Project IN-DEPTH
WRIISC VA-NIH Project IN-DEPTH
WRIISC VA-NIH Investigative Deep Phenotyping (IN-DEPTH) of 1990-1991 Gulf War Veteran Health
Primary DC WRIISC staff: Matthew Reinhard, PsyD; Michelle Costanzo, PhD; Nancy Klimas, MD; Arghavan Hamedi; Dina Lyon; Kamila Pollin; Lucas Crock; Emily Zurek; Diana Ngo; Timothy Chun; John Barrett; Rachel Stewart; Charity Breneman; Immanuel Samuel; Ryan Brewster
A New Approach Through a Unique and Historic Collaboration
Background: Researchers with the Department of Veterans Affairs (VA) War Related Illness and Injury Study Center (DC) and the National Institutes of Health (NIH) National Institute of Neurological Disorders and Stroke are leading a first-of-its-kind collaboration to gain more insight into the causes of Gulf War Illness (GWI). GWI is known to affect as many as one-third of the 700,000 U.S. troops deployed during Operations Desert Shield/Desert Storm (ODS/S, August 1990 — June 1991).
Purpose: Project IN-DEPTH, launched in July 2022, aims to understand why many 1990-1991 Gulf War Veterans are sick and how we can help improve their health. This VA-NIH partnership provides Veterans access to an integrated and comprehensive assessment that collects a mosaic of information from each participant that can be applied to a data framework for pattern recognition across all study participants. These efforts hope to improve the understanding of the causes of GWI pathobiology to further research and potentially lead to the development of better personalized therapeutic interventions.
Eligibility: Gulf War Veterans who were deployed during ODS/S between August 1990 and June 1991, ages 48-70 at time of study enrollment.
If you are a GW Veteran, or know of someone, who might be interested in participating in Project IN-DEPTH, please email us.
Frequently Asked Question about Project IN-DEPTH
Gulf War Illness (GWI) is a chronic multi-symptom illness that is defined by a cluster of medically unexplained and chronic problems. Current treatment options have focused on treating the symptoms and not the underlying causes, which are still poorly understood.
Symptoms of GWI may include:
- Fatigue
- Headaches
- Memory or cognitive difficulties
- Joint & muscle pain
- Poor sleep
- Gastrointestinal & respiratory problems
Past GWI research has paved the way for this new collaboration. VA has been conducting research on Gulf War Veterans since the mid 1990s, leading to insights on possible causes of GWI and treatments to address symptoms and improve quality of life. However, there are more questions that need answers.
Project IN-DEPTH utilizes the Gulf War Illness Common Data Elements (recommendations of GWI research allowing for standardization of data) to guide its study methods.
To learn more about VA Gulf War research, click here.
This project involves two separate studies — VA IN-DEPTH and NIH IN-DEPTH, which work together towards the common goal of learning more about GWI.
VA IN-DEPTH focuses on recruitment and establishing and maintaining a data repository. The VA IN-DEPTH study identifies 75 Gulf War Veterans (50 with GWI, 25 healthy controls), evaluating them remotely to collect data on illness severity, domains of illness, biological samples, and impact on function. VA IN-DEPTH will involve:
- Remote national recruitment and screening
- Tiered screening strategy to allow for multiple checkpoints and evaluations of Veteran's data throughout the study
- Follow-up care and a study reunion to share results with study participants
- Data and specimen repository management for secured access broadly to study information for research and potentially lead to the development of better therapeutic interventions
NIH IN-DEPTH focuses on enrolling eligible GW Veterans for a 14-day in-person stay at the NIH Clinical Center in Bethesda, MD. During this visit, the research team will evaluate many body systems including cardiac, pulmonary, neurological, and metabolic function through:
- Medical exams
- Blood work
- Stationary bike exercise testing
- Neuropsychological testing
- Medical imaging (ex. MRI)
Phenotype refers to a person's observable traits, or how an illness presents itself that can be measured or observed. Deep Phenotyping is a method to describe the health or illness of a person by looking at how different parts of their body function and interact with one another.
During the InDepth study, comprehensive testing will be done during a14-day hospital admission at the NIH Clinical Center to look at multiple body systems affected by Gulf War Illness and how these systems operate functionally and structurally at rest as well as when the body is placed under stressors. Additional study measures will be done at home, such as wearing an activity monitor and completing a diary of activity and responses.
Study participants must:
- Have been deployed to the Persian Gulf (August 1990 to June 1991)
- Be 48-70 years of age
- Have access to a doctor
- Be willing to take part in a 14-day inpatient overnight stay at the National Institutes of Health (NIH) in Bethesda, MD. Travel and lodging at no cost to participants.
The VA IN-DEPTH study will guide eligible Veterans through a series of steps:
- Phone interviews
- Online Surveys
- In-home blood draw & vitals
- Psychological screenings
- Clinical & qualitative interviews
- Storing your data & specimens
A repository is a central location that receives, stores, and disseminates specimens (Biorepository) or data (Data Repository) to other scientists. The VA IN-DEPTH study will establish and maintain these data and biospecimen repositories.
These repositories allow other scientists to use the data and specimens collected from Project IN-DEPTH to answer further scientific questions and to develop future treatments for GWI. Other researchers also can use and learn from this data.
To protect study data, no names will appear in the repository - only deidentified (not connected to your name) or coded data (uses a study ID number) goes into the repositories. Scientists who want to use and learn from these data will have to apply to have access.
After completing Project IN-DEPTH, Veterans will have the opportunity to participate in follow up-care. Veterans can:
- Schedule a telehealth consultation with the study team and their primary care physician to discuss clinically relevant research findings.
- Request a summary note be added to their medical record.
- Complete a satisfaction survey about their experience with the study.
Following the completion of the study, a reunion will be held for the study teams and participants to share data results and overall Veteran experiences.
There is no cost to participate in the study. Travel and lodging will be provided for each participant.
If you are referred to the NIH IN-DEPTH Study after screening, you will receive compensation for procedures you complete. If needed, NIH will cover travel expenses to and from the Clinical Center within the United States.
For more information about project IN-DEPTH please email us.
