Evidence map›Paper›PMID 37965360›Full record

ArticleFrontiers in psychiatry2023

A regulatory pathway model of neuropsychological disruption in Havana syndrome.

Thomas P Chacko, J Tory Toole, Matthew C Morris, Jeffrey Page, Robert D Forsten, John P Barrett, Matthew J Reinhard, Ryan C Brewster, Michelle E Costanzo, Gordon Broderick

Registry-linked trialAbstract read
In one paragraph

Article in Frontiers in psychiatry, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07267819 (The Efficacy of Xeomin as a Prophylactic Therapy for Migraine in Patients With Traumatic Brain Injuries), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07267819 recruitingnot on this mapstarted 2025, after this paper: background citation

The Efficacy of Xeomin as a Prophylactic Therapy for Migraine in Patients With Traumatic Brain Injuries (TBIs) Versus Anomalous Health Incidents (AHIs)

TypeobservationalSponsorUniformed Services University of the Health SciencesRan2025 to 2028Enrolled60ConditionsMigraine, Traumatic Brain Injury, Anomalous Health IncidentsArmsXeomin (incobotulinumtoxinA)
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Thomas P ChackoCenter for Clinical Systems Biology, Rochester General Hospital, Rochester, NY, United States.
J Tory TooleCenter for Clinical Systems Biology, Rochester General Hospital, Rochester, NY, United States.
Matthew C MorrisCenter for Clinical Systems Biology, Rochester General Hospital, Rochester, NY, United States.
Jeffrey PageCenter for Clinical Systems Biology, Rochester General Hospital, Rochester, NY, United States.
Robert D ForstenWar Related Illness and Injury Study Center (WRIISC), Department of Veterans Affairs, Washington, DC, United States.
John P BarrettWar Related Illness and Injury Study Center (WRIISC), Department of Veterans Affairs, Washington, DC, United States.
Matthew J ReinhardWar Related Illness and Injury Study Center (WRIISC), Department of Veterans Affairs, Washington, DC, United States.
Ryan C BrewsterWar Related Illness and Injury Study Center (WRIISC), Department of Veterans Affairs, Washington, DC, United States.
Michelle E CostanzoWar Related Illness and Injury Study Center (WRIISC), Department of Veterans Affairs, Washington, DC, United States.
Gordon BroderickCenter for Clinical Systems Biology, Rochester General Hospital, Rochester, NY, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: In 2016 diplomatic personnel serving in Havana, Cuba, began reporting audible sensory phenomena paired with onset of complex and persistent neurological symptoms consistent with brain injury. The etiology of these Anomalous Health Incidents (AHI) and subsequent symptoms remains unknown. This report investigates putative exposure-symptom pathology by assembling a network model of published bio-behavioral pathways and assessing how dysregulation of such pathways might explain loss of function in these subjects using data available in the published literature. Given similarities in presentation with mild traumatic brain injury (mTBI), we used the latter as a clinically relevant means of evaluating if the neuropsychological profiles observed in Havana Syndrome Havana Syndrome might be explained at least in part by a dysregulation of neurotransmission, neuro-inflammation, or both. Method: Automated text-mining of >9,000 publications produced a network consisting of 273 documented regulatory interactions linking 29 neuro-chemical markers with 9 neuropsychological constructs from the Brief Mood Survey, PTSD Checklist, and the Frontal Systems Behavior Scale. Analysis of information flow through this network produced a set of regulatory rules reconciling to within a 6% departure known mechanistic pathways with neuropsychological profiles in Results: Predicted expression of neuro-chemical markers that jointly satisfy documented pathways and observed symptom profiles display characteristically elevated IL-1B, IL-10, NGF, and norepinephrine levels in the context of depressed BDNF, GDNF, IGF1, and glutamate expression (FDR < 5%). Elevations in CRH and IL-6 were also predicted unanimously across all subjects. Furthermore, simulations of neurological regulatory dynamics reveal subjects do not appear to be "locked in" persistent illness but rather appear to be engaged in a slow recovery trajectory. Discussion: This computational analysis of measured neuropsychological symptoms in Havana-based diplomats proposes that these AHI symptoms may be supported in part by disruption of known neuroimmune and neurotransmission regulatory mechanisms also associated with mTBI.

Indexed as

anomolous health incidentscomputational modelHavana syndromemild traumatic brain injuryneuroimmunologyneuropsychologyneurotransmissionregulatory pathways

Identifiers

PMID37965360
PMCPMC10642174

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Registered trials

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