Hi, I’m Wendy Zukerman and you’re listening to Science Vs from Gimlet. The show that pits facts against futuristic weapons. Today… we're cracking open the case of a mysterious illness. It hit US Government officials in Havana, Cuba, several years ago[1]… and since then things have gotten weirder and weirder…
<<news clips>>
Victims have reported damage to their hearing, vision, balance, and memory
The cause? Unknown.
It's not going to end we're going to see more of these attack in the future, and we need to be prepared for them
There could be folks out there that know what happened
This is so shocking and disturbing
Let's set the scene. It's 2016… and government officials from the U.S. are working in Cuba -- and before they even get there, they're warned -- it's going to be a little hostile.
TG: they're told - you know, you don't have any privacy, you're going to be listened to, your phones are going to be tapped, you're going to be followed on the street[2]
This is Tim Golden, Editor at Large for ProPublica.[3][4] Tim and a colleague tried to work out how this mystery started…
TG: Initially it was all very murky, and it was unclear what was going on…
They dug into this - talking to more than 3 dozen officials and poring through confidential government documents.[5] And Tim told us that Patient Zero was a young CIA officer
TG: Who had been a fairly athletic guy[6]
who in December 2016… wakes up one night because he hears this loud, piercing sound in one ear…and it seems to be following him around the room[7] He feels unstable… nauseated, and soon after said he couldn't think properly[8]…. Just over a month later, two other CIA officers say the same thing happens to them.[9]
TG: Hearing a kind of a sharp sound that was a kind of metallic sound and then they had had headaches and dizziness and other symptoms that had followed that and being sort of shaken by this
These CIA officers were sent back to the US to get checked out-- and a doctor said they'd sustained serious injuries.[10] When the top guy at the Embassy heard this -- in late March[11] - Tim says he called a staff-wide meeting to tell people what they knew.
TG: You know everybody had to leave their cell phones outside and go into what’s called a SCIF - a sensitive compartmented information facility - so you know, a secure, windowless room
He said that some people might have been attacked -- described the loud sound, the weird symptoms. And told diplomats that if they thought they were getting hit... they should move away from windows. At the the time, the US Government's best guess about what was going on - was that this was coming from some kind of sonic device[12].
TG: But they really didn't know what this was and most of what they said was — if anybody has been exposed, if anybody thinks that they've been exposed, please let us know.
WZ: What did the people at the embassy tell you about how they felt after this meeting?
TG: I think some people were very worried. I think some people were just completely freaked out … and I think they were more worried because they were told that this was all highly secret and sensitive and they weren't allowed to inform their families[13]
After this meeting, more and more people came forward[14] - saying they got sick after experiencing some kind of attack. And it was happening under all sorts of circumstances.
TG: Right, you had people in their homes, behind walls, you had people in hotel rooms with big windows in the rooms. You had people who may have even been on the street in certain circumstances
Right away, this had huge political consequences[15]… the U.S. Government quickly said that Cuba was responsible for what had happened[16]… and the Trump administration pulled a bunch of people out of the Embassy in Havana[17].
All in all -- the CDC said that possibly 46 Americans were affected in Cuba[18]... some who still haven't fully recovered[19][20]. Canadians in Cuba also said this happened to them[21]… And a declassified Government document says there are reports of this going on in China and Uzbekistan[22]…
TG: This was just a very weird mysterious thing, there's just not a lot of situations in which the power of the American national security community is focused in on a problem, and it really just gets nowhere in trying to figure out… Ok well what did this??
The U.S. government was kinda freaking out - cause it seemed like they were getting attacked by a new kind of weapon here. At first -- the culprit was some kind of sonic weapon... a special sound that damaged people's brains … and then late last year[23], a new idea got a lot of attention[24] - that this was some kind of high powered microwave weapon.
But something else has been floating around from Day 1: That perhaps there was never any weapon at all. That these symptoms are so vague and weird, perhaps this could be a case of mass hysteria[25].
So today we’re trying to get to the bottom of this - looking at the science to figure out - what really happened down in Cuba?
When it comes to these so called attacks… there's a lot of …
<<news clip>>
The cause? Unknown.
But then there's science…
AHHH
Science Vs ….is coming up just after the break.
BREAK
Welcome back. We just heard that starting in 2016 all these people fell mysteriously ill after hearing a strange noise in Havana, Cuba… and the US Government started scrambling to figure out what was going on. Were these diplomats really under attack? To help them out… they fired off an email… to Professor Douglas Smith[26].
DS: it just said so we're looking for some expert to, you know, weigh in on this and I thought- this is a scam haha It was a weird- you know you have a lot of people self identifying as coming from the government- and you’re like, common’ you know haha
But this was no scam. The government was reaching out to Doug because he studies brain injuries at the University of Pennsylvania… And they wanted him to get a bunch of specialists together to take a look at these patients… to help figure out: what was going on here? Did these people have actual brain injuries... ?
DS: you know is there really something there, could it be just psychological or was there something real. So I assembled a team.
He brings together nerds who treat brain injuries[27], and study brain images[28]. Two dozen patients who had been in Cuba[29] made their way to UPenn to see Doug and the team…And they get to work. Examining the patients. And right away, Doug notices something coming up again and again- the sound. Most of his patients heard it too[30]
DS: some described kind of a-- hearing a low metallic kind of tone or scraping noises. For some it was kind of a trilling insect-y sound or just kind of a buffeting sound, if you drive with the car window down on the highway, that bawowowowo[31]
He also noticed that a lot of the patients had problems with their balance, hearing, with headaches and sleep[32]….But the big thing that really bothered these patients: was that they just couldn't think as clearly as they used to. Like their concentration and memory was shot.[33]
DS: they noticed that they really weren't being able to do their jobs and they just felt kind of devastated by the end of each day...ah so for example trying to get your suitcase packed- just trying to figure--what do I put first or where do I have to go for this- just this utter confusion of doing a simple task - was really unnerving for some of these folks. You know you start to get angry with yourself: this is a simple thing, why can't I do even this simple thing?
And to help get to the bottom of what might have caused this?? They put the patients through some tests. So for example, one test Doug told us about looks at the patients’ eye movements — it’s called convergence
DS: So basic convergence is when your eyes go cross eyed- so if i put my finger straight in the air and I moved it toward your nose, your eyes have to converge-- they have to kind of move together like a cross-eyed look
Doug says, most people can move their eyes like that pretty easily. But half of the patients struggled to do this- like eventually their eyes broke away and stopped tracking the finger.[34][35] And to Doug ...the eye...tripping up like this? This suggests there’s something going haywire in the brain here.[36] He said, think about it like this. For your neurons to work… they have to fire at each other in this really fast co-ordinated way…like they’re in a relay race and passing around a baton.[37] But for these patients?
DS: All the timing is wrong and you end up having the baton drop someplace, which we see in the way that the eyes cannot converge any more
As Doug ran more and more tests on these patients - he realized something very weird. The symptoms they were having - he’d seen them before…. in people with concussions.[38] And Doug would know...concussions are sorta his beat. He's on the Scientific Advisory Board for the NFL[39]. But, of course, unlike footballers, these patients weren't spending all day bashing their heads on the field.
DS: We didn't have that history of the head impact and yet they're describing neurological symptoms that were pretty intriguing. Actually some patients called it immaculate concussion
WZ: Immaculate concussion… Because they weren’t hit on the head?
