Mystery deepens on brain issues of diplomats

In late 2016, dozens of U.S. diplomats working in Cuba and China began reporting odd mental symptoms: persistent headaches, vertigo, blurred vision, hearing phantom sounds. Since then, scientists and commentators have groped for plausible explanations. Deliberate physical attacks, involving microwaves or other such technology? Or were psychological factors, subconscious yet mind-altering, the more likely cause?

The strangeness of the symptoms, and the spookiness of the proposed causes, have given the story a life of its own in the diplomatic corps, the Pentagon and in assorted pockets of the internet where conspiracy theories thrive.

Now, researchers are reporting results from the first brain-imaging studies of 40 of those diplomats, who were carefully examined by neurologists after returning home from Cuba. The study, appearing Tuesday in the medical journal JAMA, concludes that the diplomats experienced some kind of brain trauma. But the nature and cause of that trauma were not clear, as it did not resemble the signature of more familiar brain injuries such as repeated concussions or exposure to battlefield blasts.

“The main thing we can do with brain imaging is ask whether something happened to the brain,” said Dr. Ragini Verma, a professor of radiology at the University of Pennsylvania Perlman School of Medicine and lead author of the new report. “And the answer we found is that yes, it did.”

Based on the findings, Verma said that a wholly psychogenic or psychosomatic cause was very unlikely. “But I don’t know the cause,” she said. “The imaging by itself cannot tell us that.”

Outside experts were divided on the study’s conclusions. Some saw important new evidence; others say it is merely a first step toward an explanation and difficult to interpret given the small number of patients.

“It’s good work, but there’s just not enough here to come to any conclusion,” said Dr. Mark Rasenick, a neuroscientist at the University of Illinois Chicago School of Medicine. Rasenick is a member of the Cuban Academy of Science and has close ties to scientists there who have been skeptical that invisible weapons were involved. “I think the only reason it’s going in JAMA is that it’s such a politically charged topic.”

In an editor’s note, two editors of the journal acknowledged the uncertainties in the findings but added: “These unique data provide additional information and contribute to a growing evidence base that may help in understanding the neurological signs and symptoms experienced by this group of individuals.”

The new study was an extension of examinations, conducted at the University of Pennsylvania Center for Brain Injury and Repair, of several dozen diplomats returning from Cuba. In 2018, the Penn team, which included Drs. Douglas Smith and Randel Swanson, reported on the first 21 of those patients and identified a range of peculiar and often shared symptoms.

“The unique circumstances of these patients, and the consistency of the clinical manifestations, raised concern for a novel mechanism of a possible acquired brain injury,” that report concluded.

Whether that presentation reflects a physical injury from an enigmatic weapon, or something else, is still far from clear, the authors acknowledged.