Havana Syndrome: New Recommendations and Enrollment Criteria for a Shared Study of Possible Cases
Main Article Content
Abstract
Background: From November 2016 to the summer of 2021, some U.S. diplomats and their family members residing in Havana and other locations, including China, Russia, Colombia, Switzerland, and France, reported the sudden onset of auditory, vestibular, and neurological symptoms. The aim of this study is to define enrollment criteria for patients with a possible diagnosis of Havana Syndrome.
Methods: This study, through a review of the scientific literature, proposes the definition of criteria for proper enrollment of patients with a possible diagnosis of "Havana Syndrome".
Results: In view of the increasing number of cases, their wide geographic distribution, and the lack of certainty regarding etiopathogenesis, it is essential to propose a strategy for sharing case histories.
Conclusions: A correct enrollment of patients is crucial since specialists can then disclose new strategies for the study of case histories and for a clear definition of the diagnosis. This way, it will be possible to have a wide discussion of clinical and epidemiological results among specialists in different medical, engineering, and intelligence disciplines.
Keywords:
Havana syndrome, recommendations, criteria, diagnosis, enrollment, symptoms
Article Details
How to Cite
POSA, Franco et al.
Havana Syndrome: New Recommendations and Enrollment Criteria for a Shared Study of Possible Cases.
Medical Research Archives, [S.l.], v. 11, n. 3, mar. 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/3617>. Date accessed: 25 apr. 2024.
doi: https://doi.org/10.18103/mra.v11i3.3617.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Asadi-Pooya AA. Havana syndrome: a scoping review of the existing literature. Rev Environ Health. Published online August 15, 2022. doi:10.1515/reveh-2021-0182
2. National Academies of Sciences, Engineering, and Medicine; Division on Engineering and Physical Sciences; Health and Medicine Division; Standing Committee to Advise the Department of State on Unexplained Health Effects on U.S. Government Employees and Their Families at Overseas Embassies. An Assessment of Illness in U.S. Government Employees and Their Families at Overseas Embassies. (Pavlin JA, Relman DA, eds.). National Academies Press (US); 2020. Accessed February 1, 2023. http://www.ncbi.nlm.nih.gov/books/NBK566407/
3. Abouzari M, Goshtasbi K, Sarna B, Lin HW, Djalilian HR. Proposal for a new diagnosis for U.S. diplomats in Havana, Cuba, experiencing vestibular and neurological symptoms. Med Hypotheses. 2020;136:109499. doi:10.1016/j.mehy.2019.109499
4. Rubin GJ, Hahn G, Everitt BS, Cleare AJ, Wessely S. Are some people sensitive to mobile phone signals? Within participants double blind randomised provocation study. BMJ. 2006;332(7546):886-891. doi:10.1136/bmj.38765.519850.55
5. Hubler GK, Hoffman SW, Andreadis TD, DePalma RG. Pulsed Microwave Energy Transduction of Acoustic Phonon Related Brain Injury. Front Neurol. 2020;11:753. doi:10.3389/fneur.2020.00753
6. Bartholomew RE, Baloh RW. Challenging the diagnosis of “Havana Syndrome” as a novel clinical entity. J R Soc Med. 2020;113(1):7-11. doi:10.1177/0141076819877553
7. Finger S, Zeitler W. Benjamin Franklin and his glass armonica: from music as therapeutic to pathological. Prog Brain Res. 2015;216:93-125. doi:10.1016/bs.pbr.2014.11.005
8. Crichton F, Chapman S, Cundy T, Petrie KJ. The Link between Health Complaints and Wind Turbines: Support for the Nocebo Expectations Hypothesis. Front Public Health. 2014;2:220. doi:10.3389/fpubh.2014.00220
