{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T20:56:57Z","timestamp":1787605017962,"version":"build-2736575974"},"reference-count":32,"publisher":"Walter de Gruyter GmbH","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Since 2016, numerous American and Canadian diplomats and secret (intelligence) agents in Cuba, China, and other places in the world have experienced an abrupt onset of unusual clinical symptoms including, tinnitus, visual problems, vertigo, and cognitive difficulties, after they encountered strange sounds; this has been called \u201cHavana syndrome\u201d (HS). MEDLINE, Scopus, and Ovid databases from 2016 until 24 September 2021 were systematically searched for the related published manuscripts. The\u00a0following search strategy was implemented: \u201cHavana syndrome\u201d OR \u201cNeurological Symptoms and US Diplomats\u201d. The primary search yielded 120 publications. Only five original studies and 18 non-original articles were considered to be relevant. While these studies provided a\u00a0constellation of signs and symptoms for HS, none provided a good level of\u00a0evidence. In conclusion, Havana syndrome is\u00a0a nonspecific neurological illness with an\u00a0unidentified causative factor(s), an acute phase of auditory-vestibular symptoms and a chronic phase of nonspecific neurobehavioral symptoms. This syndrome should be considered and investigated as a health concern, and not as a political issue.<\/jats:p>","DOI":"10.1515\/reveh-2021-0182","type":"journal-article","created":{"date-parts":[[2022,8,13]],"date-time":"2022-08-13T09:23:03Z","timestamp":1660382583000},"page":"655-661","source":"Crossref","is-referenced-by-count":4,"title":["Havana syndrome: a scoping review of the existing literature"],"prefix":"10.1515","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2598-7601","authenticated-orcid":false,"given":"Ali A.","family":"Asadi-Pooya","sequence":"first","affiliation":[{"name":"Department of Neurology , Jefferson Comprehensive Epilepsy Centre, Thomas Jefferson University , Philadelphia , PA , USA"},{"name":"Epilepsy Research Center, Shiraz University of Medical Sciences , Shiraz , Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2022,8,15]]},"reference":[{"key":"2023112414471489341_j_reveh-2021-0182_ref_001","doi-asserted-by":"crossref","unstructured":"Nelson, R. Havana syndrome might be the result of energy pulses. Lancet 2021;396:1954. https:\/\/doi.org\/10.1016\/s0140-6736(20)32711-2.","DOI":"10.1016\/S0140-6736(20)32711-2"},{"key":"2023112414471489341_j_reveh-2021-0182_ref_002","doi-asserted-by":"crossref","unstructured":"Golomb, BA. Diplomats\u2019 mystery illness and pulsed radiofrequency\/microwave radiation. Neural Comput 2018;30:2882\u2013985. https:\/\/doi.org\/10.1162\/neco_a_01133.","DOI":"10.1162\/neco_a_01133"},{"key":"2023112414471489341_j_reveh-2021-0182_ref_003","doi-asserted-by":"crossref","unstructured":"Baloh, RW, Bartholomew, RE. Havana syndrome: mass psychogenic illness and the real story behind the embassy mystery and hysteria. Gewerbestrasse: Havana Syndrome 2020.","DOI":"10.1007\/978-3-030-40746-9"},{"key":"2023112414471489341_j_reveh-2021-0182_ref_004","doi-asserted-by":"crossref","unstructured":"Hutton, B, Salanti, G, Caldwell, DM, Chaimani, A, Schmid, CH, Cameron, C, et al.. The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations. Ann Intern Med 