Twenty-five years after 700,000 U.S. troops fought and won the first Gulf War with remarkably low casualties, research "clearly and consistently" shows that exposure to pesticides and other toxins caused Gulf War Illness, a complex and debilitating disorder that affects as many as 250,000 of those deployed, according to a new report led by a Boston University School of Public Health (BUSPH) researcher.

In a special issue of the journal Cortex that coincides with the 25th anniversary of the war, Roberta White, professor of environmental health at BUSPH, and colleagues from a dozen other institutions comprehensively review studies on Gulf War Illness (GWI), especially those since 2008. They conclude that exposure to pesticides and ingestion of pyridostigmine bromide (PB) - prophylactic pills intended to protect troops against the effects of possible nerve gas - are "causally associated with GWI and the neurological dysfunction in Gulf War veterans."

The research team also cites multiple studies showing a link between veterans' neurological problems and exposure to the nerve-gas agents sarin and cyclosarin, as well as to oil well fire emissions. These "toxic wounds" resulted in damage to veterans' nervous systems and immune systems, including neuroendocrine and immune dysregulation, autonomic nervous system irregularities, and reduced white and gray matter in veterans' brains, the review says.

White and colleagues have been studying the health of troops deployed in the 1991 Gulf War for more than 20 years to determine why so many of them suffer from a multi-system disorder characterized by fatigue, joint and muscle pain, headaches, concentration and memory problems, gastrointestinal distress, and skin rashes. They note that effective treatments for the illness have been elusive, but that a recent treatment research effort has begun to produce promising leads.

"Further research into the mechanisms and etiology of the health problems of (Gulf War) veterans is critical to developing biomarkers of exposure and illness, and preventing similar problems for military personnel in future deployments. This information is also critical for developing new treatments for GWI and related neurological dysfunction," they write.