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Treating Havana Syndrome: Cognition, Balance, and Graded Symptom Checklist Score Following Neurological Rehabilitation

Matthew M. Antonucci1, 2, 3*, Mia Cozart3, 4, Frederick R. Carrick1, 5, 6, 7 and Derek A. Barton1, 2, 3
  • 1 Carrick Institute, United States
  • 2 Plasticity Brain Centers, United States
  • 3 Accelerate Multidisciplinary Neuroscience Research Center, College of Medicine, University of Central Florida, United States
  • 4 University of Central Florida, United States
  • 5 University of Central Florida College of Medicine, United States
  • 6 MGH Institute of Health Professions, United States
  • 7 Bedfordshire Centre for Mental Health Research, University of Cambridge, United Kingdom

Background: In March 2018, what was most likely a directional microwave weapon (Bartholomew 2018), caused debilitating neurological conditions consisting of cognitive decline, fatigue, and headache, exacerbated by cognitive effort. (Swanson 2018). The constellation of these symptoms resulting from this event has become known as Havana Syndrome and is reported to have afflicted 21 individuals. A patient presented to Plasticity Brain Centers for evaluation and treatment of persistent symptoms following a recent diagnosis of Havana Syndrome (patient’s age and sex omitted to protect identity). The patient's symptoms included difficulty with cognition, headache, and eye strain. Findings: Upon intake, the patient reported on the graded symptom checklist (GSC) (Simon 2017) a symptom severity score of 52. During neurocognitive testing on the C3 Logix program, her Trail Making Test times were 61.4 seconds, and 82.3 seconds (TMT-A, TMT-B). A Comprehensive Assessment of Postural Systems (CAPS®) (Pagnacco 2014) was performed assessing balance and stability, on both a solid and foam surface, with eyes open, eyes closed, and with multiple head positions. An average stability score upon intake was calculated as 20.9% (severe deficit), with multiple falls. Methods: A five-day, multi-modal program of neurological exercises were administered in ten one-hour treatment sessions (Carrick 2017). Each session consisted of repetitive peripheral somatosensory stimulation, cognitive exercises with the PEAK- Brain Training application (Brainbow Ltd.), neuromuscular reeducation exercises with complex movements of the right upper and lower extremity, vestibular rehabilitation exercises, orthoptic exercises, and off-vertical axis rotation utilizing a multi-axis rotational chair (MARC, ReNeuro Robotics, Dallas, TX, USA). Outcome: Upon completion of the program, the patient’s symptom severity score decreased to 33 (an improvement of 36.54%); TMT-A time was 31.9 seconds (an improvement of 48.04%); TMT-B time was 43.5 seconds (an improvement of 47.14%). Stability scores improved, with the average stability score calculated as 47.164% (an improvement of 125.41%), but still severely compromised. Conclusion: With no known treatment available, this report suggests that a multi-modal, 5-day intensive therapy program may be a plausible intervention to improve symptom severity, balance, and cognitive impairment in patients with Havana Syndrome.

References

Bartholomew RE. Comment and response: neurological symptoms in US government personnel in Cuba. JAMA 2018;320:602. 10.1001/jama.2018.8702 30120470 Carrick FR, Clark JF, Pagnacco G, Antonucci MM, Hankir A, Zaman R, and Oggero E (2017) Head–Eye Vestibular Motion Therapy Affects the Mental and Physical Health of Severe Chronic Postconcussion Patients. Front. Neurol. 8:414. doi: 10.3389/fneur.2017.00414 Pagnacco G, Carrick FR, Wright CH, Oggero E. In-situ verification of accuracy, precision and resolution of force and balance platforms. Biomed Sciences instrumentation (2014) 50:171-8 Simon M, Maerlender A, Metzger K, Decoster L, Hollingworth A, McLeod TV. Reliability and on current Validity of Select C3 Logix Test Components. Developmental Neuropsychology (2017) Oct; 0: 1-14. Doi: 10.1080/87565641.2017.1383994. Epub 2017 Oct 25. Swanson RL, Hampton S, Green-McKenzie J, et al . Neurological manifestations among US government personnel reporting directional audible and sensory phenomena in Havana, Cuba. JAMA 2018;319:1125-33. 10.1001/jama.2018.1742 29450484

Keywords: Havana Syndrome, Microwave damage, encephalopathy, cognitive impaiment, Balance impairment, Intensive therapy program

Conference: International Symposium on Clinical Neuroscience, Orlando, United States, 24 May - 26 May, 2019.

Presentation Type: Poster Presentation

Topic: Clinical Neuroscience

Citation: Antonucci MM, Cozart M, Carrick FR and Barton DA (2019). Treating Havana Syndrome: Cognition, Balance, and Graded Symptom Checklist Score Following Neurological Rehabilitation. Front. Neurol. Conference Abstract: International Symposium on Clinical Neuroscience. doi: 10.3389/conf.fneur.2019.62.00076

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Received: 18 May 2019; Published Online: 27 Sep 2019.

* Correspondence: Dr. Matthew M Antonucci, Carrick Institute, Cape Canaveral, United States, drnucci@gmail.com