DS: Concussion without the concussion, right
After all of Doug's team saw the patients… they came together to talk about what they found…
DS: It was in a small conference room we're kind of jammed in, I got a little catering and I said alright, what do people think? Just one person just piped up and said- I don’t know for the rest of you but I really think this is real-- this is absolutely real they have real neurological symptoms. And then one by one everybody else agreed and independently they all came to the same conclusion — unanimously — that this was real
And Doug would keep probing these patients -- later doing sophisticated scans of their brains to see what was going on in there. And yeah, he found that there were differences between the brains of healthy folks -- and these patients. And for Doug -- these scans back up that something was wrong here.[40]
DS: There was something there but as far as a smoking gun, this doesn't tell us what caused it
WZ: Just that something did
DS: Something did
So. Something happened to these people. But what? Everything pointed to that sound-- the thing that these people said they heard right before getting sick... Both scientists and the media zeroed in on it.[41][42]
<<News clips>>
These mysterious sonic attacks
Sonic Attacks
Sonic Attacks
Sonic weapon
As the media hype is reaching fever pitch[43][44][45][46][47][48] - in October of 2017…. Associated Press gets sent a recording -- of THE sound that some Embassy works said hurt their brain in Cuba.[49] It was published online… and we're going to play it here… be careful though… this recording isn’t the most pleasant. Here it is —
<sound>[50]
So what is that sound???? Well, once it came out -- scientists from around the world pored over it to see -- to see what it could be[51]. One of those scientists was Professor Fernando Montealegre-[MONT_EL-EGRE] Zapata…. he took the recording to his lab… and analysed it really closely… and compared it to some other sounds he had on file… got a match. Finding what he thought was the heinous… culprit… [52]
FM: That recording that the AP agency published….is a cricket
This is Fernando. He’s an entomologist[53] at the University of Lincoln in the UK.[54]
FM: It's a cricket- I am 100 percent sure that it is a cricket.
Fernando studies insects, and normally he doesn’t touch politics. But he felt the need to chirp up here…. saying, people were too quick, to conjure up some scary villain. Because for Fernando hearing this sound, it was more like hearing from an old friend.
FM: In Colombia in the country where I grew up- I remember I was probably 12 years old and I have always been fascinated with these crickets…
So one day, little Fernando scooped up a cricket from his backyard, and plopped it into a little jar in his bedroom. Later that night, he fell asleep next to his new pet… until...2 or 3 in the morning when he was rudely awakened….
FM: It was just so loud I said what the hell is going on here- then I realized the sound was coming from the little jar. oh you are the one who is singing, ohh. And I just took the animal and put it outside and still outside I could hear it really loud
Crickets make this sound by rubbing their little wings together[55] to call to their mates[56]…. And Fernando says he can really understand why people wouldn’t recognize this noise as a cricket - particularly if you're not familiar with these insects -- and that’s because they make a surprising amount of noise -- particularly if they're singing indoors...and then that sound is going to bounce around and get even louder
FM: The wings are already resonating, and they are very loud, and if they are in a room- just
WZ: Fernando’s just picked up a toilet paper roll
FM: Singing from here- ROOOOOOO Yea, yea it would be even louder, yea. and this can cause you nightmares - believe me
Fernando took the recordings he had of crickets and played them over a loudspeaker INSIDE a room...capturing the echos. here's what it sounds like... [57]
<indoor cricket audio>
And here’s the AP recording:
<AP recording>
Pretty bloody close… and Fernando says minor differences could be because he doesn't know exactly where this was recorded, so it might have echoed differently. And there are other researchers who agree this recording was a cricket[58][59]. Now, this doesn't necessarily mean that what happened in Cuba wasn't a sonic attack -- it's possible whoever sent that recording to the AP got confused. But there's a couple of very good reasons to think there was no sonic weapon here. Number 1. For a noise to hurt people from outside their home...it has to be a BIG NOISE…. I mean...really, really loud.
We talked to Dr. Mitchell Valdés-Sosa about this. He’s a neuroscientist heading Cuba's committee to study what happened here.[60]
MVS: It would have taken the noise that a jet engine produces right immediately outside to have reached the levels that could damage the hearing[61][62]
WZ: Woww It's literally like when you go to a rock concert and if you're up the front and the music is too loud, that's the effect we're talking about here[63][64]
MVS: Yes exactly.
And Mitchell says if you were blasting weird noises around Havana -- lots of other people would hear it. And Mitchell says that researchers in Cuba - talked to a bunch of people who worked at the Embassy or lived near the diplomats who got sick.
MVS: And no Cuban reported anything strange, and Cuba is a very porous society you know, There's a lot of gossip and ya know grapevine and anything that happens anyplace in Havana, in less than fifteen minutes the rest of Havana knows about it--nobody saw nothing
WZ: or heard anything
MVS: or heard anything strange[65]. So this...this is simply absurd
And other scientists agree -- including Doug - our concussion researcher. Who also told us that other kinds of sound...like ultrasound or infrasound[66][67][68][69] don't make sense either.
DS: we don't know of anything from a sonic source, a sound source that can cause damage to the brain that might explain the symptoms
So after countless news reports and hot takes on sonic attacks...we started hearing less and less about them... they kind of fell by the wayside… much like a ratty scrunchy in the 2000s… and so by early last year… the case of the immaculate concussion had gone cold… that was until just a few months ago… when a group of scientists published a report for the very prestigious National Academy of Sciences - they looked at all kinds of explanations for what might have caused this… from insecticides[70]… to viruses[71]. And said the most likely thing that happened? Was that perhaps these people were hit with something that's never been seen on the battlefield before. A new kind of device. And that's coming after the break
BREAK
Welcome back. We just learned that these so-called sonic attacks in Havana? They probably weren’t sonic….that is...it’s very unlikely that some weird sound was blasted into the ears of Diplomats. But, now we have new information for what this weapon might actually be. You see... late last year… The National Academy of Sciences put out a report[72] where a group of 19 scientists got together, and said the most likely culprit?[73] Nothing to do with sound… but instead… a high powered device that uses microwaves to pummel the brain[74]…
And the idea of beaming microwaves onto embassy workers - it actually isn't new. It's kind of retro.
Starting in the 1950s, the Soviet Union shot microwaves it to the US embassy in Moscow[75]… and they did this over more than two decades[76]. The US military didn't think this made anyone sick[77][78]. But in the decades since - the Russians have kept researching this.
In published papers they're clearly studying what souped up, ultra powerful microwaves can do.[79][80][81]
<<Add beginning of Russia clip>>
And scientists even talked about their work in a news report on Russian Telly.
<<More Russian Clip>>
Because of all this - people have even suggested that Russia could have had a hand in this[82]. So is that possible - could a device using high powered microwaves -- be behind what happened in Cuba? To find out we’re talking to Chris Collins, Professor of Radiology at New York University.[83] And before we got to talking about the mysterious world of microwave weapons… Chris had some very important advice for me, that has nothing to do with weapons.
CC: This is something you must do! Hot Krispy Kreme donuts!! They have this neon sign… Neon sign says hot donuts now!! the hot glazed donuts they melt in your mouth !! it’s mind altering--
WZ: OMG
CC: You have to have them while they're hot
WZ: They're better than if you shoved them in the microwave, right? yeah
CC: I've never done that….
But we didn't call Chris up to talk about donuts. We called him to help us figure out this microwave weapon thing...
