{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T17:42:52Z","timestamp":1769276572013,"version":"3.49.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"7-8","funder":[{"name":"CDMRP\/DoD Gulf war illness Research Program Innovative Treatment","award":["#11488016"],"award-info":[{"award-number":["#11488016"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,22]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Autonomic nervous system dysregulation is commonly observed in Gulf War illness (GWI). Using a new sample, we sought to replicate and extend findings from a previous study that found autonomic symptoms predicted physical functioning in Veterans with GWI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>A linear regression model was used to predict physical functioning (36-item Short Form Health Survey (SF-36); n\u2009=\u200973, 75% male). First, we examined the predictive value of independent variables individually in the model including: the 31-item Composite Autonomic Symptom Score (COMPASS-31) total score, body mass index (BMI), mental health burden (i.e., post-traumatic stress disorder [PTSD] and\/or depression), and COMPASS-31 subscales: orthostatic intolerance, vasomotor, secretomotor, gastrointestinal, bladder, and pupillomotor. Next, we estimated linear regression models containing the three variables (autonomic symptoms, BMI, and mental health burden) identified as predictors of physical functioning from the prior study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>These linear regression models significantly predicted physical functioning and accounted for 15% of the variance with COMPASS-31, 36.6% of variance with COMPASS-31 and BMI, and 38.2% of variance with COMPASS-31, BMI, and mental health burden. Then, forward step-wise linear regressions were applied to explore new models including COMPASS-31 subscales. Two new models accounted for more of the variance in physical functioning: 39.3% with added gastrointestinal symptoms (\u03b2\u2009=\u2009\u22122.206, P\u2009=\u2009.001) and 43.4% of variance with both gastrointestinal (\u03b2\u2009=\u2009\u22121.592, P\u2009=\u2009.008) and secretomotor subscales (\u03b2\u2009=\u2009\u22121.533, P\u2009=\u2009.049). Unlike the previous study we intended to replicate, mental health burden was not a significant predictor in any of our models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Treatments that address autonomic dysregulation should be prioritized for research and clinical recommendations for Veterans with GWI who experience chronic pain.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usab546","type":"journal-article","created":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T06:05:04Z","timestamp":1640844304000},"page":"e1462-e1467","source":"Crossref","is-referenced-by-count":4,"title":["Self-Reported Autonomic Dysregulation in Gulf War Illness"],"prefix":"10.1093","volume":"188","author":[{"given":"Timothy J","family":"Avery","sequence":"first","affiliation":[{"name":"U.S. Department of Veterans Affairs, War Related Illness and Injury Study Center, VA Palo Alto Heath Care System , Palo Alto, CA 94301, USA"},{"name":"Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine , Stanford, CA 94305, USA"},{"name":"National Center for PTSD, Veterans Affairs Palo Alto Health Care System , Menlo Park, CA 94025, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle C","family":"Mathersul","sequence":"additional","affiliation":[{"name":"U.S. Department of Veterans Affairs, War Related Illness and Injury Study Center, VA Palo Alto Heath Care System , Palo Alto, CA 94301, USA"},{"name":"Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine , Stanford, CA 94305, USA"},{"name":"Discipline of Psychology, Murdoch University , Murdoch, WA 6150, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R Jay","family":"Schulz-Heik","sequence":"additional","affiliation":[{"name":"U.S. Department of Veterans Affairs, War Related Illness and Injury Study Center, VA Palo Alto Heath Care System , Palo Alto, CA 94301, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"Mahoney","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine , Stanford, CA 94305, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter J","family":"Bayley","sequence":"additional","affiliation":[{"name":"U.S. Department of Veterans Affairs, War Related Illness and Injury Study Center, VA Palo Alto Heath Care System , Palo Alto, CA 94301, USA"},{"name":"Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine , Stanford, CA 94305, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,12,30]]},"reference":[{"key":"2023072301084201300_R1","volume-title":"U.S. Department of Defense Gulf War Illness Research Program","year":"2018"},{"issue":"1","key":"2023072301084201300_R2","article-title":"Progression of intervention-focused research for Gulf War illness","volume":"6","author":"Chester","year":"2019","journal-title":"Mil Med Res"},{"key":"2023072301084201300_R3","volume-title":"Gulf War Illness: A Systematic Review of Therapeutic Interventions and Management Strategies","author":"Freeman","year":"2020"},{"key":"2023072301084201300_R4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2020.11.024","article-title":"Yoga is effective in treating symptoms of Gulf War illness: a randomized clinical trial","author":"Bayley","year":"2021","journal-title":"J Psychiatr Res"},{"issue":"11","key":"2023072301084201300_R5","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1001\/jama.280.11.981","article-title":"Chronic multisymptom illness affecting Air Force veterans of the Gulf War","volume":"280","author":"Fukuda","year":"1998","journal-title":"JAMA"},{"key":"2023072301084201300_R6","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.cortex.2015.08.022","article-title":"Recent research on Gulf War illness