Researchers report acute findings from Havana embassy phenomenon

December 12, 2018

Beginning in late 2016, U.S. diplomats and family members stationed in Havana, Cuba, reported a number of sudden-onset symptoms, including dizziness, ear pain and tinnitus. They noted a high frequency, loud and very localized sound that sometimes followed them as they moved through a room. For the first time, researchers from the University of Pittsburgh School of Medicine and the University of Miami Miller School of Medicine have described these acute symptoms and their associated clinical findings. The analysis is published today in the journal Laryngoscope Investigative Otolaryngology.

"This report is incredibly important because it represents the findings from patient evaluations that were conducted shortly after exposure, and an analysis of the data confirming that they had a unique set of symptoms that we have not seen before," said Carey Balaban, Ph.D., one of the corresponding authors on the study and a professor of otolaryngology in Pitt's School of Medicine who also has appointments in the departments of Neurobiology, Communication Science & Disorders, and Bioengineering at Pitt.

The study included a retrospective review of clinical data from 25 people at the U.S. Embassy who reported a localized sensation of noise and pressure, and 10 individuals who were housemates of those affected and did not experience the sensations.

"Objective testing showed evidence of a balance dysfunction that affects the inner ear and a unique pattern of cognitive dysfunction," said Michael E. Hoffer, M.D., professor of otolaryngology and neurological surgery at Miami's Miller School of Medicine and the lead and co-corresponding author. "This cluster of auditory, vestibular and neurological symptoms, along with associated psychological issues, does not resemble more classic traumatic brain injury (TBI), based on our team's vast experience in this area."

Over the course of a few months beginning in February 2017, Hoffer, along with University of Miami's Hillary Snapp, Au.D., Ph.D., associate professor of otolaryngology and chief of audiology; Bonnie E. Levin, Ph.D., professor of neurology and director of the Division of Neuropsychology; and James Buskirk, a doctoral student and physical therapist, evaluated individuals who suspected they had been affected, between four and 60 days after exposure. The team also evaluated a larger group of 105 embassy workers who denied any "exposure" to noise or a pressure sensation.

Balaban, who has collaborated with Hoffer for more than two decades on research involving balance disorders and traumatic brain injuries, was called in to join the team because of his longstanding experience in studying complex and often difficult-to-understand symptoms involving balance disorders. Balaban has published extensively on inner ear physiology, including seminal research that has shown a link between balance disorders and cognitive dysfunction, anxiety and migraine.

The study found that all of the 25 people with symptoms noticed unsteadiness and features of cognitive impairment. Dizziness (92 percent) and cognitive complaints (56 percent) were the most common symptoms. Formal testing revealed that all of them had an inner ear abnormality and evidence of cognitive dysfunction. After the evaluations, a number of the patients were treated for balance, cognitive and emotional symptoms.

"This is the first and only report of the acute presentation seen shortly after exposure in this unique group of patients," said Hoffer. "Our findings are unaffected by the influence of time, variable amounts of rehabilitation, workers compensation concerns or media attention. It is an important contribution to this field and in helping us to determine what happened."

While the study did not attempt to determine the cause of the symptoms in these U.S. Embassy residents, the researchers noted that intense ultrasonic exposures can produce "a syndrome involving manifestations of nausea, headache, tinnitus, pain, dizziness and fatigue," based on occupational health literature. "The exposure responsible for these findings is unknown," they wrote. "It would be imprudent to exclude any potential directed or non-directed energy sources at this time."
-end-
No funding was provided for this work.

University of Pittsburgh Schools of the Health Sciences

Related Cognitive Impairment Articles from Brightsurf:

Professional athletes may not suffer more severe cognitive impairment than others, study indicates
DALLAS - Nov. 11, 2020 - Even though repeated hits to the head are common in professional sports, the long-term effects of concussions are still poorly understood.

Actively speaking two languages protects against cognitive impairment
A study has shown that Alzheimer's patients with a higher degree of bilingualism receive a later diagnosis of mild cognitive impairment

USPSTF statement on screening for cognitive impairment in older adults
The US Preventive Services Task Force (USPSTF) concludes that current evidence is insufficient to make a recommendation about screening for cognitive impairment in adults 65 or older.

Scientists discover link between autism and cognitive impairment
Scientists have found how a single gene fragment impacts social behaviour and cognitive ability, revealing a common molecular mechanism for autism and Fragile X syndrome.

Mild cognitive impairment, ISS produces the first epidemiological estimation
In a study published in the Journal of Alzheimer's Disease, ISS researchers estimated about 680,000 cases of mild cognitive impairment (MCI), in a total of 12,730,960 migrants, aged between 60 and 89 years, living in the European Union (EU) in 2018.

Research underscores value of cognitive training for adults with mild cognitive impairment
Researchers at the Center for BrainHealth®, part of The University of Texas at Dallas, combined two non-pharmacological interventions for adults with Mild Cognitive Impairment (MCI): eight sessions of Strategic Memory Advanced Reasoning Training (SMART), a cognitive training program shown to improve reasoning and ability to extract bottom-line messages from complex information; and Transcranial Direct Current Stimulation (tDCS) over the left frontal region, associated with cognitive control and memory recovery success in people with Alzheimer's.

Kidney disease triggers cognitive impairment, even in early stages
Chronic kidney disease (CKD) is increasingly recognized as a systemic condition.

Lowering blood pressure reduces risk of cognitive impairment
Intensive control of blood pressure in older people significantly reduced the risk of developing mild cognitive impairment (MCI), a precursor of early dementia, in a clinical trial led by scientists at Wake Forest School of Medicine, part of Wake Forest Baptist Health.

Advances in the study of drugs to combat cognitive impairment in schizophrenia
A study by the UPV/EHU has assessed the effectiveness of various drugs, which are used to delay cognitive deterioration in patients with Alzheimer's, in improving cognitive impairment displayed by patients with schizophrenia.

Antioxidants may prevent cognitive impairment in diabetes
Cognitive difficulties in patients with diabetes, caused by repeated episodes of low blood sugar, could be reduced with antioxidants, according to a new study presented at the Society for Endocrinology annual conference in Glasgow.

Read More: Cognitive Impairment News and Cognitive Impairment Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.