Toomey Rosemary, Alpern Renee, Vasterling Jennifer J, Baker Dewleen G, Reda Domenic J, Lyons Michael J, Henderson William G, Kang Han K, Eisen Seth A, Murphy Frances M
Research Service, Boston VA Healthcare System, Boston, Massachusetts, USA.
J Int Neuropsychol Soc. 2009 Sep;15(5):717-29. doi: 10.1017/S1355617709990294. Epub 2009 Jul 29.
Many U.S. Gulf War-era veterans complained of poor cognition following the war. This study assessed neuropsychological functioning in veterans 10 years after the war through objective tests. 2189 Gulf War-era veterans (1061 deployed, 1128 non-deployed) were examined at 1 of 16 U.S. Veterans Affairs medical centers. Outcomes included neuropsychological domains derived from factor analysis and individual test scores. Deployed veterans performed significantly worse than non-deployed veterans on 2 of 8 factors (motor speed & sustained attention, analysis not corrected for multiple comparisons) and on 4 of 27 individual test variables (Trails A & B, California Verbal Learning Test-List B, and Continuous Performance Test sensitivity, with only Trails B surviving Bonferroni correction). Within deployed veterans, Khamisiyah exposure was negatively correlated with motor speed after controlling for emotional distress. Depressive symptoms and self-reported exposure to toxicants were independently and significantly associated with worse sustained attention. Other factors were also associated with self-reported exposures. The findings were not a result of differential effort across groups. Gulf War deployment is associated with subtle declines of motor speed and sustained attention, despite overall intact neuropsychological functioning. Evidence suggests that toxicant exposures influence both these functions, and depressive symptoms also influence attention.
许多海湾战争时期的美国退伍军人战后抱怨认知能力不佳。本研究通过客观测试评估了战后10年退伍军人的神经心理功能。在美国16个退伍军人事务医疗中心中的1个对2189名海湾战争时期的退伍军人(1061名参战,1128名未参战)进行了检查。结果包括通过因素分析得出的神经心理领域和个体测试分数。在8个因素中的2个因素上(运动速度和持续注意力,分析未针对多重比较进行校正),以及在27个个体测试变量中的4个变量上(连线测验A和B、加利福尼亚言语学习测验列表B以及连续操作测验敏感性,只有连线测验B在Bonferroni校正后仍具有统计学意义),参战退伍军人的表现明显比未参战退伍军人差。在参战退伍军人中,排除情绪困扰因素后,暴露于Khamisiyah与运动速度呈负相关。抑郁症状和自我报告的接触有毒物质情况与较差的持续注意力独立且显著相关。其他因素也与自我报告的接触情况有关。这些发现不是由于不同组之间努力程度的差异所致。尽管总体神经心理功能完好,但海湾战争参战经历与运动速度和持续注意力出现细微下降有关。有证据表明,接触有毒物质会影响这两种功能,抑郁症状也会影响注意力。