Gulf War Illness (GWI) is a debilitating condition that affects ~25% of veterans of the Gulf War. We have found at the War Related Illness & Injury Study Center that Gulf War veterans commonly report symptoms of nausea (52%) and dizziness (17%), both associated with vestibular (balance system) damage. In addition, Gulf War veterans have increased incidence of motor vehicle accidents. Dizziness and vertigo not only result in significant impairment, but also can result in poor balance, all of which contribute to significant reductions in quality of life. The goal of this work is to examine how much vestibular damage is present in veterans with GWI. We will also examine a novel method to enhance vestibular function and see how this improves balance. We will then test this method of enhancing vestibular function as a novel treatment for GWI.

The purpose of this study is to use mild electrical stimulation to improve balance and reduce dizziness in GWI veterans with verified balance problems. We have previously found that low levels of electrical stimulation, delivered at levels that cannot be felt, can improve balance. This proposal will examine three different questions:

1. What is the level of vestibular dysfunction in a group of veterans with Gulf War Illness?

2. Can low levels of electrical stimulation improve balance in veterans with Gulf War Illness?

3. Does wearing a portable electrical stimulator for a longer period of time improve symptoms like dizziness over the long term?

By developing a portable stimulator that is similar to a hearing aid and that can be worn behind the ear, we will be able to examine the effectiveness of this device over a 12-week trial. As veterans will not feel any electrical stimulation while wearing it, this could represent a new treatment device for balance problems in veterans that would be easy to use with little discomfort. In addition, as veterans will take this stimulator home with them for treatment, they will not need to be near a VA facility, reducing the burden on them for treatment.

The ultimate goal of this work is to improve balance through the use of a portable stimulator about the size of a hearing aid for GWI veterans suffering with balance problems. There are currently limited treatments for patients suffering with these issues and this innovative device, used to improve balance and vestibular function in veterans, addresses a significant post-deployment health issue. This device can also be made available for veterans with chronic balance problems who live in rural areas without easy access to VA facilities for balance rehabilitation visits.