Ok so… microwaves -- whether they're in your kitchen appliances, or perhaps a military grade weapons -- are a type of electromagnetic energy[84]. And they’re actually used in lots of tools around us--- we also beam microwaves at cars... with a police radar gun.
CC: The policeman can be quarter of a mile away[85] - and can tell how fast your particular car is going - because there is this beam of microwave energy
The gun sends out an invisible wave -- a microwave -- through the air…to your car -- these waves hit your car[86]… and energy bounces back to the gun -- letting the cop know how fast you're driving[87].
And Chris told us that a microwave weapon -- could be a suspect here for a couple of key reasons. Unlike blasting sound from a speaker, which other people would hear -- microwaves can be beamed out from a device and then aimed at something very specific - whether it's a car -- or someone's head.[88]
But there’s another - cooler - reason to point the finger at microwaves…. and that's because this could explain why some diplomats reported hearing weird sounds.[89] So we've basically knocked out the possibility that these noises came from someone blasting sounds at them … but what if -- instead, the weapon somehow made them hear noises inside their head - noises that no one else could hear? Because that's something microwave beams can do. It's known as the Frey Effect because back in the 1960s a scientist called Allan Frey, realised that if he beamed microwaves at someone's head from several hundred feet away -- and then flicked the beam on and off at a particular rate -- sort of pulsing it -- the person would hear sounds.[90]
CC: And so people will do a single pulse -- which would just -- result in a click![91]
We spoke to two academics who did this to themselves and one said -- it sounded a bit like clanking keys together underwater. And you can hear this because[92][93]… the pulsing microwave beam makes some tissue in your brain a tiny tiny bit hotter and then it cools back down. This all happens so fast that it creates a wave of pressure that travels inside your head to your inner ear.[94][95]
CC: and that expansion and contraction causes a vibration
WZ: And when you say vibrations- vibrations in the tissue — the brain tissue is literally moving just a little
CC: Yes yes you can say that
WZ: Like a slice of brain that's like… brrr
CC: Ha! Little, little waves travelling through the tissue, if you will
It's a bit like if you tap a really large piece of Jell-O on one side, you can see the jiggles traveling through it. That jiggling rattles the little hair cells in your ear[96]... and that send a message BACK to your brain, which is interpreted as if you just heard a
CC: Click
And you can get fancier than a click … if you start playing about with how you switch on and off the microwave beams -- you can make people hear different things - like even a musical note![97]
CC: If you were to turn it on and off at say 262 times a second[98], you would actually be able to hear Middle C
WZ: And a middle C - just to remind us - if you could sing that?
CC: hahah Middle C?! Yea well...without picking up my guitar...I’m going to say it’s around aahhhh!
We checked, and Chris was pretty much bang on with his middle C![99] No guitar needed. Anyway. What all this tells us is that if you had the right machine that could emit microwaves just so ... you could point it at someone and make them hear something weird. And Chris says - yeah if you didn't know what’s going on here -- that really might be very creepy.
CC: Just suppose that you heard a sound and you can move and get away from it, I mean you would definitely remember that -- you can imagine being traumatised by it. So a microwave weapon is suspected exactly because of that
So microwaves… they are ticking some boxes here. You could make someone hear a sound -- that others around you can't hear. But before we pack up and have our coffee and donuts... Chris says -- that much like a donut… this microwave theory -- has one big hole in it...and it starts here -- experiments have shown that these sounds you hear through the Frey effect … the clicks and buzzes… they're really faint. One academic said he could barely hear it in a silent room.
CC: It would be very quiet!! Ok, It would be very quiet!![100][101] But these patients talk about a very loud sound and a very -- it’s a sustained sound[102][103][104]
Diplomats in Cuba could hear the sounds easily -- above the traffic and hubbub of Havana[105]… And Chris says that to get the sounds that loud sound in your head… If you were to use microwaves.. you'd need to crank the power WAY UP
CC: Yes, exactly that, you're cranking up the power! So to get from something that’s barely audible to something that’s very loud, even painfully loud... you really are increasing the power a million times higher, certainly hundreds of thousands of times.[106]
And just like zapping a donut too long in the microwave… if you start cranking the power up… things donut look so good.
CC: And you would definitely fry somebody's brain before you could cause a loud sustained sound with a microwave weapon
WZ: Oh wow, fry their brain? They'd see a singed burn patch?
CC: Yea, I mean, you'd fry the skin too. To put this into perspective - you don't even, these patients don't even complain about a warming sensation, let alone being instantly fried
None of the diplomats reported feeling even a bit warm on their face[107][108]… and for Chris, this is a big problem with the microwave idea.
In fact, he’s just about ready to pop it in the bin -- but there’s one thing stopping him. Chris told us that the vast majority of the research into microwaves and what they can do to us -- is about safety -- nerds like Chris aren't trying to design weapons that use this stuff to hurt people...
CC: Have we explored all possibilities? And the answer is - well, no. If you had more nefarious intent, you probably wouldn't be publishing in the same journals that the rest of us are, and you probably wouldn't publish at all
Basically, Chris is like -- who knows what secret military scientists are cooking up?
CC: So this is getting very hypothetical. OK? And I don’t - it's really hard to imagine how that could be done
Other academics have pointed to other problems with this microwave idea. Like really powerful microwaves -- can screw with nearby electronics[109] -- crashing phones and computers.[110][111][112] And this is actually the kind of thing the Soviets said they were doing decades ago -- targeting electronics, not brains[113]. And the US military is in the game too, These days, they're pouring[114][115] money into high-powered microwave weapons for this very thing— seeing if they can knock out drones or even mess up power grids[116]. But in Havana… no one reported anything like this -- it seemed like phones and computers were working just fine.[117] As for that NAS report? We reached out to a bunch of scientists who worked on it, and they wouldn't talk to us.
So - given that a newfangled microwave weapon seems pretty unlikely here - what did happen to these people in Cuba? Well, throughout all this, a couple of big things have kept tickling our brains. One is that not everyone who got sick reported hearing a weird noise[118]. And then there were the symptoms - while you could kind of cluster some people's symptoms into the same sort of stuff -- headaches… dizziness… looking at all the patients -- there was no single thing that all of them had.[119][120]... And it's these facts that's leading some researchers to wonder -- perhaps a weapon didn't hurt all these people. -- perhaps there's something psychological going on. Now the reason that this was pooh poohed from the beginning was because scientists said they found real objective injuries in these patients. Things they said they could measure. So there was this idea -- that, well then, this can't be psychological.[121]
AC: Our language likes things to be one or other. You know, we want it to be brain thing or a psychological thing - but that's not how the brain works.
This is Alan Carson, a neuropsychiatrist at The University of Edinburgh[122]
AC: My understanding is that there were a group of people who felt undoubtedly ill but there were also a group of doctors who felt if the patient feels undoubtedly ill, then it can't be psychological because that’s not real. I don’t think it’s the right paradigm
Alan's work -- and many others -- are showing that things can start psychological -- and quickly manifest into these very real physical symptoms.[123][124][125] Or physical things can become psychological[126][127]… Here's how this whole thing in Havana might have played out...let's say one of those CIA agents who first reported these symptoms was never attacked by a weapon, but instead was hit with a nasty bout of vertigo… [128][129][130][131] … It can hit all of a sudden - sometimes for no known reason[132] and it’s pretty common.[133][134]
AC: You know I've had it myself- you just roll over in bed one night and it feels like someone has picked you up and thrown you over- it's utterly terrifying, and that's even if you know what it is and if you’ve got no idea it's a truly bizarre experience
All right, so let’s say you've just arrived in Cuba -- You roll out of bed… totally off balance…feeling dizzy[135] having been told that this trip is going to be hostile -- and people are going to follow you around… you don't think. Oh crap - vertigo. But instead your first thought is: I'm getting attacked…
AC: In the same way as if I'm lying watching telly tonight and I get a twinge across my chest- I’ll probably think I just stretched for my cup of tea wrong. But if one of my closest friends of my age has just died of a heart attack- I'm going to approach that in a differential way.
