WASHINGTON, October 18, 2000 (GulfLINK) - Johns Hopkins University has been awarded a federal grant from the Department of Defense to investigate possible causes of illnesses experienced by some Gulf War veterans. This new research project is one of more than 190 federally funded research projects valued at nearly $175 million.

"The research projects are looking at the various exposures we know some Gulf War veterans experienced, such as smoke from oil well fires, pesticides, low-level nerve agent exposure for those around Khamisiyah in early March 1991, diesel fuel exhaust, various vaccines and medications, physical and emotional stress, not to mention different food and water," said Michael Kilpatrick, M.D., deputy director of medical outreach and issues in the Office of the Special Assistant for Gulf War Illnesses.

Despite all that has been done, Kilpatrick said there really is a need for more research, because past projects have not provided final answers on Gulf War vets' illnesses.

The study is being conducted by researchers at the Johns Hopkins University Hospital in Baltimore, Md.. The research team, led by Peter C. Rowe, M.D., a professor at the Johns Hopkins University School of Medicine, will investigate whether some Gulf War veterans who suffer from chronic fatigue might have a treatable medical condition.

Researchers will test for two medical conditions in Gulf War veterans - neurally mediated hypotension and postural tachycardia syndrome. Both conditions occur after periods of sitting or standing upright. Normally, in an upright or standing position, gravity causes blood to pool in the blood vessels of the abdomen, arms and legs. To allow a person to remain sitting or standing, the nervous system makes internal adjustments that keep a proper amount of blood flowing to the brain. When these adjustments are not effective, the result can be neurally mediated hypotension or postural tachycardia syndrome.

Symptoms vary from person to person, but can include fatigue, lightheadedness, headaches, nervousness, difficulty sleeping, muscle pain, trouble thinking, concentrating or remembering and a fast heart rate. If there is a further reduction in blood and oxygen flow to the brain, some people may feel faint or may faint. Several of these symptoms are similar to those experienced by Gulf War veterans.

The researchers want to know if these two conditions are unrecognized problems that might be causing the chronic fatigue symptoms some Gulf War veterans experience. They will compare three study groups of 47 individuals. The first group will be veterans who deployed to the Gulf War and who report symptoms which can include fatigue, lightheadedness, headaches, nervousness, difficulty sleeping, muscle pain, trouble thinking, concentrating or remembering or a fast heart rate.

The second group will include veterans who deployed to the Gulf War but are not experiencing any symptoms. The last group will include Gulf War-era veterans who were not deployed. Study participants will complete a series of questionnaires and undergo a physical exam and a tilt-table test where participants will be asked to lie on a table that is gradually tilted to 70 degrees, almost the angle of standing. Participants are then tested for either an abnormally increased heart rate or an abnormal drop in blood pressure. The entire visit will take approximately four to five hours.

Additionally, researchers are hoping to draw a link between possible exposures to environmental factors such as pesticides, vaccinations or infections Gulf War veterans may have experienced and neurally mediated hypotension or postural tachycardia syndrome. Researchers will also ask study participants about any family history of problems with regulating blood pressure to learn whether environmental factors or family history are associated with having neurally mediated hypotension or postural tachycardia syndrome.

The changes in heart rate and or blood pressure which lead to these symptoms cannot usually be found in a routine medical office visit. The symptoms are usually diagnosed by the tilt-table test.

The good news is that these conditions are treatable. Once patients have received the diagnosis, lifestyle adjustments and medications can help regulate blood pressure or heart rate. The study results will be provided to the participant's primary care physicians for follow-on treatment.

To be eligible for the study, participants must be no older than 50, and have served during the Gulf War at any time between August 1990 and July 1991. They must have persistent tiredness which is not explained by another illness, and which began during or after deployment to the Gulf War theater. They must also have other symptoms which began during or after that deployment, and which are not explained by another illness.

Study participants will need to provide the names, addresses and phone numbers of their first-degree relatives - biological parents, brothers, sisters and children 18 or older - for the family history portion of the study. Family members will be interviewed by telephone about their medical history.

Travel expenses will be paid to and from the Johns Hopkins Hospital for those interested in participating in the study. For participants who are not well enough to travel unaccompanied, expenses for a travel companion are also covered. Participants will be receive a $100 stipend. Active-duty servicemembers participating in the study will receive $50 per blood draw; only one blood draw per participant is anticipated. Each family member interviewed by telephone will also receive $25 for participation.

For more information and a application, call toll-free (877) 800-9516 or visit the study's website at www.med.jhu.edu/gws.