# Acute exercise tolerance among Veterans with Gulf War Illness

> **NIH VA IK2** · WM S. MIDDLETON MEMORIAL VETERANS HOSP · 2020 · —

## Abstract

The purpose of this Career Development Award (CDA-2) application is to facilitate Dr. Jacob Lindheimer's
transition from a new investigator of chronic, multi-symptom illnesses (CMI) into an independent translational
investigator in the VA Healthcare System. The specific focus of this CDA-2 is on studying aerobic exercise
intolerance in a prevalent and debilitating CMI known as Gulf War Illness. Dr. Lindheimer is an integrative
psycho-physiologist with a background in the field of exercise science and is currently a Post-Doctoral Fellow
at the War Related Illness and Injury Study Center of the VA New Jersey Healthcare System. He works closely
with his co-mentors, Drs. Dane Cook and Michael Falvo, on a multi-site Merit Review study of patho-
physiological mechanisms in GWI. This CDA-2 will allow Dr. Lindheimer to obtain additional skills in (1) clinical
trials and biostatistics, (2) analysis and interpretation of immunological assay data, and (3) clinical exercise
physiology testing. An additional training goal is for Dr. Lindheimer to continue developing the neuroimaging
skills that he acquired during his post-doctoral fellowship training. Neuroimaging will not be used as an
outcome measure in the proposed research, but will be an essential component of a subsequent Merit Review
application in Year 5 of this CDA-2.
The overall goal of the research plan is to provide critical information for developing an exercise prescription
that is tolerable for Veterans with GWI. To that end, a novel and innovative study design has been developed
to measure the dose-response relationship between aerobic exercise intensity and a pervasive phenomenon
that affects CMI populations (e.g., Gulf War Illness, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome,
Fibromyalgia) known as post-exertion malaise (PEM). Although it is clear that aerobic exercise can induce
PEM, the specific features of exercise that elicit PEM are not. A within-subjects, randomized, controlled,
crossover study will test the effect of light- moderate- and vigorous exercise on symptomatic, behavioral and
biological indices of PEM in a sample of Veterans with GWI (n=40).
Our central hypothesis is that is that there will be a dose-dependent, relationship between exercise
intensity and PEM, which is manifested by: increases in GWI symptom severity (Aim 1), increases in pain
sensitivity (Aim 1), decreases in cognitive performance (Aim 1), up-regulation of pro-inflammatory and
regulatory cytokines (i.e., IL-6, IL-8, IL-10, TNF-α) (Aim 2), decreases in physical activity behavior (Aim 3), and
increases in sedentary behavior (Aim 3). Validated questionnaires will be used to measure GWI symptoms.
Pain sensitivity will be measured with psycho-physical procedures used to determine perceptual responses to
a range of thermal stimuli. Cognitive performance will be measured with a computerized version of the Paced
Auditory Serial Addition Task. Pro-inflammatory cytokines will be measured by multi-cytokine array...

## Key facts

- **NIH application ID:** 9932317
- **Project number:** 5IK2CX001679-03
- **Recipient organization:** WM S. MIDDLETON MEMORIAL VETERANS HOSP
- **Principal Investigator:** Jacob Lindheimer
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-07-01 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9932317

## Citation

> US National Institutes of Health, RePORTER application 9932317, Acute exercise tolerance among Veterans with Gulf War Illness (5IK2CX001679-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9932317. Licensed CC0.

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