# CSRD Research Career Scientist Award Application

> **NIH VA IK6** · WM S. MIDDLETON MEMORIAL VETERANS HOSP · 2021 · —

## Abstract

Chronic multi-symptom illnesses (CMI) are complex and poorly understood diseases principally
characterized by fatigue, pain, and problems with cognitive function. For Veterans, these diseases are
collectively referred to as Gulf War Illnesses (GWI) and affect ~250,000 Gulf War Veterans (GVs) (25-35% of
the 1991 GV population). Nearly 50% of GVs seek VA clinical care, and nearly 40% receive disability
compensation. To date, the causes of these symptoms are not known, and as a result, no efficacious
treatments are available. Moreover, recent evidence suggests that Veterans of more recent conflicts, such as
Operations Enduring and Iraqi Freedom, are also experiencing CMI.
 The general focus of my research is to determine the mechanisms that act to maintain chronic multi-
symptom illnesses (CMI) – such as myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS),
fibromyalgia (FM), and GWI – with a career goal of improving the health and quality of life of deployed
Veterans. My research employs multiple state-of-art technologies that allow us to test the central, autonomic,
cardiopulmonary, and immune systems of each Veteran that visits my lab. As a result, my research has shown
that multiple physiological systems are dysfunctional in both GVs and civilians with CMI. Moreover, dysfunction
within these systems is magnified and symptoms are exacerbated following an exercise challenge (i.e., post-
exertion malaise [PEM]), providing a controllable model for their study. Thus, a central hypothesis of my
research is that dysfunction across multiple physiological systems interacts to produce and maintain the
symptoms of GWI, and this dysfunction is best studied by challenging physiological systems and testing how
they interact. Data from my lab has shown that GVs with chronic musculoskeletal pain have reduced white
matter health and that acute exercise makes them more sensitive to pain compared to healthy GVs. However,
my lab has also reported that being physically active has a potential protective effect against both the identified
deficits and the symptoms of these diseases. These results suggest that acute and chronic exercise may have
differential effects on GV health, important information for developing non-pharmacological therapies that can
be used to safely treat GWI.
 My current VA-sponsored research directly tests our multisystem hypothesis by comparing GVs with
GWI to healthy GVs across multiple physiological systems, at rest and following acute exercise challenge; we
use advanced statistical methods to test whether interactions among multiple systems significantly explain
symptoms of GWI. Capitalizing on the expertise of my lab and my collaborators, we test: 1) central nervous
system regulation using structural and functional magnetic resonance imaging; 2) autonomic regulation using
brain doppler methods for cerebral blood flow measurement; 3) immune and metabolic regulation using
measures of gene expression, metabolomics, and proteomics fro...

## Key facts

- **NIH application ID:** 10231863
- **Project number:** 1IK6CX002369-01
- **Recipient organization:** WM S. MIDDLETON MEMORIAL VETERANS HOSP
- **Principal Investigator:** DANE B. COOK
- **Activity code:** IK6 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2021-04-01 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10231863

## Citation

> US National Institutes of Health, RePORTER application 10231863, CSRD Research Career Scientist Award Application (1IK6CX002369-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10231863. Licensed CC0.

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