Unraveling a mystery

Dr. Robert Haley, chief of epidemiology at the University of Texas Southwestern Medical Center, sounds as exuberant as a schoolboy winning his first science fair when he talks about all the media attention garnered by his team's latest study on Gulf War Syndrome -- results of which unequivocally point to brain damage caused by exposure to toxic chemicals as the cause of the veterans' myriad mysterious ills.

"It made the front page of The New York Times national section and the Wall Street Journal and every paper in the country," he says. "Dan Rather reported it on the CBS Evening News, and CNN had it on for 24 hours. It was completely unanticipated."

What Haley means is that the medical center never sent out a press release or called a news conference -- not that that always guarantees media coverage. His colleague Dr. James Fleckenstein, a professor of radiology at the medical center, simply reported the results at the Radiological Society of North America meeting in late November -- -before the research paper was even peer reviewed and published -- and the media went wild. Not only did Haley's work get national and international coverage, but the press, for the most part, also was positive, with numerous editorials calling for the federal government to fund more of Haley's research.

But that's not the only positive feedback the Southwestern team has received recently. In mid-October, the Pentagon released the results of a study supporting Haley's earlier work, which pointed to an experimental drug given to American troops during the war to protect against a nerve gas as one possible culprit behind the chronic illnesses suffered by thousands of Gulf War vets. The Pentagon study sharply contradicted two earlier government studies -- by a presidential committee and by the Institute of Medicine -- that ruled out the drug as a cause.

It wasn't long ago -- just two years ago, in fact -- that Haley was the Rodney Dangerfield of the medical research field. He and his research team didn't get any respect. Naysayers in the Pentagon, Veterans Affairs Administration, and the media doubted such a thing as Gulf War Syndrome existed, much less gave credence to theories on what caused it. When the respected PBS news show Frontline devoted an hour-long segment to the subject in the fall of 1997, Haley and the Southwestern Medical Center team's work was glossed over and relegated to the category of fringe theories.

"There's a whole sea change occurring," Haley says. "When meaningful research gets done, the research causes changes in thinking. That's the beauty of science. It's not like politics. Here it really does change if you do good work in respected publications."

The latest study builds on the group's earlier work ("The war over Gulf War Syndrome," March 5, 1998), in which the doctors hypothesized that the veterans' symptoms -- chronic fatigue, sleeplessness, motor coordination problems, memory loss, and muscle pain -- stemmed from damage in the brain stem and basal ganglia caused by low level exposure to a combination of neurotoxic chemicals, including nerve gas, an experimental nerve-gas antidote, and pesticides.

What the recent study showed was that a group of sick vets had substantial brain damage compared with a control group of healthy vets. Haley's team had previously done magnetic resonant imaging of veterans' brains and discovered that structurally their brains were normal -- that is, they did not suffer a loss of brain cells. So this time, convinced that their brain-damage theory was right, they tested the actual chemical component of the existing brain cells with a relatively new technique called magnetic resonant spectroscopy.

"This is way out in the frontier," Haley says.

MRS scans of 22 veterans who complained of illness indicated they had 10 to 25 percent less of the chemical NAA, or N-acetyl-aspartate, in their brain stems and basal ganglia compared with 18 healthy vets. Scientists conducting the readings did not know which samples belonged to the ill veterans. The same results turned up on a second test of six other Gulf War veterans.

"That's a significant loss," Haley says. "Even a 5 percent loss would be significant."

Scientists are not sure exactly what the chemical NAA does, Haley says. "But the way to think about it is that if a brain cell is sick, it can't make much of it. So it's a perfect measure of neurotoxicity."

Developed in the last five years, MRS has helped unravel other medical mysteries such as epilepsy. MRS scans show that people who suffer from epilepsy have a reduction of NAA in the temporal lobe. Schizophrenics also have an abnormal NAA level in the left basal ganglia.