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ORIGINAL CONTRIBUTION Cholinergic Autonomic Dysfunction in Veterans With Gulf War Illness Confirmation in a Population-Based Sample Robert W. Haley, MD; Elizabeth Charuvastra, RN†; William E. Shell, MD; David M. Buhner, MD; W. Wesley Marshall, MD; Melanie M. Biggs, PhD; Steve C. Hopkins, BS; Gil I. Wolfe, MD; Steven Vernino, MD, PhD Background: The authors of prior small studies raised the Results: The Autonomic Symptom Profile scales were sig- hypothesis that symptoms in veterans of the 1991 Gulf War, nificantly elevated in all 3 syndrome groups (P .001), pri- such as chronic diarrhea, dizziness, fatigue, and sexual dys- marily due to elevation of the orthostatic intolerance, sec- function, are due to cholinergic autonomic dysfunction. retomotor, upper gastrointestinal dysmotility, sleep dysfunction, urinary, and autonomic diarrhea symptom do- Objective: To perform a confirmatory test of this prestated mains. The Composite Autonomic Severity Score was also hypothesis in a larger, representative sample of Gulf War higher in the 3 syndrome groups (P = .045), especially in veterans. syndrome 2, primarily due to a significant reduction in su- domotor function as measured by the Quantitative Sudo- Design: Nested case-control study. motor Axon Reflex Test, most significantly in the foot; the score was intermediate in
JAMA Neurology – American Medical Association
Published: Feb 1, 2013
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