(2013) Committee on Gulf War and Health Treatment for Chronic Multisymptom Illness, Washington (DC):

(2016) Committee on Gulf War and Health. Gulf War and Health: Update of Health Effects of Serving in the Gulf War Vol. 10:

Abdel-Rahman A, Abou-Donia S, El-Masry E, Shetty A, Abou-Donia M (2004) Stress and combined exposure to low doses of pyridostigmine bromide, DEET, and permethrin produce neurochemical and neuropathological alterations in cerebral cortex, hippocampus, and cerebellum. J Toxicol Environ Health A 67:163–192. https://doi.org/10.1080/15287390490264802

Article  CAS  PubMed  Google Scholar 

Abdullah L, Crynen G, Reed J, Bishop A, Phillips J, Ferguson S, Mouzon B, Mullan M, Mathura V, Mullan M et al (2011) Proteomic CNS profile of delayed cognitive impairment in mice exposed to Gulf War agents. Neuromolecular Med 13:275–288. https://doi.org/10.1007/s12017-011-8160-z

Article  CAS  PubMed  Google Scholar 

Abdullah L, Evans JE, Bishop A, Reed JM, Crynen G, Phillips J, Pelot R, Mullan MA, Ferro A, Mullan CM et al (2012) Lipidomic profiling of phosphocholine-containing brain lipids in mice with sensorimotor deficits and anxiety-like features after exposure to Gulf War agents. Neuromolecular Med 14:349–361. https://doi.org/10.1007/s12017-012-8192-z

Article  CAS  PubMed  Google Scholar 

Abou-Donia MB, Conboy LA, Kokkotou E, Jacobson E, Elmasry EM, Elkafrawy P, Neely M, Bass CR, Sullivan K (2017) Screening for novel central nervous system biomarkers in veterans with Gulf War Illness. Neurotoxicol Teratol 61:36–46. https://doi.org/10.1016/j.ntt.2017.03.002

Article  CAS  PubMed  Google Scholar 

Alshelh Z, Albrecht DS, Bergan C, Akeju O, Clauw DJ, Conboy L, Edwards RR, Kim M, Lee YC, Protsenko E et al (2020) In-vivo imaging of neuroinflammation in veterans with Gulf War illness. Brain Behav Immun 87:498–507. https://doi.org/10.1016/j.bbi.2020.01.020

Article  CAS  PubMed  PubMed Central  Google Scholar 

Amaraneni M, Pang J, Mortuza TB, Muralidhara S, Cummings BS, White CA, Vorhees CV, Zastre J, Bruckner JV (2017) Brain uptake of deltamethrin in rats as a function of plasma protein binding and blood-brain barrier maturation. Neurotoxicology 62:24–29. https://doi.org/10.1016/j.neuro.2017.04.009

Article  CAS  PubMed  Google Scholar 

Belgrad J, Dutta DJ, Bromley-Coolidge S, Kelly KA, Michalovicz LT, Sullivan KA, O’Callaghan JP, Fields RD (2019) Oligodendrocyte involvement in Gulf War Illness. Glia 67:2107–2124. https://doi.org/10.1002/glia.23668

Article  PubMed  PubMed Central  Google Scholar 

Brady RD, Grills BL, Church JE, Walsh NC, McDonald AC, Agoston DV, Sun M, O’Brien TJ, Shultz SR, McDonald SJ (2016) Closed head experimental traumatic brain injury increases size and bone volume of callus in mice with concomitant tibial fracture. Sci Rep 6:34491. https://doi.org/10.1038/srep34491

Article  CAS  PubMed  PubMed Central  Google Scholar 

Carpenter JM, Gordon HE, Ludwig HD, Wagner JJ, Harn DA, Norberg T, Filipov NM (2020) Neurochemical and neuroinflammatory perturbations in two Gulf War Illness models: Modulation by the immunotherapeutic LNFPIII. Neurotoxicology 77:40–50. https://doi.org/10.1016/j.neuro.2019.12.012

Article  CAS  PubMed  Google Scholar 

Carreras I, Aytan N, Mellott T, Choi JK, Lehar M, Crabtree L, Leite-Morris K, Jenkins BG, Blusztajn JK, Dedeoglu A (2018) Anxiety, neuroinflammation, cholinergic and GABAergic abnormalities are early markers of Gulf War illness in a mouse model of the disease. Brain Res 1681:34–43. https://doi.org/10.1016/j.brainres.2017.12.030

