Novel Interventions for Gulf War Veterans' Illnesses

针对海湾战争退伍军人疾病的新颖干预措施

• 批准号: 10508491
• 负责人: Deanna L. Mori
• 金额: --
• 依托单位: VA BOSTON HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-01 至 2023-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10508491
• 关键词: Aftercare; Chinese; Chronic; Cognition; Diffusion Magnetic Resonance Imaging; Drug Side Effects; Education; Effectiveness; Exercise; Fatigue; Functional Magnetic Resonance Imaging; Goals; Gulf War; Gulf War veteran; Healthcare; Home; Individual; Intervention; Investigation; Length; MRI Scans; Measures; Mind-Body Intervention; Participant; Patients; Pharmacotherapy; Physical Function; Pilot Projects; Quality of life; Randomized; Reporting; Research; Research Design; Rest; Stretching; Symptoms; Tai Ji; Treatment Efficacy; Veterans; Well in self; Work; chronic pain management; cognitive function; comparison intervention; disabling symptom; effective therapy; experience; follow up assessment; follow-up; improved; intervention participants; meetings; neurobiological mechanism; novel; pain reduction; pain symptom; persistent symptom; physical conditioning; public health relevance; randomized trial; reduce symptoms; symptom treatment

 DESCRIPTION (provided by applicant): Over 40,000 Veterans who served in the 1991 Gulf War (GW) have a persistent form of chronic multisymptom illness that defines Gulf War Veterans Illness (GWVI). With no existing proven treatments to provide relief to these sufferers, it is critical to find efficacious and acceptable treatments for GWVI. Our long-term goal is to develop a safe, readily available, mind-body treatment to reduce pain and other chronic symptoms and enhance wellness in Veterans with GWVI. Tai Chi is a traditional Chinese mind-body therapy that has been practiced for centuries. In the last decade, we have demonstrated that Tai Chi can improve both physical health and psychological well-being in patients with a variety of chronic conditions. The proposed randomized trial will establish the effectiveness of a Tai Chi mind-body treatment in Veterans with GWVI. One hundred and twenty participants meeting criteria for GWVI will be randomly assigned to either a Tai Chi exercise or a stretching and wellness education group for 12 weeks with a post-treatment assessment, and follow-up assessments. For an exploratory sub-study, 40 Veterans (approximately 20 from each condition) will undergo MRI scanning at each assessment point. We will accomplish the following Specific Aims: Specific Aim 1: Evaluate whether the Tai Chi intervention will reduce symptoms of pain in Veterans with GWVI more than the Wellness intervention. We hypothesize that participants randomized to the Tai Chi intervention will show a greater reduction in pain symptoms than those in the Wellness intervention and will maintain changes over a 9-month follow-up period. Specific Aim 2: Evaluate whether the Tai Chi intervention improves fatigue, cognition, quality of life, and physical functioning in GW Veterans with GWVI, as compared to the Wellness intervention. We hypothesize that participants randomized to the Tai Chi intervention will evidence more improvement in fatigue, cognitive functioning, quality of life, and physical functioning than those randomized to the Wellness intervention and will maintain changes over a 9-month follow-up period. Specific Aim 3: Explore a potential neurobiological mechanism by which Tai Chi can reduce pain and other symptoms and improve quality of life in Veterans with GWVI. We hypothesize differences in resting state fMRI and on diffusion tensor imaging (DTI) in participants randomized to the Tai Chi intervention compared with Wellness intervention participants and that these differences will maintain over the 9-month follow-up period. The proposed trial, informed by our prior investigations, with a robust study design and strong research team, will produce valuable results that can have a direct and immediate impact on healthcare practices for GWVI. If proven as an effective treatment for the symptoms of GWVI, this non-pharmaceutical treatment could easily be implemented in VA facilities, and Veterans could be taught how to continue to practice independently within their own homes. Providing GW Veterans even moderate relief from chronic and debilitating symptoms of GWVI could have a profound impact on improving their overall sense of well-being and quality of life, the ultimate measure of treatment efficacy.

 描述（由申请人提供）： 在1991年的海湾战争（GW）中服役的40,000多名退伍军人具有持续形式的慢性多症疾病，定义了海湾战争退伍军人疾病（GWVI）。由于没有现有的经过验证的治疗方法可以缓解这些患者，因此至关重要的是为GWVI找到有效且可接受的治疗方法。我们的长期目标是开发一种安全，随时可用的心身治疗，以减轻疼痛和其他慢性症状，并通过GWVI来增强退伍军人的健康。太极拳是一种传统的中国思维疗法，已经实践了几个世纪。在过去的十年中，我们已经证明了Tai Chi可以改善各种慢性病患者的身体健康和心理健康。拟议的随机试验将确定在GWVI退伍军人中进行TAI CHI心理治疗的有效性。符合GWVI标准的一百二十名参与者将随机分配到Tai Chi练习或伸展和健康教育小组，并进行了12周，并进行了治疗后评估和后续评估。对于探索性子研究，每个评估点将进行40名退伍军人（大约20个条件的退伍军人）进行MRI扫描。我们将完成以下特定目标：具体目标1：评估太极干预是否会减少GWVI退伍军人的疼痛症状，而不是健康干预。我们假设随机分配到TAI CHI干预的参与者将显示出比健康干预中的疼痛症状更大的减轻，并且将在9个月的随访期内保持变化。具体目的2：与健康干预相比，评估太极干预是否可以改善具有GWVI的GW退伍军人的疲劳，认知，生活质量和身体机能。我们假设参与者将随机与Tai Chi干预的参与者相比，可以证明疲劳，认知功能，生活质量和身体功能的改善 随机分配到健康干预措施，并将在9个月的随访期内保持变化。特定目的3：探索一种潜在的神经生物学机制，泰思通过该机制可以减轻疼痛和其他症状并改善GWVI退伍军人的生活质量。我们假设与健康干预参与者相比，参与者随机分配到TAI CHI干预的参与者中静息状态和扩散张量成像（DTI）的差异，并且这些差异将在9个月的随访期间保持。通过我们先前的调查，通过强大的研究设计和强大的研究团队得出的拟议试验将产生有价值的结果，可以直接和直接影响GWVI的医疗保健实践。如果被证明是GWVI症状的有效治疗方法，则可以在VA设施中轻松实施这种非药物治疗，并且可以教退伍军人如何继续在自己的家中独立练习。提供GW退伍军人，甚至可以缓解GWVI的慢性和使人衰弱的症状，这可能会对改善其整体幸福感和生活质量的感觉产生深远的影响，这是治疗效率的最终度量。