9. Crichton F, Dodd G, Schmid G, Gamble G, Cundy T, Petrie KJ. The power of positive and negative expectations to influence reported symptoms and mood during exposure to wind farm sound. Health Psychol. 2014;33(12):1588-1592. doi:10.1037/hea0000037
10. Dyer O. Microwave weapon caused syndrome in diplomats in Cuba, US medical team believes. BMJ. 2018;362:k3848. doi:10.1136/bmj.k3848
11. Aristi G, Kamintsky L, Ross M, et al. Symptoms reported by Canadians posted in Havana are linked with reduced white matter fibre density. Brain Commun. 2022;4(2):fcac053. doi:10.1093/braincomms/fcac053
12. Lin JC. The Havana Syndrome and Microwave Weapons [Health Matters]. IEEE Microwave Magazine. 2021;22(11):13-14. doi:10.1109/MMM.2021.3102201
13. Bartholomew RE. Politics, scapegoating and mass psychogenic illness: claims of an “acoustical attack” in Cuba are unsound. J R Soc Med. 2017;110(12):474-475. doi:10.1177/0141076817745711
14. Verma R, Swanson RL, Parker D, et al. Neuroimaging Findings in US Government Personnel With Possible Exposure to Directional Phenomena in Havana, Cuba. JAMA. 2019;322(4):336-347. doi:10.1001/jama.2019.9269
15. Nelson R. Havana syndrome might be the result of energy pulses. Lancet. 2021;396(10267):1954. doi:10.1016/S0140-6736(20)32711-2
16. Rubin R. More Questions Raised by Concussion-like Symptoms Found in US Diplomats Who Served in Havana. JAMA. 2018;319(11):1079-1081. doi:10.1001/jama.2018.1751
17. Dagro A, Wilkerson J. A computational investigation of strain concentration in the brain in response to a rapid temperature rise. J Mech Behav Biomed Mater. 2021;115:104228. doi:10.1016/j.jmbbm.2020.104228
18. Golomb BA. Diplomats’ Mystery Illness and Pulsed Radiofrequency/Microwave Radiation. Neural Comput. 2018;30(11):2882-2985. doi:10.1162/neco_a_01133
19. Bartholomew RE, Pérez DFZ. Chasing ghosts in Cuba: Is mass psychogenic illness masquerading as an acoustical attack? Int J Soc Psychiatry. 2018;64(5):413-416. doi:10.1177/0020764018766185
20. Jauchem JR, Cook MC. High-intensity acoustics for military nonlethal applications: a lack of useful systems. Mil Med. 2007;172(2):182-189. doi:10.7205/milmed.172.2.182
21. Swanson RL, Hampton S, Green-McKenzie J, et al. Neurological Manifestations Among US Government Personnel Reporting Directional Audible and Sensory Phenomena in Havana, Cuba. JAMA. 2018;319(11):1125-1133. doi:10.1001/jama.2018.1742
22. Muth CC, Lewis SL. Neurological Symptoms Among US Diplomats in Cuba. JAMA. 2018;319(11):1098-1100. doi:10.1001/jama.2018.1780
23. Reed G. What Happened to the US Diplomats in Havana? Mitchell Valdés MD PhD Director, Cuban Neuroscience Center. MEDICC Rev. 2018;20(4):14-19. doi:10.37757/MR2018.V20.N4.5
24. Farrell JAD, Landman BA, Jones CK, et al. Effects of signal-to-noise ratio on the accuracy and reproducibility of diffusion tensor imaging–derived fractional anisotropy, mean diffusivity, and principal eigenvector measurements at 1.5T. J Magn Reson Imaging. 2007;26(3):756-767. doi:10.1002/jmri.21053
25. Rubin R. Alleged acoustic attack on US diplomats puzzling experts. Lancet. 2017;390(10099):e22. doi:10.1016/S0140-6736(17)32359-0
26. Hoffer ME, Levin BE, Snapp H, Buskirk J, Balaban C. Acute findings in an acquired neurosensory dysfunction. Laryngoscope Investigative Otolaryngology. 2019;4(1):124-131. doi:10.1002/lio2.231
27. Green-McKenzie J, Shofer FS, Matthei J, Biester R, Deibler M. Clinical and Psychological Factors Associated With Return to Work Among United States Diplomats Who Sustained a Work-Related Injury While on Assignment in Havana, Cuba. J Occup Environ Med. 2022;64(3):212-217. doi:10.1097/JOM.0000000000002450
