A study found no brain injuries linked to Havana syndrome. Participants question the research
A study by the National Institutes of Health spanning four years did not find signs of brain injuries in people affected by the mysterious ailment known as Havana syndrome, but the results, published Monday in a medical journal, have been disputed by participants who accused authors of bias and mishandling confidential medical information.
According to a research paper published Monday in the Journal of the American Medical Association, the NIH team found no signs of brain injuries in advanced MRI scans of 81 people who experienced “anomalous health incidents,” the government term for the events associated with the Havana syndrome.
Two earlier imaging studies published in JAMA had found signs of mild traumatic injury and other changes in the brains of people exposed to the incidents in Cuba and China.
Havana syndrome got its name from the city where U.S. diplomats and intelligence officials first reported in 2016 experiencing strange noises and sensations of pressure, and later developed debilitating symptoms including vertigo, migraines, and hearing and cognitive problems.
The incidents were later reported around the world, which led to suspicions that a foreign adversary, possibly Russia, was attacking U.S. diplomats and spies with directed energy or some other unknown weapon.
The NIH imaging study, conducted by the NIH Clinical Center between June 2018 and November 2022, recruited participants stationed in Cuba and other places including China, Austria and the United States. Only 49 of the 81 patients were scanned twice.
A second paper published in JAMA says the researchers did not find significant differences in the blood, vision, hearing and cognitive tests of 86 participants and those of a smaller control group “except for self-reported and objective measures of imbalance; symptoms of fatigue, post-traumatic stress, and depression.” According to that study, 41% of participants had symptoms of neurological disorders.
“The post-traumatic stress and mood symptoms reported are not surprising, given the ongoing concerns of many of the participants,” said Louis French, the deputy director of the National Intrepid Center of Excellence at Walter Reed National Military Medical Center and a co-author of the study. “Often, these individuals have had significant disruption to their lives and continue to have concerns about their health and their future. This level of stress can have significant negative impacts on the recovery process.”
Although it ended in 2022, the study was published Monday amid news that the House Intelligence Committee is launching a formal inquiry into how spy agencies handled the Havana syndrome investigation.
The House committee’s inquiry follows complaints by whistleblowers.
The results of the study align with an earlier intelligence community assessment published in March 2023 and finding that most of the symptoms experienced by those affected were probably the result of “pre-existing conditions, conventional illnesses and environmental factors,” because an attack by a foreign adversary was unlikely.
The March 2023 assessment cites the NIH study, which was unpublished at the time, to support its conclusions.
However, the new study is unlikely to put the issue to rest, as some of the participants have questioned the integrity of the research.
Before the papers were published, Tim Breegen, a lawyer with the firm Hogan Lovells, sent an email to
JAMA’s editorial board and the NIH Director of Research Integrity with a document listing several concerns raised by some of the study’s participants. Breegen did not immediately respond to a request for comment.
Breegen’s complaint, obtained by the Miami Herald, includes allegations that NIH officials and researchers involved in the study maintained close contact with the CIA and were pressured to “ensure the studies ‘found’ what was asked of them.” The email says that doctors involved in the study made private remarks to patients that they were pressured or were afraid to report a traumatic brain injury diagnosis accurately, and that patients were told verbally of findings that were not later reported in writing in their medical records.
“As the nature and scope of the cooperation between CIA and NIH throughout this process has come to light, participants have dropped from the program, undermining the integrity of any longitudinal study findings and impeding the duty of both to put the welfare of Agency personnel first,” the complaint says.
The document said the NIH asked the CIA to provide a comparative control group, “given the unique and complex nature of the study’s participants and the unique demands of fielddeployed intelligence officers.” However, the control group provided was not comparative or matched to the study participants,
“and NIH staff routinely complained to participants about this fact,” the document adds.
The complaint also questions the inclusion in the study of one NIH doctor who in 2017 made repeated comments about the Havana syndrome being an instance of mass hysteria.
Other allegations involve ethical issues in the recruitment of participants and the handling of medical data.
According to the complaint, several patients were coerced into taking part in the NIH study. They were told it was the only way to get blood tests or brain scans and “were effectively blocked by their respective employers to visit other private institutions for that testing.”
Participants were told that the only way to get follow-up medical care at Walter Reed was if the NIH approved it. According to the document, enrollment in the NIH study “became a mandatory gateway to further care when its role was properly confined to data collection and analysis.”
The complaint adds that some officials who were evacuated from their posts after being affected by one of the mysterious incidents were directly told to report to the NIH, which acted as the clearing medical entity to send them and their family members “back to post after weeks of research, with no treatment or treatment recommendations given to impacted individuals.”
The document also claims that NIH researchers disclosed specific test results to participants’ government employers without keeping them anonymous and without authorization, which resulted in negative consequences for study participants.
Asked about the allegations, an NIH spokesperson said: “We understand that some patients may be disappointed that researchers were unable to identify clear markers of injury. We take these allegations very seriously and will be reviewing the research’s performance in accordance with policy, which will determine the appropriate offices’ next steps. Beyond this, we wouldn’t discuss a review.”
A JAMA spokesperson did not say whether the journal investigated the complaints.
“The publication process is confidential, so we can neither confirm nor deny anything that occurred prior to publication,” said Jen Zeis, the director of communications and engagement for JAMA Network, which includes 13 peer-review journals.
But JAMA also published
Monday an article by Dr. David Relman, a prominent Stanford University professor, pointing out several limitations of the NIH study and research in general about the Havana syndrome. Although the journal calls it an editorial, it does not represent the journal’s views, Zeis said.
“With few differences between cases and controls in the two current studies, one might suspect that nothing or nothing serious happened with these cases. This would be ill-advised,” Relman said.
Relman led a National Academy of Sciences study between 2019 and 2020 that concluded that the set of symptoms that came to be known as Havana syndrome was “unlike any disorder in the neurological or general medical literature” and is “consistent with the effects of directed pulsed radiofrequency energy.” He was co-chair of an intelligence community experts panel that found that commercially available devices known as directional loudspeakers or acoustic lasers could cause the symptoms.
Relman said that “incomplete information, nonstandardized clinical testing, delayed reporting, and the sensitive nature of the circumstances, individuals, and their work” have hampered understanding of the syndrome.
Among the problems affecting the NIH study, he notes that some patients were scanned up to four years after the incidents, “which is important for a syndrome that evolves quickly with time.” He also argues that the researchers aggregated cases for their analysis, diluting findings for particular clusters of individuals.
Relman said NIH investigators relied on blood biomarkers developed for traumatic brain injury, which are known to peak about 24 hours after an incident and return to normal levels three to seven days later. However, only 16 of the 86 individuals studied had their blood tested within three days of their particular incidents. “Hence, their study lacked relevant statistical power,” Relman wrote.
He also said that current MRI technology used in the study “may be insensitive to, or improperly timed for, the kinds of potentially transient cellular and local physiological disruption that characterizes” the health incidents.
The authors of the NIH study acknowledged some of these limitations. They said that testing closer to the incident might have resulted in different findings and that their research could not be directly compared to previous ones because they used a different sample pool of individuals.