Now you're super worried about this -- and that anxiety can brings on all these other symptoms[136][137] -- symptoms that could potentially turn up in eye tests[138][139] or brain scans[140][141][142]...
AC: and it sort of snow balls[143][144][145]
And then there's a big staff meeting -- about a scary sonic device -- and so perhaps this starts happening to more and more people[146][147][148][149][150] . And talking to some of the experts it's a bit like DIPLOMATS. CIA AGENTS. Important - Men - wouldn't be affected by something like this..
AC: It's completely spurious to suggest they wouldn't - it's only human and natural that you would[151] and until people have a more grown up view of what the brain is, and what psychological means you're always going to have problems getting a sensible answer
Alan doesn't think he has the answer here -- he's just watched this "what happened in Havana" story play out in the press and scientific circles -- and keeps seeing this mistake: it's either real or psychological? When it so easily could have been both.
So what do we think happened in Cuba? Well, while we were researching this -- we really flipped and flopped trying to work out what started it all… And you know - some researchers, like Doug, are still convinced there's something else going on here -- this wasn't triggered by something psychological[152]..
For us though -- it comes down to the question of whether there’s this brand new weapon that no one has publicly seen - and we don’t even know how it would work … or whether the main thing going on here is this very well known phenomenon where our brain makes us sick…. so for now -- that's where we are leaning.
But who knows -- maybe Vladimir Putin is listening to this episode -- with a knowing grin, and a very, very warm donut in his hand…
That’s Science Vs
CITATIONS
Right next to the show notes -- you'll also see an application to our Science Vs internship
A couple of quick things! If you wanna help the show -- listen on Spotify! Do it! It's free! Spotify. Another thing - if you wanna know more about this topic -- the guys over Stuff You Should Know just tackled this too. Go check it out. And finally…! Flora Lichtman - from the very very wonderful Every Little Thing gave us the idea for this episode -- back in the before times. We've been following it ever since. Thanks Flora!!! And her podcast is - Every Little Thing.
This episode was produced by Nick DelRose and me, Wendy Zukerman, with help from Meryl Horn, Rose Rimler, Michelle Dang and Taylor White. We’re edited by Blythe Terrell. Fact checking by Eva Dasher. Mix and sound design by Bumi Hidaka. Music written by Bumi Hidaka, Peter Leonard, Marcus Bagala, Emma Munger and Bobby Lord. Translation help by Kristin Torres. A huge thanks to all of the researchers who helped us out for this episode -- we spoke to around two dozen experts to get their thoughts on many different parts of this -- from the brain studies to the possibility of microwave weapons. A lot of them only wanted to talk on background - but thank you so much for your time. And special thanks to Ayo Oti, Navani Otero, Andrea B. Scott, the Zukerman family and Joseph Lavelle Wilson.
I’m Wendy Zukerman, fact you next time.
[1] Since 2016, the U.S. State Department has reported that 25 staff at the U.S. embassy in Havana have complained of symptoms such as hearing loss and vertigo.
[2] “Before we go to Cuba, it is drilled into our heads: There will be surveillance. There will be listening devices in your house, probably in your car. Assume they are always watching.”
[3]Tim Golden; Editor at Large: Tim Golden is a journalist and filmmaker who has worked primarily on issues of national security, foreign policy and criminal justice.
[4] Tim’s first ProPublica article on the Havana Sonic Attacks was published on Feb 14, 2018. And here’s Tim’s second ProPublica article on the subject
[5]A ProPublica investigation of the case, based on interviews with more than three dozen U.S. and foreign officials and an examination of confidential government documents, represents the first detailed public account of how the Cuba incidents unfolded.
[6] it was not until the end of December that the first victim sought help at the small medical clinic inside the embassy. That officer — the fit younger man in his 30s — came with a more serious complaint: He had developed headaches, hearing problems and a sharp pain in one ear, especially, following a strange experience in which something like a beam of sound seemed to have been directed at his home.
[7] According to Science magazine: the agent said he had heard “a really odd, loud noise that seemed to follow him in the room,” says Hoffer, who examined him in February.
[8] An individual assigned to the U.S. Embassy in Cuba was awakened one night at home in Havana in 2016 by severe pain and a sensation of intense pressure in the face, a loud piercing sound in one ear with directional features, and acute disequilibrium and nausea. Symptoms of vestibular and cognitive dysfunction ensued.
[9] On December 30, 2016, Patient Zero in the Cuba crisis visited the Embassy health office... Around January 9, 2017, the same C.I.A. officer reported a second incident to the medical office.
[10]The New Yorker (details confirmed through other interviews): In early February, 2017, Michael Hoffer, a professor of otolaryngology at the University of Miami, received a call from a State Department doctor, who told him, “We have a problem.” Hoffer—who had worked with the military to treat head traumas, and had kept his security clearance—agreed to help. He soon saw one of the victims, and in the following months others flew to Miami. Hoffer ran a battery of tests, which confirmed that the C.I.A. officers had sustained serious injuries.
[11] In late March, DeLaurentis convened a town-hall-style meeting for staff at the Embassy. Several of Lee’s colleagues came forward to report that they, too, had been exposed. And : At the end of March 2017, recalls the U.S. diplomat who spoke with Science, then Ambassador Jeffrey DeLaurentis summoned personnel with security clearances—about 30 in all—for a classified briefing in a special installation in the embassy. Also, confirmed through Conversation on Background
[12] The “working hypothesis,” the diplomat says, was the victims were being targeted by a long-range acoustic device
[13] Eighty embassy community members underwent initial evaluation between February and April 2017
[14]As of May 2018, we know 24 Embassy Havana community members have been medically confirmed to have sustained brain injuries while serving in Havana with the severity of injury ranging from mild impairment to injuries in a few patients so severe they may never be able to return to their previous jobs.
[15] Despite the uncertainty about the cause of the problems, and with no evidence that Cuba had caused or had taken insufficient action to prevent the harm, the Trump administration evacuated most of the Embassy staff from the country and designated Cuba as an unaccompanied post. It then demanded that Cuba reduce the size of its embassy staff in Washington. The consequences were that several U.S. organizations cancelled planned educational trips to the island, and Cubans seeking a visa for travel to the United States had to travel to a third country to obtain one.
[16] "They did some bad things in Cuba" - President Trump https://www.youtube.com/watch?v=hSLR963QRwY @ 00:48
[17] On September 29, the Department ordered the departure of non-emergency personnel assigned to the U.S. Embassy in Havana, as well as all family members. Until the Government of Cuba can ensure the safety of our diplomats in Cuba, our Embassy will be reduced to emergency personnel in order to minimize the number of diplomats at risk of exposure to harm. (also, here)
[19] Doug Smith confirmed some patients still have persisting symptoms
[20] As of June 2020, many of these personnel continue to suffer from these and/or other health problems.
