Studies using nonspecific definitions of Gulf War neurological syndrome are biased toward finding negative results. Early in the history of Gulf War illness research, around 1993, a decision was made in the government to the effect that ‘there is no Gulf War syndrome’, and this led to pressure on researchers who wanted government funding not to use a case definition of the illness in their research. Without at least a provisional case definition, however, it is virtually impossible to design studies that will elucidate the nature of the illness, or illnesses, and connect them with causes.
“The most important example of the unproductive use of a nonspecific case definition concocted was the series of studies from the Kings College London group. In place of a case definition describing the disease that veterans were complaining of, they defined Gulf War illness as having a score of greater than 72.2 on the SF-36 questionnaire, which measures functional impairment regardless of the cause. This case definition essentially counted veterans as having Gulf War illness if they had any condition that caused them to feel bad. Consequently, many veterans with diseases other than Gulf War neurological syndrome that made them feel bad were mistakenly counted as cases, and conversely, many with typical symptoms of Gulf War neurological syndrome but who were not very ill with it were not counted as cases. This severe degree of bidirectional misclassification has caused all studies from the Kings College London group to reach spuriously negative conclusions”.
Professor Haley also provided evidence (against Professor Wessely’s studies) that: “Studies using nonspecific measures of nerve agent exposure are biased toward finding negative results”.
Wessely told the Inquiry: “The Gulf war syndrome debate is really just of academic importance” but Lord Lloyd (a former law lord) said there was “every reason” to accept the existence of a “Gulf War Syndrome” (The Independent Public Inquiry on Gulf War Illness. Report published on 17th November 2004).
In March 2008, The US National Academy of Sciences published another report by Dr Beatrice Golomb (of the University of California, San Diego, and Chief Scientist to the US Congress-appointed Committee on Gulf War Illnesses); this report found evidence linking the symptoms experienced by the Gulf War Veterans – including muscle and joint pain, rashes and breathing problems – to a particular class of chemicals, specifically to the anti-nerve gas agent given to the troops, to the pesticides used to control sand-flies, and to the nerve gas sarin. Dr Golomb told Reuters that: “Convergent evidence now strongly links a class of chemicals – acetylcholinesterase inhibitors – to illness in Gulf War veterans”. She said that a lot of attention had been given to psychological factors, but that “psychological stressors are inadequate to account for the excess illness seen” (
http://www.bbc.co.uk/1/hi/health/7288902.stm ). The Proceedings of the National Academy of Sciences is specific: “Increasing evidence suggests excessive illness in Persian Gulf War veterans can be explained partly by exposure to organophosphate and carbamate acetylcholinesterase inhibitors, including pyridostigmine bromide (PB), pesticides and nerve agents (and) this exposure may be causally linked to excess health problems in Gulf War veterans” (Proc. Natl. Acad. Sci. USA, 10.1073/pnas.0711986105).
This study was reported in The Economist (War of nerves. 13th March 2008), which also reported Professor Wessely’s comments about these irrefutable findings: “This may encourage sick veterans that a cause of their suffering could finally be found, but Simon Wessely, a professor at the Institute of Psychiatry’s centre for military health research, is sceptical. He says that the review is ‘an opinion piece that continues a line of argument Dr Golomb has put forwards for some time’”.
In a response to The Economist, Malcolm Hooper (Emeritus Professor of Medicinal Chemistry and Chief Scientific Adviser to the UK Gulf War Veterans) wrote: “The casual and dismissive comments by Professor Simon Wessely about the recent review by Professor Beatrice Golomb that makes clear the link with chemicals used in the first Gulf War are unacceptable. (They are) indicative of the resistance to extensive American research studies that have identified serious damage to the brains of sick soldiers, major heart and cardiovascular disorders, as well as immune, respiratory and neuromuscular disorders, including an excess of motor neurone disease. Despite no official funding, UK research has found excess osteoporosis and severe endocrine damage in UK veterans. The neglect of these veterans is shameful. Golomb’s paper challenges us to seek and speak the truth and to act accordingly”.
It seems strange that Professor Wessely should reject the science reported in the Proceedings of the New York Academy of Sciences (which has an impressive impact factor rating) in favour of his own speculation.
Moreover, it seems that he fails to see that he is doing exactly that of which he accuses Dr Golomb – i.e. his own view is nothing more than “an opinion piece that continues a line of argument” that he has “put forward for some time”. The big difference that Professor Wessely seems to have missed -- either by accident or by design -- is that Dr Golomb has got actual evidence to support her findings, whereas he has none.