Article  CAS  PubMed  Google Scholar 

CDC (2022) TBI Data https://www.cdc.gov/traumaticbraininjury/data/index.html2022

Chao LL (2018) The relationship between traumatic brain injury and rates of chronic symptomatic illness in 202 Gulf war veterans. Mil Med. https://doi.org/10.1093/milmed/usy109

Article  PubMed  Google Scholar 

Chao LL, Abadjian L, Hlavin J, Meyerhoff DJ, Weiner MW (2011) Effects of low-level sarin and cyclosarin exposure and Gulf War Illness on brain structure and function: a study at 4T. Neurotoxicology 32:814–822. https://doi.org/10.1016/j.neuro.2011.06.006

Article  CAS  PubMed  Google Scholar 

Cheng CH, Alshelh Z, Guan Y, Sullivan K, Loggia ML, Koo BB (2021) Association of the tissue microstructural diffusivity and translocator protein PET in Gulf War Illness. Brain Behav Immun Health 18:100364. https://doi.org/10.1016/j.bbih.2021.100364

Article  CAS  PubMed  PubMed Central  Google Scholar 

Cheng CH, Koo BB, Calderazzo S, Quinn E, Aenlle K, Steele L, Klimas N, Krengel M, Janulewicz P, Toomey R et al (2020) Alterations in high-order diffusion imaging in veterans with Gulf War Illness is associated with chemical weapons exposure and mild traumatic brain injury. Brain Behav Immun 89:281–290. https://doi.org/10.1016/j.bbi.2020.07.006

Article  CAS  PubMed  PubMed Central  Google Scholar 

Christova P, James L, Carpenter A, Lewis S, Johnson R, Engdahl B, Georgopoulos AP (2020) C-reactive protein is associated with reduction of the volume of hippocampus and decreased fractional anisotropy of the fornix. J Neurol Neuromed. https://doi.org/10.29245/2572.942X/2020/3.1272

Article  Google Scholar 

Coughlin SS (2016) Need for studies of the health of gulf war women veterans. Mil Med 181:198. https://doi.org/10.7205/MILMED-D-15-00563

Article  PubMed  Google Scholar 

Dickey B, Madhu LN, Shetty AK (2021) Gulf war illness: mechanisms underlying brain dysfunction and promising therapeutic strategies. Pharmacol Ther 220:107716. https://doi.org/10.1016/j.pharmthera.2020.107716

Article  CAS  PubMed  Google Scholar 

Dursa EK, Barth SK, Schneiderman AI, Bossarte RM (2016) Physical and mental health status of gulf war and gulf era veterans: results from a large population-based epidemiological study. J Occup Environ Med 58:41–46. https://doi.org/10.1097/JOM.0000000000000627

Article  PubMed  Google Scholar 

DVBIC (2022) DOD Worldwide Numbers TBI http://dvbic.dcoe.mil/dod-worldwide-numbers-tbi

Emmerich T, Zakirova Z, Klimas N, Sullivan K, Shetty AK, Evans JE, Ait-Ghezala G, Laco GS, Hattiangady B, Shetty GA et al (2017) Phospholipid profiling of plasma from GW veterans and rodent models to identify potential biomarkers of Gulf War Illness. PLoS ONE 12:e0176634. https://doi.org/10.1371/journal.pone.0176634

Article  CAS  PubMed  PubMed Central  Google Scholar 

Martland H (1928) Punch drunk. JAMA 91:1103–1107

Article  Google Scholar 

Haley RW, Billecke S, La Du BN (1999) Association of low PON1 type Q (type A) arylesterase activity with neurologic symptom complexes in Gulf War veterans. Toxicol Appl Pharmacol 157:227–233. https://doi.org/10.1006/taap.1999.8703

Article  CAS  PubMed  Google Scholar 

Haley RW, Kramer G, Xiao J, Dever JA, Teiber JF (2022) Evaluation of a gene-environment interaction of PON1 and low-level nerve agent exposure with gulf war illness: a prevalence case-control study drawn from the US military health survey’s national population sample. Environ Health Perspect 130:57001. https://doi.org/10.1289/EHP9009