[21] We conducted a multimodal study examining 26 Canadian diplomats and their family members, the majority of whom presented with symptoms similar to their American counterparts while residing in Havana.
[22] Include declassified Government report - that says there were reports in other posts including the Capital of Uzbekistan and a confirmed case in China. pg 4.
[23] December, 2020 https://www.ncbi.nlm.nih.gov/books/NBK566407/
[24] many of the distinctive and acute signs, symptoms, and observations reported by DOS employees are consistent with the effects of directed, pulsed radio frequency (RF) energy "appears to be the most plausible mechanism"
[25] e.g. Havana Syndrome: Mass Psychogenic Illness and the Real Story Behind the Embassy Mystery and Hysteria From the same author "Over the past 100 years, the medical community has accumulated a vast amount of evidence for the existence of psychogenic war trauma under an array of disparate labels. Each of these conditions uniquely reflect the times and manifest in a slightly different form to reflect the circumstances. Due to the large variation in symptoms, none of these conditions are truly syndromes. To this lengthy list, we should add another: ‘Havana syndrome’."
[27] e.g. https://www.med.upenn.edu/apps/faculty/index.php/g275/p1991822 and https://www.pennmedicine.org/providers/profile/stephen-hampton / https://www.pennmedicine.org/providers/profile/ramon-diaz-arrastia
[28] https://www.med.upenn.edu/sbia/rverma.html and https://www.pennmedicine.org/providers/profile/ronald-wolf
[29] Of 24 individuals with suspected exposure identified by the US Department of State, 21 completed multidisciplinary evaluation an average of 203 days after exposure.
[30] For 18 of the 21 individuals (86%), there were reports of hearing a novel, localized sound at the onset of symptoms in their homes and hotel rooms (Table 2).
[31] Of the patients, high-pitched sound was reported by 16 (76%), although 2 (10%) noted a low-pitched sound. Words used to describe the sound include “buzzing,” “grinding metal,” “piercing squeals,” and “humming.” ...The sounds were often associated with pressurelike (n = 9, 43%) or vibratory (n = 3, 14%) sensory stimuli, which were also experienced by 2 of the 3 patients who did not hear a sound. The sensory stimuli were likened to air “baffling” inside a moving car with the windows partially rolled down.
[32]Persistent symptoms (>3 months after exposure) were reported by these individuals including cognitive (n = 17, 81%), balance (n = 15, 71%), visual (n = 18, 86%), and auditory (n = 15, 68%) dysfunction, sleep impairment (n = 18, 86%), and headaches (n = 16, 76%). Objective findings included cognitive (n = 16, 76%), vestibular (n = 17, 81%), and oculomotor (n = 15, 71%) abnormalities
[33]Persistent cognitive manifestations were reported by 17 individuals (81%). Subjective symptoms included memory problems (n = 16, 76%), feeling mentally foggy (n = 16, 76%), impaired concentration (n = 15, 71%), and feeling cognitively slowed (n = 14, 67%) (Table 3). I
[34] Convergence insufficiency is the inability to maintain binocular function (keeping the two eyes working together) while working at a near distance. Typically, one eye will turn outward (intermittent exotropia) when focusing on a word or object at near.
[35] Vergence testing included step vergence with prism bar, vergence facility with prisms, and near point of convergence. Table 2: Convergence insufficiency: 11 (52%)
[36] Because convergence insufficiency (4–6) and pupillary light reflex effects (7) are described in the mild traumatic brain injury (mTBI) literature, detailed analyses are likely germane to the differential diagnosis of the Havana individuals.
[37] Neurons communicate with each other via electrical events called ‘action potentials’ and chemical neurotransmitters. At the junction between two neurons (synapse), an action potential causes neuron A to release a chemical neurotransmitter. The neurotransmitter can either help (excite) or hinder (inhibit) neuron B from firing its own action potential.
[38] CDC describes concussion: For example, in the first few minutes your child or teen might be a little confused or a bit dazed, but an hour later your child might not be able to remember how he or she got hurt.
[39] Prof. Smith is the Scientific Director of the Big 10/ Ivy league Collaboration on Concussion and he also serves as a member on the Scientific Advisory Boards of the US National Football League (NFL), the National Collegiate Athletic Association (NCAA)-DoD consortium on concussion and the International Concussion Society.
[40] Among US government personnel in Havana, Cuba, with potential exposure to directional phenomena, compared with healthy controls, advanced brain magnetic resonance imaging revealed significant differences in whole brain white matter volume, regional gray and white matter volumes, cerebellar tissue microstructural integrity, and functional connectivity in the auditory and visuospatial subnetworks but not in the executive control subnetwork. The clinical importance of these differences is uncertain and may require further study.
[41]The most distinctive clinical aspects of the illnesses were the nature of the onset and the initial features: the sudden onset of a perceived loud sound
[42] Because these recordings are the only non-medical evidence available on the “sonic health attacks” in Cuba, much attention has focused on identifying the origin of this acoustic signal, and on establishing whether it is connected to the reported health outcomes.
[44]The attack, which may have been caused by a sonic wave machine, seemed to begin last December.
[45] The recording, released Thursday by the AP, is the first disseminated publicly of the many taken in Cuba of mysterious sounds that led investigators initially to suspect a sonic weapon.
[46]US embassy employees in Cuba possibly subject to ‘acoustic attack’
[47] Mystery of sonic weapon attacks at US embassy in Cuba deepens
[48]A supersecret sonic weapon being used to attack diplomats in a foreign country may sound like the start of a sci-fi novel, but that's exactly what several U.S. diplomats in Cuba may have been exposed to, the U.S. State Department recently announced.
[49] The Associated Press has obtained a recording of what some U.S. Embassy workers heard in Havana in a series of unnerving incidents later deemed to be deliberate attacks. The recording, released Thursday by the AP, is the first disseminated publicly of the many taken in Cuba of mysterious sounds that led investigators initially to suspect a sonic weapon.
[51] In March 2018, after analyzing the clip and conducting reverse engineering, computer scientists at the University of Michigan in Ann Arbor thought that the sound could have been caused by interference after eavesdropping devices were placed too close together.
[53] I am an entomologist with a solid research background in biomechanics, acoustics, sensory and comparative biology. I study ultrasound-sensitive ears and ultrasound generators in insects, and their evolution. I use a combination of innovative methods such as Laser Doppler Vibrometry, micro-CT x-ray tomography, 3D computer-generated images, and computer modelling.
[54] Dr. Fernando Montealegre-Zapata, Bioacoustics and Sensory Biology Lab
[55] The file-and-plectrum act as a frequency multiplier taking the low wing beat frequency as the input and converting it into an impulse-train of sufficiently high frequency close to the resonant frequency of the harp. The forced vibration response results in beats producing the characteristic sound of the cricket song.
[56] Male field crickets emit pure-tone mating calls by rubbing their wings together.
[57] While the temporal pulse structure in the recording is unlike any natural insect source, when the cricket call is played on a loudspeaker and recorded indoors, the interaction of reflected sound pulses yields a sound virtually indistinguishable from the AP sample.