and other health problems in veterans of the 1991 Gulf War: effects of toxicant exposures during deployment","volume":"74","author":"White","year":"2016","journal-title":"Cortex"},{"key":"2023072301084201300_R7","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.neuro.2020.02.006","article-title":"Brainstem atrophy in Gulf War Illness","volume":"78","author":"Zhang","year":"2020","journal-title":"Neurotoxicology"},{"issue":"2","key":"2023072301084201300_R8","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1001\/jamaneurol.2013.596","article-title":"Cholinergic autonomic dysfunction in veterans with Gulf War illness: confirmation in a population-based sample","volume":"70","author":"Haley","year":"2013","journal-title":"JAMA Neurol"},{"issue":"4","key":"2023072301084201300_R9","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1016\/j.amjmed.2018.11.045","article-title":"Medical correlates of chronic multisymptom illness in Gulf War veterans","volume":"132","author":"Blanchard","year":"2019","journal-title":"Am J Med"},{"key":"2023072301084201300_R10","doi-asserted-by":"crossref","DOI":"10.1177\/2164956120922812","article-title":"Brain and physiological markers of autonomic function are associated with treatment-related improvements in self-reported autonomic dysfunction in veterans with gulf war illness: an exploratory pilot study","volume":"9","author":"Mathersul","year":"2020","journal-title":"Glob Adv Health Med"},{"key":"2023072301084201300_R11","doi-asserted-by":"crossref","DOI":"10.3389\/fnins.2013.00269","article-title":"Self-reported post-exertional fatigue in Gulf War veterans: roles of autonomic testing","volume":"7","author":"Li","year":"2014","journal-title":"Front Neurosci"},{"issue":"3\u20134","key":"2023072301084201300_R12","doi-asserted-by":"crossref","first-page":"e179","DOI":"10.1093\/milmed\/usx052","article-title":"Report of autonomic symptoms in a clinical sample of veterans with Gulf War illness","volume":"183","author":"Fox","year":"2018","journal-title":"Mil Med"},{"issue":"12","key":"2023072301084201300_R13","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1016\/j.mayocp.2012.10.013","article-title":"COMPASS 31: a refined and abbreviated Composite Autonomic Symptom Score","volume":"87","author":"Sletten","year":"2012","journal-title":"Mayo Clin Proc"},{"issue":"2","key":"2023072301084201300_R14","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/0304-3959(87)91074-8","article-title":"The short-form McGill pain questionnaire","volume":"30","author":"Melzack","year":"1987","journal-title":"Pain"},{"key":"2023072301084201300_R15","author":"Ware","year":"2013"},{"issue":"1","key":"2023072301084201300_R16","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1136\/jnnp.23.1.56","article-title":"A rating scale for depression","volume":"23","author":"Hamilton","year":"1960","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"4","key":"2023072301084201300_R17","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1111\/j.2044-8260.1967.tb00530.x","article-title":"Development of a rating scale for primary depressive illness","volume":"6","author":"Hamilton","year":"1967","journal-title":"Br J Soc Clin Psychol"},{"issue":"2","key":"2023072301084201300_R18","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1002\/jts.22399","article-title":"Validation of an electronic medical record-based algorithm for identifying posttraumatic stress disorder in U.S. Veterans","volume":"32","author":"Harrington","year":"2019","journal-title":"J Trauma Stress"},{"key":"2023072301084201300_R19","volume-title":"IBM SPSS Statistics for Windows, Version 24.0","year":"2012"},{"issue":"12","key":"2023072301084201300_R20","doi-asserted-by":"crossref","first-page":"2886","DOI":"10.1097\/MIB.0000000000000568","article-title":"The effect of breathing, movement, and meditation on psychological and physical symptoms and inflammatory biomarkers in inflammatory bowel disease: a randomized controlled trial","volume":"21","author":"Gerbarg","year":"2015","journal-title":"Inflamm Bowel Dis"},{"issue":"4","key":"2023072301084201300_R21","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1002\/jts.21936","article-title":"Breathing-based meditation decreases posttraumatic stress disorder symptoms in U.S. military veterans: a randomized controlled longitudinal study","volume":"27","author":"Sepp\u00e4l\u00e4","year":"2014","journal-title":"J Trauma Stress"},{"issue":"19","key":"2023072301084201300_R22","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph16193751","article-title":"The gut-microbiome in Gulf War veterans: a preliminary report","volume":"16","author":"Janulewicz","year":"2019","journal-title":"Int J Environ Res Public Health"},{"issue":"10","key":"2023072301084201300_R23","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1093\/aje\/152.10.992","article-title":"Prevalence and patterns of Gulf War illness in Kansas veterans: association of symptoms with characteristics of person, place, and time of military service","volume":"152","author":"Steele","year":"2000","journal-title":"Am J Epidemiol"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/188\/7-8\/e1462\/50937031\/usab546.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/188\/7-8\/e1462\/50937031\/usab546.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,23]],"date-time":"2023-07-23T01:10:16Z","timestamp":1690074616000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/188\/7-8\/e1462\/6489131"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,30]]},"references-count":23,"journal-issue":{"issue":"7-8","published-online":{"date-parts":[[2021,12,30]]},"published-print":{"date-parts":[[2023,7,22]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usab546","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,7,1]]},"published":{"date-parts":[[2021,12,30]]}}}