This process is defined as an amplification of responsiveness of central pain-signaling neurons that clinically manifest as hyperalgesia and/or allodynia ( Latremoliere and Woolf, 2009). One mechanism that has been proposed to drive the complaints of GWI and related illnesses is central sensitization ( Latremoliere and Woolf, 2009 Baraniuk and Zheng, 2010). The exact relationships between headache subtypes, fatigue, pain, hyperalgesia, and other systemic complaints has been difficult to establish because of heterogeneous symptom presentation and/or lack of biomarkers that identify a distinct pathophysiological process in GWI. Studies in FM have reported similar migraine predominance ( de Tommaso et al., 2011). We recently determined that migraines are the primary type type of headaches in CFS ( Ravindran et al., 2011). However, the type and severity of headaches are not evaluated as a part of the GWI, CFS, or FM case designation criteria ( Wolfe et al., 1990 Fukuda et al., 1994, 1998 RAC-GWVI, 2008 Wolfe et al., 2010 Ravindran et al., 2011). Complaints of headaches are also reported in Gulf War veterans and over 50% of FM patients ( Gray et al., 2002 de Tommaso et al., 2011 Li et al., 2011). Headache is one of the eight ancillary criteria in the CFS case definition ( Fukuda et al., 1994 Baraniuk and Zheng, 2010 Ravindran et al., 2011). Gulf War veterans often meet the criteria for chronic fatigue syndrome (CFS) ( Fukuda et al., 1994) and fibromyalgia (FM) strongly suggesting overlap in symptoms for GWI and CFS ( Wolfe et al., 1990 Peres et al., 2002 Latremoliere and Woolf, 2009 Baraniuk and Zheng, 2010 Wolfe et al., 2010 Ravindran et al., 2011 de Tommaso et al., 2011). Veterans with GWI suffer from a wide array of symptoms that include headaches, cognitive dysfunction, chronic pain, fatigue, and other complaints ( Fukuda et al., 1998 Gray et al., 2002 Li et al., 2011). Gulf War Illness (GWI), also known as Chronic Multisymptom Illness (CMI), affects 25–30% of the 697,000 veterans deployed to the 1990–1991 Persian Gulf War ( Fukuda et al., 1998 Gray et al., 2002 RAC-GWVI, 2008 Li et al., 2011). The high migraine prevalence warrants the inclusion of a structured headache evaluation in GWI and CFS subjects, and treatment when present. GWI and CFS may share dysfunctional central pathophysiological pathways that contribute to migraine and subjective symptoms. Measures of fatigue, pain, and other ancillary criteria were comparable between GWI and CFS subjects with and without headache.Ĭonclusion: The high prevalence of migraine in CFS was confirmed and extended to GWI subjects. However, migraine status was independent of gender in GWI and CFS groups ( x 2 = 2.7 P = 0.101). There was a predominance of females in the CFS compared to GWI and controls. Results: Migraines were detected in 64% of GWI (odds ratio = 11.6 ) (mean ) and 82% of CFS subjects (odds ratio = 22.5 ) compared to only 13% of controls.
All subjects had history and physical examinations, fatigue and symptom related questionnaires, measurements of systemic hyperalgesia (dolorimetry), and assessments for exclusionary conditions. Methods: 50 GWI, 39 CFS and 45 controls had structured headache evaluations based on the 2004 International Headache Society criteria. The type and prevalence of headaches in GWI have not been adequately assessed. Symptoms of GWI and CFS have considerable overlap, including headache complaints. Objective: To assess the prevalence of headache subtypes in Gulf War Illness (GWI) and Chronic Fatigue Syndrome (CFS) compared to controls.īackground: Approximately, 25% of the military personnel who served in the 1990–1991 Persian Gulf War have developed GWI.
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