[58] Last year some complaints by noise exposure to the so called “noise attacks” were referred by American diplomats. This paper intends to present a sound characterization of possible noise events experienced including audible structure of this acoustic episodes (target sound)....Several unusual sound episodes are shown as broadband spectra where apparently a cosmopolitan acoustic background is combined with possible high frequency pitches similar to those produced by some kind of Orthoptera. There exist some kind of similitude between background noise with cricket sounds and this target sound spectrum.
[59] Recently, around her home at Havana City, the author recorded during calling, photographed in situ (fig. 1d) and collected a large series of adult and juvenile specimens of a conspicuous ground cricket. After a careful comparison, they were identified satisfactorily as the Fast-calling Short-tailed Cricket Anurogryllus celerinictus Walker, 1973. It was described originally from Jamaica (type-locality), Grand Cayman and Florida (Walker, 1973), but so far never recorded from Cuba. Through personal communications -- Mitchell Valdés-Sosa told us the author found the cricket after the so-called Havana Attacks.
[61]For most industrial sound it takes daily exposure for several years to produce measurable damage. Above a certain level, however- 140 dB or so -a single sound may produce permanent damage.
[63] Noise-induced hearing loss (NIHL) is a process of permanent metabolic cochlear damage, caused by chronic exposure to sound levels between 90 dB and 140 dB. Evidence of NIHL has been shown in choristers,3 symphony orchestra musicians,4 in those attending rock concerts
[64] See Table 1- Peak dBA for 3 groups of rock concert ticket holders
[65]While acoustic or electromagnetic fields might conceivably have produced audible sounds at the embassy, no physical agents have been reported at levels that might plausibly have injured the employees.
[66] Any sound gets less powerful the further you are from a loudspeaker, but ultrasound loses power far more quickly with distance than audible sounds do. A single ultrasonic emitter (loudspeaker) would struggle to generate enough power to affect someone halfway across a typical room.
[67] “Furthermore, it is not a long-range weapon: ultrasound does not travel far in air. With a commercial ultrasonic ‘pest scarer’ placed in a room, only the individuals in that room, and perhaps the neighbouring room, are exposed to levels sufficient to cause adverse effects – and only in a minority of individuals.”
[68] Pg 51 Ultrasound is difficult to propagate through air for any significant distance (Leighton, 2007) and therefore the number of airborne applications of ultrasound is small….pg 149: Very little acoustic energy is transmitted across an interface between air and tissue and, to a first approximation, ultrasound above about 300 kHz does not propagate through air. Therefore, for many applications, the operator of ultrasound equipment is effectively screened from exposure.
[69] we don’t have evidence that ultrasound can cause damage unless long term occupational exposure: “With the exception of permanent hearing threshold changes (which have for ultrasound to date only been associated with long term occupational ultrasonic exposure in the presence of significant levels of lower frequency noise), all reports of ill effects attributed to ultrasonic exposure indicate that the symptoms disappear when the source of exposure is removed, yet Swanson et al. tested individuals an average of 203 days after the suspected exposure and stated that “most patients referred following suspected exposure in Havana exhibited significant impairment that persisted for months with no significant improvement in multiple cases until rehabilitation was initiated.”
[70]NAS Report pg 21—information provided by presenters from Dalhousie University indicated widespread heavy spraying of OPs (including the OP chlorpyrifos) and pyrethroids throughout Cuba to prevent the spread of Zika virus by mosquitoes. If the images of pesticide spraying shown in the formal presentations to the committee were reflective of actual conditions in Havana, it is highly likely that U.S. Embassy personnel were exposed to OP
Pg 23: the committee concludes that it is not likely that acute high-level exposure to OPs and/or pyrethroids contributed to the unexplained illnesses observed in the Havana cases because there is no convincing evidence of acute high-level exposures and the clinical history of affected U.S. Embassy personnel is not consistent with acute OP poisoning.
[71] The committee considered endemic and epidemic infectious diseases known to have been present in Cuba during 2016-2018 and focused on those with known neurological manifestations… These included dengue, chikungunya, and Zika virus infections.
[72] NAS report: An Assessment of Illness in U.S. Government Employees and Their Families at Overseas Embassies
[73] many of the distinctive and acute signs, symptoms, and observations reported by DOS employees are consistent with the effects of directed, pulsed radio frequency (RF) energy. "appears to be the most plausible mechanism"
[74] The NAS team concluded that the “most plausible” cause was a “directed, pulsed radiofrequency energy” device, but stressed that this conclusion was speculative because of the lack of access to relevant U.S. government information. “In particular, much of the detail and many of the investigations performed by others were not available to [the NAS committee],” the report stated, “either because they are classified for reasons of national security or restricted for other reasons (e.g., internal department deliberations, protected health information, etc.)” (Nice summary from here)
[75] According to a Wikileaks document - the signal was about five microwatts per square centimeter, the signal was well below the threshold needed to heat things, as a microwave oven does. Yet it was also a hundred times more powerful than the Soviets’ maximum exposure standards, which were much more stringent than those of the United States. PRIOR TO MAY/JUNE 1975 TYPICAL MAXIMUM POWER LEVELS IN LIMITED LIVING AND WORKING AREAS WERE UP TO 5 MICROWATTS PER SQUARE CENTIMETER FOR NEVER MORE THAN 8 HOURS PER DAY. THESE TYPICAL MAXIMUM LEVELS WERE 5/10,000 OF U.S. SAFETY STANDARD AND 50 PER CENT OF THE SOVIET STANDARD.
[76] The US embassy in Moscow was irradiated by the Soviet government from 1953 to April, 1979
[77] The Moscow Signal,” as officials in Washington called the radiation, was too low to do any obvious harm to the people in the building.
[78] (p42/59) In 1980 - Military researchers wrote "no convincing evidence has been discovered" that would implicate microwave exposure of Moscow Embassy employees in causing adverse health effects
[79] 2014: "By now, there have been developed new repetitive pulsed microwave sources based on electron accelerators with a short (several to tens of nanoseconds) pulse duration and high peak pulse power." - Russian Academy of Sciences
[80] In a paper published in 2018, Russian scientists wrote "Siberian Branch of the Russian Academy of Sciences for the last 20 years, it has been shown that nanosecond repetitive pulsed microwave radiation (RPM) causes a variety of bioeffects from the molecular, cellular to the organismic levels of organism"
[81] Table 1 shows the US and Russian research on pulse microwaves
[82] The Russians and the Chinese certainly possess the capabilities of fielding high-power microwave sources like the ones that appear to have been used in Cuba and China.
The officers were traveling to discuss countering Russia covert operations with foreign intelligence agencies, a fact that adds to suspicions that Moscow is behind the episodes.
[84]other types of EM radiation that make up the electromagnetic spectrum are microwaves, infrared light, ultraviolet light, X-rays and gamma-rays. ...Microwave radiation will cook your popcorn in just a few minutes, but is also used by astronomers to learn about the structure of nearby galaxies.
[85] the radar’s range typically exceeds 800 meters
[86] Radar technology is considered an active remote sensing system because it actively sends a microwave pulse and senses the energy reflected back.
[87] These waves are shifted in frequency by the Doppler effect, and the beat frequency between the directed and reflected waves provides a measure of the vehicle speed.
[88] This analysis leads to a rough estimate of the likely maximum range of such a weapon, which is unlikely to be more than 10 km against a hardened target.
