Do ‘Havana Syndrome’ and Gulf War Illness Share Neuroinflammation as a Common Disease Mechanism?
This question was presented two weeks ago in poster format at the annual European Academy of Neurology conference in Vienna, Austria. The title can be cited as: Roesel T. Do “Havana Syndrome” and Gulf War Illness Share Neuroinflammation as a Common Disease Mechanism? European Journal of Neurology 2022. 29 (Supplement 1): 870.
The abstract reads:
Introduction
Multiple neurological symptoms reported by North Americans following deployment exposures characterize Gulf War Illness (GWI) and “Havana Syndrome” (HS). MRI-detected brain structural alterations are present in both but with disparities. Integrated PET/MRI scans, using the radiolabel 11C-PBR28 (peripheral-type benzodiazepine receptor), detects neuroinflammation by binding to upregulated translocator proteins (TSPO) in activated astrocytes and microglia. Significant neuroinflammation in the precuneus (PC), dorsolateral prefrontal (dlPFC) and middle anterior cingulate cortex (mACC) areas was so demonstrated in 15 GWI veterans (Alshelh, et al., Brain Behav Immun, 2020). Since neuroinflammation has yet to be documented for HS, the feasibility of a PET/MRI TSPO study is determined herein.
Methods
Adjusted standard uptake volume ratio (SUVR) values for the 25 normal controls referenced above was provided by Dr. Alshelh. Sample size calculations to achieve t-tests with powers greater than 0.8 were performed to assess feasibility. Constraints were Type I error of 0.05 and a patient-control allocation of 1:1. Subtraction of the SUVR control means from the SUVR GWI means for the PC, dlPFC, and mACC areas, derived the clinically significant SUVR delta values of 0.050, 0.048, and 0.054, respectively.
Results
Twenty-two HS patients and 22 normal controls suffice to construct a TSPO neuroinflammation study with adequate power.
Conclusion
An HS TPSO integrated PET/MRI study of 44 subjects is feasible. If HS neuroinflammation is revealed, new insights can be attained into HS pathophysiology and its potential etiology. Furthermore, preventive or treatment measures for one illness may apply to the other.
Addendum: A thank you goes out to Dr. Alshelh for sharing the adjusted standard uptake volume ratios acquired from the 25 normal civilian controls. These were published in the Brain, Behavior, and Immunity article referenced above. These values made the statistical calculations possible. The 25 normal civilian controls without military service history are thanked as well for their participation in a study that benefits previously deployed service members. Dr. Alshelh’s work can also be seen in a You Tube video summary at: https://www.youtube.com/watch?v=eOiFoKD8j_E
A recent article in the Journal of Clinical Epidemiology referenced in Nature (Many researchers say they’ll share data — but don’t (nature.com)) reminds us that few authors (7%) actually respond to data requests, so additional thanks to Dr. Alshelh is in order!
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