28. Balaban CD, Szczupak M, Kiderman A, Levin BE, Hoffer ME. Distinctive Convergence Eye Movements in an Acquired Neurosensory Dysfunction. Front Neurol. 2020;11:469. doi:10.3389/fneur.2020.00469
29. Bartholomew RE, Sirois F. Occupational Mass Psychogenic Illness: A Transcultural Perspective. Transcult Psychiatry. 2000;37(4):495-524. doi:10.1177/136346150003700402
30. De Santis S, Drakesmith M, Bells S, Assaf Y, Jones DK. Why diffusion tensor MRI does well only some of the time: Variance and covariance of white matter tissue microstructure attributes in the living human brain. NeuroImage. 2014;89:35-44. doi:10.1016/j.neuroimage.2013.12.003
31. Friedman A, Calkin C, Adams A, et al. Havana Syndrome Among Canadian Diplomats: Brain Imaging Reveals Acquired Neurotoxicity. medRxiv. Published online January 1, 2019:19007096. doi:10.1101/19007096
2. National Academies of Sciences, Engineering, and Medicine; Division on Engineering and Physical Sciences; Health and Medicine Division; Standing Committee to Advise the Department of State on Unexplained Health Effects on U.S. Government Employees and Their Families at Overseas Embassies. An Assessment of Illness in U.S. Government Employees and Their Families at Overseas Embassies. (Pavlin JA, Relman DA, eds.). National Academies Press (US); 2020. Accessed February 1, 2023. http://www.ncbi.nlm.nih.gov/books/NBK566407/
3. Abouzari M, Goshtasbi K, Sarna B, Lin HW, Djalilian HR. Proposal for a new diagnosis for U.S. diplomats in Havana, Cuba, experiencing vestibular and neurological symptoms. Med Hypotheses. 2020;136:109499. doi:10.1016/j.mehy.2019.109499
4. Rubin GJ, Hahn G, Everitt BS, Cleare AJ, Wessely S. Are some people sensitive to mobile phone signals? Within participants double blind randomised provocation study. BMJ. 2006;332(7546):886-891. doi:10.1136/bmj.38765.519850.55
5. Hubler GK, Hoffman SW, Andreadis TD, DePalma RG. Pulsed Microwave Energy Transduction of Acoustic Phonon Related Brain Injury. Front Neurol. 2020;11:753. doi:10.3389/fneur.2020.00753
6. Bartholomew RE, Baloh RW. Challenging the diagnosis of “Havana Syndrome” as a novel clinical entity. J R Soc Med. 2020;113(1):7-11. doi:10.1177/0141076819877553
7. Finger S, Zeitler W. Benjamin Franklin and his glass armonica: from music as therapeutic to pathological. Prog Brain Res. 2015;216:93-125. doi:10.1016/bs.pbr.2014.11.005
8. Crichton F, Chapman S, Cundy T, Petrie KJ. The Link between Health Complaints and Wind Turbines: Support for the Nocebo Expectations Hypothesis. Front Public Health. 2014;2:220. doi:10.3389/fpubh.2014.00220
9. Crichton F, Dodd G, Schmid G, Gamble G, Cundy T, Petrie KJ. The power of positive and negative expectations to influence reported symptoms and mood during exposure to wind farm sound. Health Psychol. 2014;33(12):1588-1592. doi:10.1037/hea0000037
10. Dyer O. Microwave weapon caused syndrome in diplomats in Cuba, US medical team believes. BMJ. 2018;362:k3848. doi:10.1136/bmj.k3848
11. Aristi G, Kamintsky L, Ross M, et al. Symptoms reported by Canadians posted in Havana are linked with reduced white matter fibre density. Brain Commun. 2022;4(2):fcac053. doi:10.1093/braincomms/fcac053
12. Lin JC. The Havana Syndrome and Microwave Weapons [Health Matters]. IEEE Microwave Magazine. 2021;22(11):13-14. doi:10.1109/MMM.2021.3102201
13. Bartholomew RE. Politics, scapegoating and mass psychogenic illness: claims of an “acoustical attack” in Cuba are unsound. J R Soc Med. 2017;110(12):474-475. doi:10.1177/0141076817745711