[89] NAP pg 19-- These reported symptoms are consistent with some of the first-person accounts provided to the committee. Frey reported these symptoms with an RF source transmitting at 1.3 GHz (which provides the greatest absorption depth into cortical tissue) with a PRF of 244 Hz, 6 µs pulse width, peak power density of 267 mW/cm2, and average power density of 0.4 mW/cm2 (Frey, 1962).
[90] The intent of this paper is to bring a new phenomenon to the attention of physiologists. Using extremely low average power densities of electromagnetic energy, the perception of sounds was induced in normal and deaf humans….Most of the transmitters used to date in the experimentation have been pulse modulated with no information placed on the signal. The rf sound has been described as being a buzz, clicking, hiss, or knocking, depending on several transmitter parameters, i.e., pulse width and pulse-repetition rate (PRF).
[91] When a radiofrequency field is sharply pulsed so as to produce a burst of electromagnetic waves of short rise time and high peak intensity, most individuals on whom the burst of waves is incident hear a popping or clicking sound. This effect was first systematically studied by Allan Frey
[92]audible sounds are produced by rapid thermal expansion resulting from a calculated temperature rise of only 5x10^-6C in tissue at the threshold level due to absorption of the energy in the RF pulse
[93] The auditory pathway by which acoustic waves detected by the ear become interpreted as sound in the brain is well known and several studies …. The first stage of sound transduction is mechanical distortion of cochlear hair cells
[94] A minuscule but rapid rise in tissue temperature (~10−6 °C), resulting from the absorption of pulsed microwave energy, creates an expansion of brain matter. …. An acoustic wave of pressure travels inside the head to the inner ear. There, it activates the hair cells in the cochlea, which then relays it to the central auditory system for perception, via the same process involved in normal hearing. There, it activates the hair cells in the cochlea, which then relays it to the central auditory system for perception, via the same process involved in normal hearing.
[95] Sudden if extremely slight heating of tissues, because of their thermally-dependent change of density, is believed to launch a minuscule pressure wave detected (as are ordinary sound waves) at the cochlea.
[96] The auditory pathway by which acoustic waves detected by the ear become interpreted as sound in the brain is well known and several studies …. The first stage of sound transduction is mechanical distortion of cochlear hair cells
[97] A single microwave pulse can be perceived as an acoustic click or knocking sound, and a train of microwave pulses to the head can be sensed as an audible tune, with a pitch corresponding to the pulse repetition rate (Lin 1978).
[98] Middle C (262 Hz) played on a piano and a violin.
[99] omg i just played it through this tuner https://tuner.ninja/ and he got it right on the money hahaha C4!!!!!!!! MIDDLE C ON THE PIANO [Michelle Dang]
[100] RF induced sounds can be characterized as low intensity sounds because, in general, a quiet environment is required for the auditory response.
[101] Correspondence with 2 academics who have experienced the Frey effect
[102]Affected individuals described the sounds as directional, intensely loud, and with pure and sustained tonality
[103] Around dusk, as they chatted on the patio, the same deafening sound rose from their yard again…..The colleague had been hearing the same noises at home, sometimes for an hour or more at a stretch.
[104]the AP has reviewed several recordings from Havana taken under different circumstances, and all have variations of the same high-pitched sound. Individuals who have heard the noise in Havana confirm the recordings are generally consistent with what they heard. “That’s the sound,” one of them said….The sound seemed to manifest in pulses of varying lengths... with some sustained periods of several minutes or more.
[105] Considering neighborhood in the residential area of diplomat housings, nature of its background noise is composed by far road traffic, heat exchangers of air conditioners, remote pet noises like barking of dogs, cheeping of birds, steps in motion and human voices far away.
[106] Correspondence and calculations from Chris Collins
[107] The main direct threat to personnel from microwave radiation is through heating of the body tissue41. Cites this 1961 Paper: Most of the experimental work to date supports the belief that the chief effect of microwave energy on living tissue is to produce heating. Consequently, exposure to microwave radiation should probably represent no hazard unless overheating is a possibility.
[108] NAS Report, pg 18: the absence of reporting of a heating sensation or internal thermal damage may exclude certain types of high-level RF energy.
[109] Radio frequency (RF) Directed Energy Weapons (DEW) have the potential to be effective against a broad range of military electronic equipment. In principle, any equipment that employs modern electronic components is at risk from RF DEW attack. The impact of such an attack could include armoured vehicles and ships operating erratically or becoming completely inoperative, and aircraft falling out of the sky.
[110] Laser weapons and high power microwaves use the highly directional nature of these light and radio beam sources to physically damage or destroy the UAV (in the case of laser) or physically damage or destroy the UAV’s electronic circuits (in the case of microwave). In both cases large amounts of electromagnetic energy are focused into a narrow beam and directed at the target UAV.
[111] pulsed microwaves affect targets not by heating, but by creating an electromagnetic field that can induce currents in electrical wires. These currents can upset or destroy electronic components/systems.
[112] RF DEW operate by projecting electromagnetic energy from a transmitter onto a target at a sufficient power that electronic systems are damaged or their operation disturbed. Damage is caused to a wide range of electronic equipment because components, wires and apertures act as antennas to couple the weapon's energy into the target. RF DEW, therefore, have the potential to affect almost all electronic equipment, not just communications receivers that might happen to be tuned to the RF DEW transmission.
[113] When the USSR finally came clean, they indicated that the purpose of the bombardment had not been to damage the health of the American personnel, but to interfere in the communications of the embassy
[114] AFRL spent $15 million to build THOR in cooperation with global engineering firms BAE Systems and Leidos, and with the Albuquerque firm Verus Research. It first unveiled the weapon in a live media demonstration in June 2019, allowing local journalists to watch and photograph the system as it effortlessly knocked a hovering drone out of the sky with an invisible and inaudible electromagnetic wave. The microwave instantaneously disables drone electronics, sending the vehicles tumbling to the ground.
[115]Lots of funding going into this: Armed forces around the world are expected to boost investment in directed energy weapons such as lasers and high-powered microwaves over the next decade as the technology matures, a new study forecasts. The U.S. military more than doubled its spending on this capability between fiscal years 2017 and 2019, from $535 million to $1.1 billion.
[116] Radio Frequency Directed Energy Weapons (RF DEW) have the potential to disrupt the operation of, or cause the failure of, a broad range of military electronic equipment. Over the past 30 years, there has been considerable effort in the development of these weapons….A high level of RF energy has the potential to damage or destroy most of electronic-based systems identified earlier: RADAR, communications equipment, electrical power generators and engine controls, navigational aids, electronic flight controls, as well as weapons fuses.
[117] Electronic equipment should have been interfered with or even disrupted by RF fields at the level where microwave hearing would elicit the sensation of “a loud sound”. Further, the RF fields from cell phone base stations are much less than the exposure level for microwave hearing. Interferences with existing telecommunications would reasonably have been expected if such intense microwaves were used."
[118] "Not all persons evaluated reported an auditory or sensory event prior to their onset of symptoms" pg 17
[119] E.g. See Table 2
[120] https://www.nap.edu/read/25889/chapter/1#x A NAS report concluded: "this constellation of clinical features is unlike any disorder in the neurological or general medical literature"
[121] The major finding is that most patients with conversion symptoms consider that they have a neurological disease.19,20 This is not surprising given their physical neurological symptoms, the absence of public awareness, and the way that words such as psychosomatic are interpreted in the popular media (and by some doctors) as ‘faking it’.21
[122] Alan Carson, Edinburgh
[123] Adverse life events, including childhood abuse, are predisposing risk factors for the development of FND (Keynejad et al., 2018; Ludwig et al., 2018) and SSD (Loeb et al., 2018; Paras et al., 2009), and traumatic experiences have enduring neurobiological effects
[124] This study confirms a baseline HPA-axis and sympathetic hyperarousal state in motor FND related to life adversities. During a social stress, dissociation between perceived stress and biological markers was observed in patients only, reflecting a dysregulation of interoception capacity, which might represent an endophenotype of this disorder.
