Gulf War Illness (GWI) is a chronic multi-symptom illness that is defined by a cluster of medically unexplained and chronic problems. Current treatment options have focused on treating the symptoms and not the underlying causes, which are still poorly understood.

Symptoms of GWI may include:

• Fatigue
• Headaches
• Memory or cognitive difficulties
• Joint & muscle pain
• Poor sleep
• Gastrointestinal & respiratory problems

Past GWI research has paved the way for this new collaboration. VA has been conducting research on Gulf War Veterans since the mid 1990s, leading to insights on possible causes of GWI and treatments to address symptoms and improve quality of life. However, there are more questions that need answers.

Project IN-DEPTH utilizes the Gulf War Illness Common Data Elements (recommendations of GWI research allowing for standardization of data) to guide its study methods.

To learn more about VA Gulf War research, click here and here.

This project involves two separate studies — VA IN-DEPTH and NIH IN-DEPTH, which work together towards the common goal of learning more about GWI.

VA IN-DEPTH focuses on GW Veteran recruitment and experience as well as establishing and maintaining a data repository. The VA IN-DEPTH study aims to identify 75 Gulf War Veterans (50 with GWI, 25 healthy controls), evaluating them remotely to collect data on illness severity, domains of illness, biological samples, and impact on function. VA IN-DEPTH will involve:

• Remote national recruitment and screening
• Tiered screening strategy to allow for multiple checkpoints and evaluations of Veteran data throughout the study
• Follow-up care and a study reunion to share results with study participants
• Secured access Data and Specimen Repository for research, potentially leading to the development of better therapeutic interventions.

NIH IN-DEPTH focuses on enrolling eligible GW Veterans for a 14-day in-person stay at the NIH Clinical Center in Bethesda, MD for deep phenotyping. During this visit, the NIH research team will evaluate many body systems including cardiac, pulmonary, neurological, and metabolic function through:

• Medical exams
• Blood work
• Stationary bike exercise testing
• Neuropsychological testing
• Medical imaging (ex. MRI)

NIH Clinical Center has the expertise and resources to look at multiple body systems affected by Gulf War Illness and how these systems operate functionally and structurally at rest as well as when the body is placed under stressors. Additional study measures will be done at home, such as wearing an activity monitor and completing a diary of activity and responses.

Phenotype refers to a person's observable traits, or how an illness presents itself that can be measured or observed. Deep Phenotyping is a method to describe the health or illness of a person by looking at how different parts of their body function and interact with one another.

During the IN-DEPTH Study, comprehensive testing will be done during a 14-day hospital admission at the NIH Clinical Center to look at multiple body systems affected by Gulf War Illness and how these systems operate functionally and structurally at rest as well as when the body is placed under stressors. Additional study measures will be done at home, such as wearing an activity monitor and completing an activity diary.

Click here to learn more about Deep Phenotyping.

Study participants must:

• Have been deployed to the Persian Gulf (August 1990 to June 1991)
• Be 48-70 years of age
• Have access to a doctor
• Be willing to take part in a 14-day inpatient overnight stay at the National Institutes of Health (NIH) in Bethesda, MD. Travel and lodging at no cost to participants.

The VA IN-DEPTH study will guide eligible Veterans through a series of steps:

• Phone interviews
• Online Surveys
• In-home blood draw & vitals
• Psychological screenings
• Clinical & qualitative interviews
• Storing your data & specimens

A repository is a central location that receives, stores, and disseminates specimens (Biorepository) or data (Data Repository) to other scientists. The VA IN-DEPTH study will establish and maintain these data and biospecimen repositories.

These repositories allow other scientists to use the data and specimens collected from Project IN-DEPTH to answer further scientific questions and to develop future treatments for GWI. Other researchers also can use and learn from this data.

To protect study data, no names will appear in the repository - only deidentified (not connected to your name) or coded data (uses a study ID number) goes into the repositories. Scientists who want to use and learn from these data will have to apply to have access.

After completing Project IN-DEPTH, Veterans will have the opportunity to participate in follow up-care. Veterans can:

• Schedule a telehealth consultation with the study team and their primary care physician to discuss clinically relevant research findings.
• Request a summary note be added to their medical record.
• Complete a satisfaction survey about their experience with the study.

Following the completion of the study, a reunion will be held for the study teams and participants to share data results and overall Veteran experiences.

There is no cost to participate in the study. Travel and lodging will be provided for each participant.

Yes, participants will also be compensated for completed research-related activities. If needed, NIH will cover travel expenses to and from the Clinical Center within the United States.

For more information about project IN-DEPTH please email us.