Symptoms reported by Canadians posted in Havana are linked with reduced white matter fibre density

Abstract

Diplomats representing the United States have reported with unusual neurologic symptoms and MRI changes after being posted in Havana, Cuba between late 2016 to 2018. Here we examined white matter microstructure and network connectivity of individuals stationed in Havana, using diffusion-weighted MRI, fixel-based analysis, and structural connectomics as implemented in MRtrix3. MRI data acquisition and clinical assessments were done in a total of 24 diplomats and their family members and 40 healthy controls. The diplomat data was grouped into an exposed cohort (n = 16) and an unexposed cohort (n = 10), and among these, 2 individuals were assessed before and after potential exposure. Fixel-based analysis revealed a reduction in fiber density in two specific regions: the fornix and the splenium, in exposed individuals, relative to unexposed individuals and healthy controls. Post-hoc analyses showed the effect remained present (p < 0.05) in both regions when comparing exposed and unexposed diplomats; and reduced fibre density was correlated with longer time period stationed in Cuba after age-correction. Reduction of fibre density was also found to be linked with clinical symptoms of persistent migraine, tinnitus, sound sensitivity and fatigue. Network statistical comparisons revealed decreased structural connectivity in two distinct networks, comprising subcortical and cortical systems in exposed individuals, relative to unexposed and normative data. While the cause for the differences between the groups remains unknown, our results reveal region-specific white matter injury that is significantly correlated with clinical symptoms.

Clinical, Biomarker, and Research Tests Among US Government Personnel and Their Family Members Involved in Anomalous Health Incidents

“…This is important because headaches, especially migraines, could produce symptom clusters similar to some of the AHI cases, albeit the etiology could be different in these instances. 36 While this study does corroborate the high rates of depression, fatigue, cognitive, and balance concerns found by other researchers, 4,[11][12][13][14][15][16] consistent neuropsychological, ocular motor, vestibular, 13,14 or imaging abnormalities were not found. 12 This discrepancy could be due to a combination of methodological and comparison group differences including the ability in the current study to recruit a vocationally matched control group.…”

“…12 While the authors of these studies were appropriately circumspect in their conclusions, the subsequent public and media narrative built around these studies was that this population has findings consistent with traumatic brain injury and that advanced imaging techniques could differentiate this group from a control population. 12,16 In early 2018, the National Institutes of Health (NIH), in consultation with the Department of State (DOS) and the IC, began an investigation of AHIs. The NIH created a referral infrastructure, engaged content experts from across the NIH Intramural Research Program, and enrolled individuals in an exploratory natural history study.…”

Havana Syndrome: New Recommendations and Enrollment Criteria for a Shared Study of Possible Cases

“…To date, no convincing hypothesis has been documented in the literature regarding the selective capacity that an exogenous substance would have in affecting only subjects of certain nationalities and employed exclusively in federal offices, or even that it could affect their relatives 6 . The onset and persistence of symptoms have occurred in well-circumscribed locations, such as the Hotel Capri and the Hotel Nacional de Cuba, as well as in the homes of U.S. and Canadian diplomats who have reported the appearance of symptoms 11 . Double-blind clinical studies have shown that simulated exposure to electromagnetic fields determines in some cases the exact same symptoms reported by subjects affected by a possible Havana Syndrome 12 .…”

“…Among the etiopathogenetic hypotheses most represented in the literature about the symptoms experienced by subjects affected by Havana Syndrome there is that of a mass psychogenic illness that probably originated from the news that circulated about "harmful health attacks" produced by an unknown sound device 13 . 11 . The most important clinical aspects described by U.S. Department of State personnel in Havana were the nature of the onset and the initial characteristics; the sudden perception of a loud sound, a feeling of intense pressure or vibration in the head, and pain in the ear.…”

White matter microstructure predicts measures of clinical symptoms in chronic back pain patients

“…Despite this, to our knowledge, it has not yet been used to study CBP specifically, however it has been applied more broadly to chronic musculoskeletal pains in general ( Bishop et al, 2018 ) and to neuropathic pain secondary to spinal cord injury (SCI; Black et al, 2022 ). We have recently reported that FBA can provide novel insights regarding the role of structural pathways in pain modulation in healthy individuals ( Aristi et al, 2022b ) and in the development of unexplained, injury-induced headaches ( Aristi et al, 2022a ).…”