[125] FND is common in emergency settings,2 stroke,3 and rehabilitation services.4 It causes considerable physical disability and distress
[126] PPPD is precipitated by episodes of vertigo or unsteadiness of vestibular, neurological or psychiatric origin. These triggers appear to induce involuntary utilisation of high-demand postural control strategies and an over-reliance on visual stimuli for spatial orientation. An initial period of high anxiety and excessive vigilance about the acute physical symptoms appears to perpetuate these reflexive processes
[127] The cause of functional neurologic disorders is unknown. The condition may be triggered by a neurological disorder or by a reaction to stress or psychological or physical trauma, but that's not always the case. Functional neurologic disorders are related to how the brain functions, rather than damage to the brain's structure (such as from a stroke, multiple sclerosis, infection or injury).
[128]vertigo and dizziness rank among the 10 most common reasons for referral to neurologists both in emergency rooms [3] and in office-based settings [4].....Recent studies have underscored the high frequency and impact of the symptom vertigo and of vestibular disorders at the population level...but the determinants and outcome of these frequent conditions are not well known yet….A number of studies have shown that dizziness (including vertigo and nonvestibular dizziness) ranks among the most common complaints in medicine, affecting approximately 20–30% of the general population
[129] Rapid head movements commonly induce vertigo because they accentuate any imbalance within the vestibular pathways. Even after compensation has occurred, head movements or change in position can trigger vertigo.
[130] Clara's story is very typical. She started out with an episode of viral labyrinthitis that upset her balance system. Other people with PPPD start off with dizziness from migraine, or dizziness after a mild head injury.
[131] Sudden onset of acute vertigo is due to acute spontaneous unilateral vestibular failure, which means sudden asymmetrical vestibular functioning, i.e., the sensory input of one side is acutely diminished with respect to that of the other side.
[132]Dizziness may be caused by several recognised medical conditions and psychiatric disorders, but 13% of cases remain idiopathic.
[133] A self-administered questionnaire was returned by 2987 adults (age span 18–86 years, 1471 women). The 1-year prevalence for vertigo was 48.3%, for unsteadiness 39.1%, and for dizziness 35.6%
[134]Dizziness is one of the more common reasons adults visit their doctors
[135] On presentation to our center, dizziness (92%) and cognitive complaints (56%) were the most common symptoms.
[136](PPPD) It is usually triggered by an episode of acute dizziness, such as vestibular neuronitis or panic attack. Symptoms persist because of failure of vestibular and brain readaptation. Secondary anxiety and functional gait disorder are common accompaniments.
[137] These triggers appear to induce involuntary utilisation of high-demand postural control strategies and an over-reliance on visual stimuli for spatial orientation. An initial period of high anxiety and excessive vigilance about the acute physical symptoms appears to perpetuate these reflexive processes, which are then inadequately mollified by top-down interactions among cortical vestibular, visual and threat assessment networks.
[138] Convergence insufficiency usually has no underlying cause, but it can be associated with stress, fatigue, and anxiety, and it may follow infection or trauma.
[139] A common sequela of head trauma,56 convergence insufficiency may also be seen in association with dorsal midbrain lesions (Parinaud syndrome; see Chapter 16),57 may be a decompensation of a long-standing exophoria, or may be idiopathic.
[140] this is the first study to investigate whole-brain white matter integrity in adolescent GAD [generalized anxiety disorder] patients. We found significantly reduced FA in bilateral uncinate fasciculus, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, and corona radiata in adolescents with GAD compared with healthy controls in the current study. Our results suggested aberrant white matter integrity in the neural circuitry associated with emotion regulation in adolescent GAD patients. This study provides a possible neurobiological basis for adolescent GAD patients.
[141]The structural connectivity of white matter may be a vulnerability marker. Hence, healthy individuals with high trait anxiety levels are susceptible to anxiety-related psychopathology.
[142] This diffusion MRI study reveals that 15 days of repeated exposure to the same inescapable stressor in rats leads to microstructural WM changes—increased FA and decreased MD and RD—of several WM bundles distributed in the entire brain.
[143]It is usually triggered by an episode of acute dizziness, such as vestibular neuronitis or panic attack. Symptoms persist because of failure of vestibular and brain readaptation. Secondary anxiety and functional gait disorder are common accompaniments.
[144] These triggers appear to induce involuntary utilisation of high-demand postural control strategies and an over-reliance on visual stimuli for spatial orientation. An initial period of high anxiety and excessive vigilance about the acute physical symptoms appears to perpetuate these reflexive processes, which are then inadequately mollified by top-down interactions among cortical vestibular, visual and threat assessment networks.
[146] Reported health effects of windfarms, with psychological expectation as the explanation: The type of health problems reported include a range of nonspecific physical symptoms, such as headache, nausea, ear problems, dizziness, and sleep dysfunction, as well as negative mood states, such as depression (e.g., Pierpont, 2009).
[147] Psychogenic response to vaccination during 2009 H1N1 pandemic: On 23 November 2009, the government was notified that within two hours of pandemic influenza vaccination, a cluster of adverse events marked by dizziness, nausea and weakness occurred in 46 (7%) of the 692 schoolchildren aged 12 to 15 years who had received the vaccine at a middle school. (See Table)
[148]Mass Psychogenic Illness following an unidentified gasoline-like smell in a Tennessee highschool: The most frequent symptoms (in this group and the group of people who reported symptoms five days later) were headache, dizziness, nausea, and drowsiness. Blood and urine specimens showed no evidence of carbon monoxide, volatile organic compounds, pesticides, polychlorinated biphenyls, paraquat, or mercury.
[149]Mass Psychogenic Illness in an electronic components manufacturing plant in Pennsylvania: The release of diesel fumes into the plant from an automobile engine may have contributed to a heightened awareness of various odors in the plant…. Analysis showed that 98 (46%) employees given questionnaires reported symptoms, including lightheadedness, headache, sleepiness, and numbness and/or tingling of the face or extremities. ….Medical records from the emergency room provided no objective evidence of chemical toxicity. Blood gas analyses for seven of 11 ill workers showed respiratory alkalosis consistent with hyperventilation.
[150]The split between neurology and psychiatry, neurological disinterest in hysteria, physician anxiety over misdiagnosis, embarrassment at the excesses of psychological theory and the enthusiasm of patients with conversion symptoms to be told they have a neurological disease are all powerful reasons why hysteria has for so long been resided in a no-man's land between neurology and psychiatry.
[151] However, it should be emphasized that in psychogenic (functional) illness (rather than malingering), individuals are not consciously motivated by primary and secondary gain
[152] The presence of subjective neurological symptoms presenting in a cohesive community has raised concerns for collective delusional disorders, including mass psychogenic illness. However, neurological examination and cognitive screens did not reveal evidence of malingering, and objective testing and behavioral observations during cognitive testing indicated high levels of effort and motivation.