Mysterious {Weapon? Virus? Cricket?} Affecting US Diplomats' Brains

A new MRI study shows intriguing findings in the brains of US Diplomats affected by so-called “Havana Syndrome”.

This week, we dive headlong into the world of spies, mysterious energy weapons, and potential mass hysteria as this study, appearing in the Journal of the American Medical Association reignites one of the weirdest medical stories in the past five years.

It’s colloquially called “Havana Syndrome”. In late 2016, American diplomats in Cuba started to experience a strange set of symptoms. It started abruptly with a pressure in the ear, sometimes associated with a high-pitched noise that sounds something like this:

It was disorienting, in some cases painful. Sequela included headaches, nausea, visual problems, gait instability and hearing loss – some individuals are still symptomatic.

Was this some new microwave weapon?  A directed energy beam? A sonic device?

Subsequent analysis revealed that the sound I played you earlier was actually a species of cricket native to Cuba.

This lead some to suggest that this was not an attack at all but rather mass psychogenic illness – a product of persistent cold-war thinking in an incredibly stressful environment.

Whatever the cause, the US dramatically reduced its diplomatic core in Havana in September of 2017. In October of that year, President Trump said the following:

“I do believe Cuba’s responsible. I do believe that”.

In February of 2018, JAMA published a study looking at MRI data from 21 individuals who had developed the syndrome. The results were fairly inconclusive, with some changes seen in brain networks, but no major structural abnormalities.

The new study in JAMA gives us more detailed brain imaging than we ever had before and ups the ante by comparing affected individuals to matched controls. 

Here are the details.

The researchers identified 40 patients with Havana Syndrome and matched them to 48 healthy controls. All participants underwent traditional structural MRI, diffusion imaging, and functional MRI. And statistically significant differences between patients and controls were seen across a variety of domains.

Here’s a smattering:

results table.jpg
Lead author Dr. Ragini Verma. Professor of Radiology. Perelman School of Medicine. University of Pennsylvania

Lead author Dr. Ragini Verma. Professor of Radiology. Perelman School of Medicine. University of Pennsylvania

Patients had less white matter in their brain than controls, but no difference in gray matter.  They had greater white matter in projection fibers, but less in association fibers. fMRI revealed deficiencies in the auditory and visual subnetworks, but not in the executive function subnetwork. In the cerebellum, specifically examined due to the constellation of symptoms which often included dizziness, there was lower mean diffusivity in the cerebellar vermis and higher fractional anisotropy.

I’m not a neurologist, so I asked lead author Dr. Ragini Verma what she made of these findings.

 These findings do not conform to anything that I’ve seen in any established mechanism of pathogenesis, that I’ve seen in any other disease.

So what do we make of this?  Well, one take is that we are seeing the clear neurologic sequela of… something – maybe a weapon, maybe an as-of-yet unidentified virus?

But that’s not the only interpretation. We have no baseline scans on these diplomats, so we can’t compare their brain findings before and after their stint in Cuba. The authors compared them to matched controls, but good matches are hard to find.  They tried to get individuals with college degrees, and jobs that require multitasking, but the tasks of diplomacy in a nation like Cuba may put unique stresses on these individuals, independent of any secret weapons.  If I were picking a control group, I’d scan the unaffected diplomats in Cuba and see how their brains look. 

I’ll be honest, I’m not really sure what’s going on here, but it is clear that these diplomats are suffering – and I’m glad to see researchers trying to determine exactly why. That being said, I have a feeling this story may get weirder before the truth wins out.

This commentary originally appeared on medscape.com.