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Protocol Details

NIH Investigative Deep Phenotyping Study of Gulf War Veteran Health (Project NIH IN-DEPTH)

This study is currently recruiting participants.

Summary | Eligibility | Citations | Contacts

Summary

Number

000051-N

Sponsoring Institute

National Institute of Neurological Disorders and Stroke (NINDS)

Recruitment Detail

Type: Participants currently recruited/enrolled
Gender: Male & Female
Min Age: 48 Years
Max Age: 70 Years

Referral Letter Required

Yes

Population Exclusion(s)

Pregnant Women;
Non-English Speaking;
Adults who are or may become unable to consent;
Children

Keywords

Veteran;
Gwi (Gulf War Illness);
Natural History

Recruitment Keyword(s)

None

Condition(s)

Gulf War Illness

Investigational Drug(s)

None

Investigational Device(s)

None

Intervention(s)

None

Supporting Site

National Institute of Neurological Disorders and Stroke

Background:

Gulf War illness (GWI) affects up to 210,000 U.S. veterans who served in the Middle East during the Gulf War in 1990-1991. Symptoms include fatigue, muscle and joint pain, forgetfulness, headaches, rashes, and sleep disturbances. Routine exams cannot determine the cause of GWI. Researchers need more information to understand this disease.

Objective:

This natural history study will look for differences in Gulf War veterans who experienced GWI and those who did not.

Eligibility:

Gulf War veterans with GWI. Healthy Gulf War veterans who do not have GWI are also needed.

Design:

Participants will stay in the NIH Clinical Center as an inpatient for 2 weeks. They will undergo many tests.

Blood will be drawn many times throughout the study. Participants will also give urine, saliva, and stool samples.

Scans to measure the brain, leg muscles, bone density and body mass will be done.

They will have an exercise stress test and muscle strength tests.

They will have a sleep study. They will have tests to look at how well the brain, heart and lungs are working.

Participants will sleep in a specialized room that measures the amount of oxygen they use and the carbon dioxide they produce on four consecutive nights.

A sample of fluid will be collected from inside the spine.

Participants will take many surveys. Some will ask about their activities. Some will be about emotional and mental health. Some will be about thinking, memory, and behavior.

Optional tests include other imaging scans and testing the autonomic nervous system. Samples of skin and muscle may be taken.

After discharge, participants will wear activity monitors for 14 days. They will keep a diary of their symptoms, including fatigue, pain, and sleep, while wearing the monitors.

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Eligibility

INCLUSION CRITERIA:

Inclusion criteria for all veterans:

- Ability to provide informed consent

- Stated willingness to comply with all study procedures and availability for the duration of the study

- Age 48-70 at time of enrollment into VA IN-DEPTH Study

- Veterans who were deployed to Gulf Region ODS/S between August 1990 - June 1991.

- Self-reported completion of at least the seventh grade of school.

- Fluency in speaking, reading, and understanding English.

- Underwent screening as part of the VA IN-DEPTH study and were unanimously determined to be eligible by the IN-DEPTH Adjudication Committee.

- Agree not to smoke in the 4 hours prior to CPET procedure

EXCLUSION CRITERIA:

Exclusion criteria for all veterans:

- Current or past psychotic disorder including depression with psychosis, bipolar disorder with psychotic symptoms and schizophrenia

- Current DSM-5-defined major depression disorder, generalized anxiety disorder, posttraumatic stress disorder, panic disorder, or obsessive-compulsive disorder unless managed for more than six months with a stable treatment regimen

- Current or past substance use disorder within last five years as diagnosed on the Structured Clinical Interview for DSM-5 (SCID-5). Prior or prescription marijuana use within the past five years will not be an exclusion.

- Current suicidal ideation

- History of head injury leading to moderate or severe traumatic brain injury, as detailed by loss of consciousness for greater than 30 minutes, a Glasgow Coma Score of 12 or less at the time of injury, post-traumatic amnesia greater than one day, or brain-scan changes related to a head injury. Persons having a history of mild TBI (mTBI) will not be excluded.

- Women who are pregnant, breastfeeding, or are within one-year post-partum.

- Current or previous malignancy. A history of malignancy that has fully resolved with surgical resection only (e.g. no chemotherapy, radiation therapy, or immunotherapy) will be allowed.

- Current systemic immunologic disorders (e.g. Type 1 diabetes, rheumatoid arthritis). Local immunological disorder (e.g. atopic dermatitis, stable autoimmune thyroid disease) and allergic disorders will be allowed.

- Current or previous long-term immune suppressive therapy. Systemic steroid use, even short-term, must not have been used within the month prior to enrollment

- Any medical condition that would make the study procedures risky for the participant (e.g. congestive heart failure, coronary artery disease, chronic obstructive pulmonary disease, severe osteoarthritis, exercise-induced angina and poorly controlled asthma).

- Active participation in a clinical protocol (e.g. anti-inflammatory drug intervention study) which includes an intervention that may affect the results of the current study.

- Inability to perform the bicycling exercise task. (e.g. coronary artery disease, not having a lower limb, disabling stroke)

- Not willing to allow for research data and samples to be shared broadly with other researchers.

- Symptom severity that makes it impossible for the volunteer to travel to NIH for extended inpatient evaluation

- Use of medications with a high-risk for withdrawal-related complications (i.e. long-acting opiates or benzodiazepines).

Additional Exclusion criteria for participants undergoing TMS:

- Pacemaker, implanted pump, stimulator, cochlear implant or metal objects inside the eye or skull.

Participants with unconfirmed metal may have further evaluation to rule out metal in the eye or skull.

Participants without metal after evaluation may proceed to TMS.

- A personal history of seizure disorder

Additional Exclusion criteria for participants undergoing MRI:

- Metal in the body which would make having an MRI scan unsafe, such as pacemakers, stimulators, pumps, aneurysm clips, metallic prostheses, artificial heart valves, cochlear implants or shrapnel fragments, or having a history of being a welder or metal worker, since small metal fragments may be in the eye. Participants with unconfirmed metal may have further evaluation to rule out metal in the eye

or skull. Participants without metal after evaluation may proceed to MRI.

- Substantial claustrophobia

- Inability to lie on back for up to 2 hours

Additional Exclusion criteria for Healthy Veteran Controls:

- Meets modified Kansas criteria for GWI.


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Citations:

Not Provided

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Contacts:

Principal Investigator

Referral Contact

For more information:

Brian T. Walitt, M.D.
National Institute of Neurological Disorders and Stroke (NINDS)
NIHBC 10 - CLINICAL CENTER BG RM 3B19
10 CENTER DR
BETHESDA MD 20892
(301) 496-5043
brian.walitt@nih.gov

Angelique Gavin
National Institute of Neurological Disorders and Stroke (NINDS)
National Institutes of Health
Building 10
Room 3B-19
10 Center Drive
Bethesda, Maryland 20892
(301) 402-0880
angelique.gavin@nih.gov

Office of Patient Recruitment
National Institutes of Health Clinical Center (CC)
Building 61, 10 Cloister Court
Bethesda, Maryland 20892
Toll Free: 1-800-411-1222
Local Phone: 301-451-4383
TTY: TTY Users Dial 7-1-1
ccopr@nih.gov

Clinical Trials Number:

NCT05375812

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