14. Verma R, Swanson RL, Parker D, et al. Neuroimaging Findings in US Government Personnel With Possible Exposure to Directional Phenomena in Havana, Cuba. JAMA. 2019;322(4):336-347. doi:10.1001/jama.2019.9269
15. Nelson R. Havana syndrome might be the result of energy pulses. Lancet. 2021;396(10267):1954. doi:10.1016/S0140-6736(20)32711-2
16. Rubin R. More Questions Raised by Concussion-like Symptoms Found in US Diplomats Who Served in Havana. JAMA. 2018;319(11):1079-1081. doi:10.1001/jama.2018.1751
17. Dagro A, Wilkerson J. A computational investigation of strain concentration in the brain in response to a rapid temperature rise. J Mech Behav Biomed Mater. 2021;115:104228. doi:10.1016/j.jmbbm.2020.104228
18. Golomb BA. Diplomats’ Mystery Illness and Pulsed Radiofrequency/Microwave Radiation. Neural Comput. 2018;30(11):2882-2985. doi:10.1162/neco_a_01133
19. Bartholomew RE, Pérez DFZ. Chasing ghosts in Cuba: Is mass psychogenic illness masquerading as an acoustical attack? Int J Soc Psychiatry. 2018;64(5):413-416. doi:10.1177/0020764018766185
20. Jauchem JR, Cook MC. High-intensity acoustics for military nonlethal applications: a lack of useful systems. Mil Med. 2007;172(2):182-189. doi:10.7205/milmed.172.2.182
21. Swanson RL, Hampton S, Green-McKenzie J, et al. Neurological Manifestations Among US Government Personnel Reporting Directional Audible and Sensory Phenomena in Havana, Cuba. JAMA. 2018;319(11):1125-1133. doi:10.1001/jama.2018.1742
22. Muth CC, Lewis SL. Neurological Symptoms Among US Diplomats in Cuba. JAMA. 2018;319(11):1098-1100. doi:10.1001/jama.2018.1780
23. Reed G. What Happened to the US Diplomats in Havana? Mitchell Valdés MD PhD Director, Cuban Neuroscience Center. MEDICC Rev. 2018;20(4):14-19. doi:10.37757/MR2018.V20.N4.5
24. Farrell JAD, Landman BA, Jones CK, et al. Effects of signal-to-noise ratio on the accuracy and reproducibility of diffusion tensor imaging–derived fractional anisotropy, mean diffusivity, and principal eigenvector measurements at 1.5T. J Magn Reson Imaging. 2007;26(3):756-767. doi:10.1002/jmri.21053
25. Rubin R. Alleged acoustic attack on US diplomats puzzling experts. Lancet. 2017;390(10099):e22. doi:10.1016/S0140-6736(17)32359-0
26. Hoffer ME, Levin BE, Snapp H, Buskirk J, Balaban C. Acute findings in an acquired neurosensory dysfunction. Laryngoscope Investigative Otolaryngology. 2019;4(1):124-131. doi:10.1002/lio2.231
27. Green-McKenzie J, Shofer FS, Matthei J, Biester R, Deibler M. Clinical and Psychological Factors Associated With Return to Work Among United States Diplomats Who Sustained a Work-Related Injury While on Assignment in Havana, Cuba. J Occup Environ Med. 2022;64(3):212-217. doi:10.1097/JOM.0000000000002450
28. Balaban CD, Szczupak M, Kiderman A, Levin BE, Hoffer ME. Distinctive Convergence Eye Movements in an Acquired Neurosensory Dysfunction. Front Neurol. 2020;11:469. doi:10.3389/fneur.2020.00469
29. Bartholomew RE, Sirois F. Occupational Mass Psychogenic Illness: A Transcultural Perspective. Transcult Psychiatry. 2000;37(4):495-524. doi:10.1177/136346150003700402
30. De Santis S, Drakesmith M, Bells S, Assaf Y, Jones DK. Why diffusion tensor MRI does well only some of the time: Variance and covariance of white matter tissue microstructure attributes in the living human brain. NeuroImage. 2014;89:35-44. doi:10.1016/j.neuroimage.2013.12.003
31. Friedman A, Calkin C, Adams A, et al. Havana Syndrome Among Canadian Diplomats: Brain Imaging Reveals Acquired Neurotoxicity. medRxiv. Published online January 1, 2019:19007096. doi:10.1101/19007096