Abstract

Anomalous Health Incidents (AHIs) of the Havana Syndrome involve sudden onset of neurological, sensory, and vestibular symptoms occurring simultaneously, followed by chronic deficits. A 2024 NIH neuroimaging study concluded “no significant MRI-detectable evidence of brain injury”. We re- analyzed Pierpaoli et al. (2024) by extracting imaging results for 43 AHI1 patients (AHI cases validated by neuro-vestibular-otolithic criteria) and 48 matched controls. AHI1 cases exhibited a consistent pattern of subtle changes. Resting-state fMRI revealed significantly reduced functional connectivity in the salience network (insula and anterior cingulate hubs) in AHI1 compared to controls (adjusted p ~0.02 for network connectivity). DTI measures did not differ after correction, but nominal microstructural abnormalities (uncorrected p < 0.05) were noted in midline white-matter tracts. The corpus callosum (body and genu) of AHI1 patients showed ~2-3% lower return-to-axis probability, and the right cingulum and inferior cerebellar peduncle also showed slight diffusivity reductions (all trend-level). These new AHI1-specific findings were then compared to the previous neuroimaging studies in AHI1 group by Verma et al. (2019). Conclusion: Focused analysis of validated AHI1 patients in Pierpaoli et al. (2024) reveals reduced connectivity in salience network, while subtle white-matter microstructural alterations closely parallel those of the Verma et al. (2019) AHI1 cases. This strengthens the evidence that AHI1 phenotype represents a genuine diffuse brain injury syndrome. Advanced neuroimaging and qEEG techniques may be required to sensitively detect AHI1-related brain abnormalities. Public health efforts are warranted to issue diagnostic criteria and address cases in both governmental and civilian populations.

Keywords

  • Havana Syndrome Anomalous Health Incidents MRI
  • qEEG
  • diagnostic criteria
  • NIH
  • CDC