Article  PubMed  Google Scholar 

Hay J, Johnson VE, Smith DH, Stewart W (2016) Chronic traumatic encephalopathy: the neuropathological legacy of traumatic brain injury. Annu Rev Pathol 11:21–45. https://doi.org/10.1146/annurev-pathol-012615-044116

Article  CAS  PubMed  PubMed Central  Google Scholar 

Hay JR, Johnson VE, Young AM, Smith DH, Stewart W (2015) Blood-brain barrier disruption is an early event that may persist for many years after traumatic brain injury in humans. J Neuropathol Exp Neurol 74:1147–1157. https://doi.org/10.1097/NEN.0000000000000261

Article  CAS  PubMed  Google Scholar 

Heboyan V, Krengel MH, Sullivan K, Iobst S, Klimas N, Wilson C, Coughlin SS (2019) Sex differences in gulf war illness: a reanalysis of data from the CDC air force study using CDC and modified kansas case definitions. J Occup Environ Med 61:610–616. https://doi.org/10.1097/JOM.0000000000001620

Article  PubMed  Google Scholar 

Hilborne LH, Golomb BA, Marshall GN, Davis LM, Sherbourne CD, Augerson W, Spektor DM, Harley N, Foulkes E, Hudson A, Anthony CR, Cecchine G, Marlowe DH, Rettig RA, Fricker RD, Reardon E, Cotton SK, Hawes-Dawson J, Pace JE, Hosek SD (2005) Examining possible causes of gulf war illness: RAND policy investigations and reviews of the scientific literature. Santa Monica, CA: RAND Corporation. https://doi.org/10.7249/RB7544

Howard JT, Stewart IJ, Amuan M, Janak JC, Pugh MJ (2022) Association of traumatic brain injury with mortality among military veterans serving after September 11, 2001. JAMA Netw Open 5:e2148150. https://doi.org/10.1001/jamanetworkopen.2021.48150

Article  PubMed  PubMed Central  Google Scholar 

Janulewicz P, Krengel M, Quinn E, Heeren T, Toomey R, Killiany R, Zundel C, Ajama J, O’Callaghan J, Steele L et al (2018) The multiple hit hypothesis for gulf war illness: self-reported chemical/biological weapons exposure and mild traumatic brain injury. Brain Sci. https://doi.org/10.3390/brainsci8110198

Article  PubMed  PubMed Central  Google Scholar 

Johnson VE, Stewart JE, Begbie FD, Trojanowski JQ, Smith DH, Stewart W (2013) Inflammation and white matter degeneration persist for years after a single traumatic brain injury. Brain 136:28–42. https://doi.org/10.1093/brain/aws322

Article  PubMed  PubMed Central  Google Scholar 

Joshi U, Evans JE, Joseph R, Emmerich T, Saltiel N, Lungmus C, Oberlin S, Langlois H, Ojo J, Mouzon B et al (2018) Oleoylethanolamide treatment reduces neurobehavioral deficits and brain pathology in a mouse model of Gulf War Illness. Sci Rep 8:12921. https://doi.org/10.1038/s41598-018-31242-7

Article  CAS  PubMed  PubMed Central  Google Scholar 

Joshi U, Pearson A, Evans JE, Langlois H, Saltiel N, Ojo J, Klimas N, Sullivan K, Keegan AP, Oberlin S et al (2019) A permethrin metabolite is associated with adaptive immune responses in Gulf War Illness. Brain Behav Immun 81:545–559. https://doi.org/10.1016/j.bbi.2019.07.015

Article  CAS  PubMed  PubMed Central  Google Scholar 

Kals M, Kunzmann K, Parodi L, Radmanesh F, Wilson L, Izzy S, Anderson CD, Puccio AM, Okonkwo DO, Temkin N et al (2022) A genome-wide association study of outcome from traumatic brain injury. EBioMedicine 77:103933. https://doi.org/10.1016/j.ebiom.2022.103933

Article  CAS  PubMed  PubMed Central  Google Scholar 

Koo BB, Michalovicz LT, Calderazzo S, Kelly KA, Sullivan K, Killiany RJ, O’Callaghan J