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Neuroimaging Findings in US Government Personnel with Possible Exposure to Directional Phenomena in Havana, Cuba
Journal article   Open access   Peer reviewed

Neuroimaging Findings in US Government Personnel with Possible Exposure to Directional Phenomena in Havana, Cuba

Ragini Verma, Randel L. Swanson, Drew Parker, Abdol Aziz Ould Ismail, Russell T. Shinohara, Jacob A. Alappatt, Jimit Doshi, Christos Davatzikos, Michael Gallaway, Diana Duda, …
JAMA : the journal of the American Medical Association, v 322(4), pp 336-347
23 Jul 2019
DOI: https://doi.org/10.1001/jama.2019.9269
PMID: 31334794
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.1001/jama.2019.9269View
Published, Version of Record (VoR) Open

Abstract

Importance United States government personnel experienced potential exposures to uncharacterized directional phenomena while serving in Havana, Cuba, from late 2016 through May 2018. The underlying neuroanatomical findings have not been described. Objective To examine potential differences in brain tissue volume, microstructure, and functional connectivity in government personnel compared with individuals not exposed to directional phenomena. Design, Setting, and Participants Forty government personnel (patients) who were potentially exposed and experienced neurological symptoms underwent evaluation at a US academic medical center from August 21, 2017, to June 8, 2018, including advanced structural and functional magnetic resonance imaging analytics. Findings were compared with imaging findings of 48 demographically similar healthy controls. Exposures Potential exposure to uncharacterized directional phenomena of unknown etiology, manifesting as pressure, vibration, or sound. Main Outcomes and Measures Potential imaging-based differences between patients and controls with regard to (1) white matter and gray matter total and regional brain volumes, (2) cerebellar tissue microstructure metrics (eg, mean diffusivity), and (3) functional connectivity in the visuospatial, auditory, and executive control subnetworks. Results Imaging studies were completed for 40 patients (mean age, 40.4 years; 23 [57.5%] men; imaging performed a median of 188 [range, 4-403] days after initial exposure) and 48 controls (mean age, 37.6 years; 33 [68.8%] men). Mean whole brain white matter volume was significantly smaller in patients compared with controls (patients: 542.22 cm3; controls: 569.61 cm3; difference, −27.39 [95% CI, −37.93 to −16.84] cm3; P < .001), with no significant difference in the whole brain gray matter volume (patients: 698.55 cm3; controls: 691.83 cm3; difference, 6.72 [95% CI, −4.83 to 18.27] cm3; P = .25). Among patients compared with controls, there were significantly greater ventral diencephalon and cerebellar gray matter volumes and significantly smaller frontal, occipital, and parietal lobe white matter volumes; significantly lower mean diffusivity in the inferior vermis of the cerebellum (patients: 7.71 × 10−4 mm2/s; controls: 8.98 × 10−4 mm2/s; difference, −1.27 × 10−4 [95% CI, −1.93 × 10−4 to −6.17 × 10−5] mm2/s; P < .001); and significantly lower mean functional connectivity in the auditory subnetwork (patients: 0.45; controls: 0.61; difference, −0.16 [95% CI, −0.26 to −0.05]; P = .003) and visuospatial subnetwork (patients: 0.30; controls: 0.40; difference, −0.10 [95% CI, −0.16 to −0.04]; P = .002) but not in the executive control subnetwork (patients: 0.24; controls: 0.25; difference: −0.016 [95% CI, −0.04 to 0.01]; P = .23).

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