, physical, emotional, and immune stressors are capable of causing these types of non-specific symptoms. The pattern of biological responses from these stressors depends on both properties of the stressor, as well as characteristics of the host. The major components of the stress response include the autonomic nervous system and the hypothalamic pituitary adrenal (HPA) axis,. Alterations of these systems from normal function have been identified in a number of conditions similar to PGWI such as chronic fatigue syndrome (CFS) and fibromyalgia (FM). In this project we have been intensively studying the activity of the biological stress response in individuals with PGWI, to determine if such persons display the same blunting of the stress response noted in FM and CFS. Parts of this project have been incorporated into a newer, more expansive project comparing physiologic alterations in several illnesses presenting with poorly defined, multisystem symptoms. A multidisciplinary team of investigators with established expertise in FM and CFS, and the measurements of neuroendocrine and autonomic function. In the current project a major finding has been in the area of pain response to physical stimuli. We found that stimulation with adequate pressure to cause similar pain in control and FM subjects resulted in 19 regions of increased regional cerebral blood flow in healthy controls and 12 significant regions in FM subjects. Since pain is one of the hallmark symptoms of FM, these data, along with other data collected, strongly suggests an augmentation of pain sensitivity in patients with FM that may be related to alterations in HPA and autonomic function. These studies are significantly expanded in the new project.