NIH Investigative Deep Phenotyping Study of Gulf War Veteran Health (Project NIH IN-DEPTH)

Eligibility Criteria

• * Ability to provide informed consent
• * Stated willingness to comply with all study procedures and availability for the duration of the study
• * Age 48-70 at time of enrollment into VA IN-DEPTH Study
• * Veterans who were deployed to Gulf Region ODS/S between August 1990 - June 1991.
• * Self-reported completion of at least the seventh grade of school.
• * Fluency in speaking, reading, and understanding English.
• * Underwent screening as part of the VA IN-DEPTH study and were unanimously determined to be eligible by the IN-DEPTH Adjudication Committee.
• * Agree not to smoke in the 4 hours prior to CPET procedure
• * Current or past psychotic disorder including depression with psychosis, bipolar disorder with psychotic symptoms and schizophrenia
• * Current DSM-5-defined major depression disorder, generalized anxiety disorder, posttraumatic stress disorder, panic disorder, or obsessive-compulsive disorder unless managed for more than six months with a stable treatment regimen
• * Current or past substance use disorder within last five years as diagnosed on the Structured Clinical Interview for DSM-5 (SCID-5). Prior or prescription marijuana use within the past five years will not be an exclusion.
• * Current suicidal ideation
• * History of head injury leading to moderate or severe traumatic brain injury, as detailed by loss of consciousness for greater than 30 minutes, a Glasgow Coma Score of 12 or less at the time of injury, post-traumatic amnesia greater than one day, or brain-scan changes related to a head injury. Persons having a history of mild TBI (mTBI) will not be excluded.
• * Women who are pregnant, breastfeeding, or are within one-year post-partum.
• * Current or previous malignancy. A history of malignancy that has fully resolved with surgical resection only (e.g. no chemotherapy, radiation therapy, or immunotherapy) will be allowed.
• * Current systemic immunologic disorders (e.g. Type 1 diabetes, rheumatoid arthritis). Local immunological disorder (e.g. atopic dermatitis, stable autoimmune thyroid disease) and allergic disorders will be allowed.
• * Current or previous long-term immune suppressive therapy. Systemic steroid use, even short-term, must not have been used within the month prior to enrollment
• * Any medical condition that would make the study procedures risky for the participant (e.g. congestive heart failure, coronary artery disease, chronic obstructive pulmonary disease, severe osteoarthritis, exercise-induced angina and poorly controlled asthma).
• * Active participation in a clinical protocol (e.g. anti-inflammatory drug intervention study) which includes an intervention that may affect the results of the current study.
• * Inability to perform the bicycling exercise task. (e.g. coronary artery disease, not having a lower limb, disabling stroke)
• * Not willing to allow for research data and samples to be shared broadly with other researchers.
• * Symptom severity that makes it impossible for the volunteer to travel to NIH for extended inpatient evaluation
• * Use of medications with a high-risk for withdrawal-related complications (i.e. long-acting opiates or benzodiazepines).
• * Substantial claustrophobia
• * Inability to lie on back for up to 2 hours