TABLE 2.

Review papers on neuropsychological outcomes.

References	Summary and recommendations
Axelrod and Milner, 2000	• Concluded that methodological issues limited the ability to understand the data. • Recommended that future studies include more sophisticated cohort comparisons, including exposure data.
Vasterling and Bremner, 2006	• Concluded that there was no clear pattern in neuropsychological outcomes and insufficient neuroimaging evidence to draw conclusions at this point. • The impact of mood and the discrepancy between subjective reports and objective measurements made it more difficult to determine the etiology of any deficits observed. • Recommended that results need replication, objective measures of exposure should be used when applicable, baseline data should be used to investigate pre-existing vulnerabilities. • Future research should be built on more complex models that incorporate individual vulnerabilities, environmental factors and their physiological and emotional consequences and immunologic functioning.
Research Advisory Committee on Gulf War Veteran’s Illnesses [RAC-GWVI], 2008	• Concluded that symptomatic veterans have a subtle “sub-clinical” CNS damage. This included deficits in attention, executive function, memory, visuospatial skills, psychomotor functioning, and mood. • Recommended that analyses of veteran subgroups, i.e., those with more pronounced cognitive deficits and those with differing exposure histories, would be most informative.
White et al., 2016	• Concluded that GW exposures are associated with decrements in cognitive function. • Future research should investigate the mechanisms and etiology of GW health problems so that biomarkers of exposure and illness may be discovered.
Janulewicz et al., 2017	• Concluded with meta-analytic methods that GW deployment is associated with deficits in visuospatial, attention, executive function, and learning and memory but not simple motor function. • Future research developing treatments or investigating biomarkers of GWI should include neuropsychological outcomes in the domains of visuospatial, attention and executive function, and learning and memory. Particularly, Block Design, Trail Making Test, Digit Span, and CVLT, were sensitive measures to use with veterans with GWI.