War Related Illness and Injury Study Center, Department of Veterans Affairs Washington, DC, United States of America; Department of Kinesiology, University of Maryland, College Park, MD, United States of America; Department of Psychology, Juniata College, Huntingdon, PA, United States of America.
War Related Illness and Injury Study Center, Department of Veterans Affairs Washington, DC, United States of America.
Life Sci. 2021 Sep 1;280:119663. doi: 10.1016/j.lfs.2021.119663. Epub 2021 Jun 2.
Gulf War Illness (GWI) is a chronic multisymptom illness affecting 250,000+ veterans of the '90-'91 Gulf War which remains under-explored in terms of its physiological characteristics. We investigated whether subjective GWI symptom severity scores were related to objective measures of autonomic nervous system activity.
We estimated activity in the two major branches of the autonomic nervous system (the parasympathetic nervous system [PNS] and the sympathetic nervous system [SNS]) via metrics of heart rate variability in a sample of Veterans who met established criteria for GWI with varying degrees of self-reported symptom severity. We hypothesized that subjective symptom severity scores would be inversely related to PNS activity and positively related to SNS activity.
Significant negative relationships were observed between the root mean square of successive differences of beat-to-beat intervals (a measure of PNS activity) and symptom severity, both overall and across specific GWI symptom categories (sp. fatigue [r = -0.574], gastrointestinal [r = -0.544]). Furthermore, significant positive relationships were observed between the cardiac sympathetic index and symptom severity, both overall and across specific symptom categories (sp. cognitive [r = 0.721], fatigue [r = 0.560], gastrointestinal [r = 0.694], skin [r = 0.686]).
Metrics of PNS activation revealed a negative relationship with self-reported symptom severity, while metrics of SNS activation revealed a positive relationship. The present results improve our understanding of the physiology of GWI and provide a new window from which to consider this medically unexplained illness.
海湾战争病（Gulf War Illness，GWI）是一种影响 25 万多名 90-91 年海湾战争退伍军人的慢性多症状疾病，其生理特征仍未得到充分探索。我们研究了主观 GWI 症状严重程度评分是否与自主神经系统活动的客观测量指标相关。
我们通过心率变异性的指标，评估了满足 GWI 既定标准且具有不同程度自我报告症状严重程度的退伍军人样本中自主神经系统的两个主要分支（副交感神经系统 [PNS] 和交感神经系统 [SNS]）的活动。我们假设主观症状严重程度评分与 PNS 活动呈负相关，与 SNS 活动呈正相关。
总体而言以及在特定 GWI 症状类别中（特殊疲劳 [r=-0.574]、胃肠道 [r=-0.544]），逐拍间差异的均方根（衡量 PNS 活动的指标）与症状严重程度之间观察到显著的负相关。此外，在整体和特定症状类别中（特殊认知 [r=0.721]、疲劳 [r=0.560]、胃肠道 [r=0.694]、皮肤 [r=0.686]），心脏交感指数与症状严重程度之间观察到显著的正相关。
PNS 激活的指标与自我报告的症状严重程度呈负相关，而 SNS 激活的指标与症状严重程度呈正相关。本研究结果提高了我们对 GWI 生理学的理解，并提供了一个新的视角来考虑这种医学上无法解释的疾病。