References

  1. [1] U.S. Government Accountability Office. (2024). Havana syndrome: Better patient communication and monitoring of key DOD tasks needed to better ensure timely treatment (Publication No. GAO-24- 106593). https://www.gao.gov/assets/gao-24-106593.pdf
  2. [2] Ber, L. (2025). Collecting Information on Diagnosed Cases of "Havana Syndrome" and its Anomalous Health Incidents (AHI) among Civilians Occurring on US Soil. Report by Targeted Justice, Inc. ResearchGate. https://doi.org/10.13140/RG.2.2.30841.38243
  3. [3] Swanson, R. L., et al. (2018). Neurological manifestations among US government personnel reporting directional audible and sensory phenomena in Havana, Cuba. JAMA, 319(11), 1125–1133. https://doi.org/10.1001/jama.2018.1742
  4. [4] National Academies of Sciences, Engineering, and Medicine. (2020). An assessment of illness in U.S. government employees and their families at overseas embassies. The National Academies Press. https://doi.org/10.17226/25889
  5. [5] IC Expert Panel Assessment. (2022). Anomalous Health Incidents: Analysis of Potential Causal Mechanisms. FOIA final response package for case 22-cv-674. https://media.salon.com/pdf/22-cv- 674%20Final%20Response%20Package.pdf
  6. [6] Ber, L. (2025). Helping physicians to understand "Havana syndrome" and a novel method of managing AHI. Advanced Medical Sciences: An International Journal, 12(1). https://doi.org/10.5121/ams.2025.12101
  7. [7] Giordano, J., et al. (2023). Assessing anomalous health incidents of “Havana Syndrome”. ECronicon Neurology, 15(7), 1–4. https://ecronicon.net/ecne/assessing-anomalous-health-incidents-of-havana- syndrome
  8. [8] Hoffer, M. E., et al. (2019). Acute findings in an acquired neurosensory dysfunction. Laryngoscope Investigative Otolaryngology, 4(1), 124-131. https://doi.org/10.1002/lio2.231
  9. [9] Pierpaoli C, et al. (2024) Neuroimaging Findings in US Government Personnel and Their Family Members Involved in Anomalous Health Incidents. JAMA. 2024;331(13):1122–1134. https://10.1001/jama.2024.2424
  10. [10] Chan L, et al. (2024). Clinical, Biomarker, and Research Tests Among US Government Personnel and Their Family Members Involved in Anomalous Health Incidents. JAMA. 2024;331(13):1109–1121. https://10.1001/jama.2024.2413
  11. [11] Verma R, et al. (2019). Neuroimaging Findings in US Government Personnel with Possible Exposure to Directional Phenomena in Havana, Cuba. JAMA. 2019;322(4):336–347. https://10.1001/jama.2019.9269
  12. [12] Relman, D.A. (2024). Neurological Illness and National Security: Lessons to Be Learned. JAMA. 2024;331(13):1093–1095. https://10.1001/jama.2023.26818
  13. [13] Giordano, J. (2024). Directed Energy Remains Key Suspect Behind Havana Syndrome. National defense Magazine, April 4, 2024. https://www.nationaldefensemagazine.org/articles/2024/4/4/directed- energy-remains-key-suspect-behind-havana-syndrome
  14. [14] McCreight, R. (2024). Analyzing & Refuting Various JAMA/NIH Claims on Havana Syndrome. Academia.edu https://www.academia.edu/128583516
  15. [15] Ber, L. (2025). Salience Network Hypoconnectivity in Core AHI Cases Warrants Diagnostic Weight. Letter to the Editor of JAMA. Pre-Print. ResearchGate. https://10.13140/RG.2.2.17687.02726
  16. [16] Koberda, J. L. (2015). LORETA Z-score neurofeedback-effectiveness in rehabilitation of patients suffering from traumatic brain injury. Journal of Neurology and Neurobiology, 1(4). https://doi.org/10.16966/2379-7150.113
  17. [17] Zinn, M. Personal Communication
  18. [18] Thatcher RW, et al. (2001). An EEG severity index of traumatic brain injury. J Neuropsychiatry Clin Neurosci. 2001;13(1):77–87. https://10.1176/jnp.13.1.77
  19. [19] Thatcher RW, et al. (2005). Quantitative EEG and the Frye and Daubert standards of admissibility: general acceptance and error rate. Clin EEG Neurosci. 2005;36(1):2–5. https://10.1177/155005940503600102
  20. [20] Friedman A, et al. (2019. Havana Syndrome Among Canadian Diplomats: Brain Imaging Reveals Acquired Neurotoxicity. medRxiv. 2019; doi: 10.1101/19007096.
  21. [21] Bigler ED, Maxwell WL. (2011) Neuroimaging and neuropathology of TBI. NeuroRehabilitation. 2011;28(2):63-74. https://10.3233/NRE-2011-0633
  22. [22] Fieremans E, et al. (2011). White matter characterization with diffusional kurtosis imaging. Neuroimage. 2011;58(1):177–188. https://10.1016/j.neuroimage.2011.06.006
  23. [23] Lewine, J.D., et al. (2019). Quantitative EEG Biomarkers for Mild Traumatic Brain Injury. Journal of Clinical Neurophysiology 36(4):p 298-305, July 2019. https://10.1097/WNP.0000000000000588
  24. [24] Lewine J.D., et al. (1999). Neuromagnetic assessment of pathophysiologic brain activity induced by minor head trauma. AJNR Am J Neuroradiol. 1999;20(5):857–866. https://www.ajnr.org/content/20/5/857.long
  25. [25] Balaban CD, et al. (2020) Distinctive Convergence Eye Movements in an Acquired Neurosensory Dysfunction. Front. Neurol. 11:469. https://10.3389/fneur.2020.00469
  26. [26] Targeted Justice, Inc. (2025). Formal Petition for NIH Action on Civilian “Havana Syndrome”/Anomalous Health Incidents: Recognition, Research Inclusion, and Clinical Protocols. Substack, Sept 29, 2025 https://lenbermd.substack.com/p/formal-petition-to-the-nih
  27. [27] Targeted Justice, Inc. (2025). Formal Petition to CDC for Recognition, Surveillance, and Guidance Regarding Civilian “Havana Syndrome” (Anomalous Health Incidents) Cases. Substack, Sept 29, 2025 https://lenbermd.substack.com/p/formal-petition-to-the-cdc
  28. [28] Griffen, J., Fridden, L. (2024) Havana Syndrome study halted as review finds some patients were coerced. Fox News, Sept 13, 2024. https://www.foxnews.com/world/havana-syndrome-study-halted- review-finds-some-patients-coerced
  29. [29] Dunleavy, J. (2025). House Intel inquiry sent criminal referral to DOJ on strange health incidents on Havana Syndrome. Just the News, Sept 28, 2025. https://justthenews.com/government/congress/house-intel-inquiry-anomalous-health-incidents-sent- doj-criminal-referral