U.S. envoys in Cuba suffered mysterious brain injuries

Neurological problems:The incidents occurred in 2016, when diplomats reported that they heard strange sounds. Picture shows the U.S. embassy in Havana.NYTMERIDITH KOHUT  

A group of U.S. diplomats stationed in Havana appeared to have symptoms of concussion without ever having received blows to their heads, medical experts have found.

The diplomats originally were said to have been victims of a “sonic attack”, a possibility that the FBI reportedly ruled out in January.

The experts’ report, published earlier this week in the journal JAMA , does not solve the mystery, instead raising even more questions about what could have caused the brain injuries.

Headache and pain

The incidents occurred in 2016, when 18 of the 21 affected diplomats reported they heard strange sounds in their homes or hotel rooms. The noises were loud and sounded like buzzing or grinding metal, or piercing squeals or humming, the diplomats recalled.

All but one reported immediate symptoms: headache, pain in one ear, loss of hearing. Days or weeks later, other symptoms emerged, including memory problems, an inability to concentrate, mood problems, headaches and fatigue.

The State Department asked researchers at the University of Pennsylvania to investigate. Their report confirmed neurological problems in the diplomats, including signs of what appear to be concussions.

“The study was conducted by the top concussion research team in the world utilising state-of-the-art methods,” said C. Edward Dixon, a professor of neurological surgery at the University of Pittsburgh, who was not involved in the research.

The findings suggest “a significant brain insult”, he said.

Weaknesses in study

Other experts were less convinced, noting inherent weaknesses in such a study despite the expertise of the group conducting it. It would be premature, they said, to conclude that there is a mysterious new medical syndrome with an unknown cause.

The study’s lead author, Douglas H. Smith, director of the Center for Brain Injury and Repair at the University of Pennsylvania, emphasised that there is much more to learn. “This is a preliminary report,” he said. “We thought it was important to get it out from a public health standpoint.”

But, he added, the patients’ symptoms were notable. “Uniformly, everyone who saw these patients was absolutely convinced,” he said. “It looked like concussion pathology. Processing speed, inability to remember — those are such classic symptoms we see in concussion.”

‘A real syndrome’

“We all believe this is a real syndrome,” Mr. Smith added. “This is concussion without blunt head trauma.”

Like concussion patients, some of the diplomats improved on their own, while others recovered only after therapy to regain balance or cognition. “Many went from being miserable to returning to work,” Mr. Smith said.

Mr. Smith and his colleagues do not think audible sound caused the injuries, as sound in an audible range does not damage the brain. Perhaps, they speculated, a device that produced another sort of harmful energy also produced an audible sound.

One drawback to the report is that there was no comparison group, said Karen Postal, immediate past president of the American Academy of Clinical Neuropsychology.

A control group would have shown whether the diplomats who were posted in Cuba did better or worse than other subjects similar to them — ideally others in the State Department who also reported sleep problems, which can interfere with thinking.NY Times