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Acetylcholinesterase Activity in Veterans of the First Gulf War
  1. John Concato,
  2. Mihaela Aslan,
  3. Margaret M. Palmisano,
  4. Caroline Carney Doebbeling,
  5. Peter Peduzzi,
  6. Keren Ofek,
  7. Hermona Soreq,
  8. Bradley Doebbeling
  1. From the Clinical Epidemiology Research Center (J.C., M.A., M.M.P.) and Cooperative Studies Program Coordinating Center (P.P.), VA Cooperative Studies Program, VA Connecticut Healthcare System, West Haven, CT; Yale University School of Medicine (J.C., M.A., P.P.), New Haven, CT; The Hebrew University of Jerusalem (K.O., H.S.), Jerusalem, Israel; the Health Services Research and Development Center on Implementing Evidence-Based Practice, Richard L. Roudebush VA Medical Center (B.D.), Indianapolis, IN; the Center for Health Services and Outcomes Research, Regenstrief Institute, Inc. (C.C.D., B.D.), Indianapolis, IN; and Indiana University School of Medicine (C.C.D., B.D.), Indianapolis, IN.
  1. This work was supported by the VA Cooperative Studies Program (CSP#520), the Department of Defense (DAMD17-97-1), and a Centers for Disease Control and Prevention Cooperative Agreement (U50/CCU711513).
  2. Data were collected and analyzed in the University of Iowa General Clinical Research Center, supported by grant M01-RR-59, National Center for Research Resources, General Clinical Research Centers Program, National Institutes of Health, and The Hebrew University of Jerusalem (Edmond G. Safra Campus), Givat-Ram, Jerusalem, Israel.
  3. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.
  4. Address correspondence to: Dr. John Concato, VA Connecticut Healthcare System, Clinical Epidemiology Research Center 151B, 950 Campbell Avenue, West Haven, CT 06516; e-mail: john.concato{at}


Background Factors affecting acetylcholine-mediated neurotransmission have been proposed as possible explanations for physical and mental health symptoms among veterans of the 1990-1991 Gulf War. This study was designed to examine relationships of deployment to the Gulf, as well as symptoms after military service, with postdeployment activity of acetylcholinesterase (AChE) and related enzymes.

Methods The patient population included 488 veterans, originally from Iowa at enlistment, who served in the US military during August 1990 to July 1991. Demographic, military, and clinical characteristics were obtained from a population-based cohort study (in 1995-1996) and from a nested case-control study (in 1999-2002). Stored serum samples (from the 1999-2002 assessment) were analyzed for activity of AChE and related enzymes. These two data sources were merged, and multiple linear regression models estimated the association of deployment, stress (anxiety) or mood disorders, and symptoms compatible with Gulf War veterans' illnesses (GWVIs), with enzyme activity.

Results Seventy-four percent (n = 361) of veterans had been deployed to the Gulf. At the time of evaluation, 23% (n = 113) of participants reported anxiety and 15% (n = 71) reported mood disorders; 49% (n = 171 of 347 eligible veterans) had symptoms of GWVIs, and the median AChE activity was 839 units. AChE activity was similar for compared groups across all categories, including an adjusted difference of −27 units (p = .50) for deployed versus nondeployed veterans and 87 units (p = .13) for veterans with versus without symptoms of GWVIs.

Conclusions Neither deployment to the Gulf nor symptoms compatible with GWVIs are associated with long-term serum AChE activity.

Key words
  • acetylcholinesterase
  • Persian Gulf War
  • neural pathways
  • stress
  • symptoms
  • veterans

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