2015;162:777\u201384. https:\/\/doi.org\/10.7326\/m14-2385.","DOI":"10.7326\/M14-2385"},{"key":"2023112414471489341_j_reveh-2021-0182_ref_005","doi-asserted-by":"crossref","unstructured":"Moher, D, Liberati, A, Tetzlaff, J, Altman, DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6:e1000097. https:\/\/doi.org\/10.1371\/journal.pmed.1000097.","DOI":"10.1371\/journal.pmed.1000097"},{"key":"2023112414471489341_j_reveh-2021-0182_ref_006","unstructured":"https:\/\/pubmed.ncbi.nlm.nih.gov\/ [Accessed 24 Sep 2021]."},{"key":"2023112414471489341_j_reveh-2021-0182_ref_007","unstructured":"https:\/\/www.scopus.com\/home.uri\/ [Accessed 24 Sep 2021]."},{"key":"2023112414471489341_j_reveh-2021-0182_ref_008","unstructured":"https:\/\/ovidsp.ovid.com\/ [Accessed 24 Sep 2021]."},{"key":"2023112414471489341_j_reveh-2021-0182_ref_009","unstructured":"https:\/\/scholar.google.com\/ [Accessed 24 Sep 2021]."},{"key":"2023112414471489341_j_reveh-2021-0182_ref_010","unstructured":"https:\/\/onlinelibrary.wiley.com\/pb-assets\/assets\/23788038\/Levels_of_Evidence-1519834967260.pdf\/ [Accessed 24 Sep 2021]."},{"key":"2023112414471489341_j_reveh-2021-0182_ref_011","doi-asserted-by":"crossref","unstructured":"Rubin, R. Alleged acoustic attack on US diplomats puzzling experts. Lancet 2017;390:e22. https:\/\/doi.org\/10.1016\/s0140-6736(17)32359-0.","DOI":"10.1016\/S0140-6736(17)32359-0"},{"key":"2023112414471489341_j_reveh-2021-0182_ref_012","doi-asserted-by":"crossref","unstructured":"Bartholomew, RE, Baloh, RW. Challenging the diagnosis of \u2018Havana Syndrome\u2019 as a novel clinical entity. J R Soc Med 2020;113:7\u201311. https:\/\/doi.org\/10.1177\/0141076819877553.","DOI":"10.1177\/0141076819877553"},{"key":"2023112414471489341_j_reveh-2021-0182_ref_013","doi-asserted-by":"crossref","unstructured":"Muth, CC, Lewis, SL. Neurological symptoms among US diplomats in Cuba. JAMA 2018;319:1098\u2013100. https:\/\/doi.org\/10.1001\/jama.2018.1780.","DOI":"10.1001\/jama.2018.1780"},{"key":"2023112414471489341_j_reveh-2021-0182_ref_014","doi-asserted-by":"crossref","unstructured":"Rubin, R. More questions raised by concussion-like symptoms found in US diplomats who served in Havana. JAMA 2018;319:1079\u201381. https:\/\/doi.org\/10.1001\/jama.2018.1751.","DOI":"10.1001\/jama.2018.1751"},{"key":"2023112414471489341_j_reveh-2021-0182_ref_015","doi-asserted-by":"crossref","unstructured":"Swanson, RL2nd, Hampton, S, Green-McKenzie, J, Diaz-Arrastia, R, Grady, MS, Verma, R, et al.. Neurological manifestations among US government personnel reporting directional audible and sensory phenomena in Havana, Cuba. JAMA 2018;319:1125\u201333. https:\/\/doi.org\/10.1001\/jama.2018.1742.","DOI":"10.1001\/jama.2018.1742"},{"key":"2023112414471489341_j_reveh-2021-0182_ref_016","doi-asserted-by":"crossref","unstructured":"Verma, R, Swanson, RL, Parker, D, Ould Ismail, AA, Shinohara, RT, Alappatt, JA, et al.. Neuroimaging findings in US government personnel with possible exposure to directional phenomena in Havana, Cuba. JAMA 2019;322:336\u201347. https:\/\/doi.org\/10.1001\/jama.2019.9269.","DOI":"10.1001\/jama.2019.9269"},{"key":"2023112414471489341_j_reveh-2021-0182_ref_017","doi-asserted-by":"crossref","unstructured":"Reed, G. What happened to the US diplomats in Havana? Mitchell Vald\u00e9s MD PhD Director, Cuban Neuroscience Center. MEDICC Rev 2018;20:14\u20139.","DOI":"10.37757\/MR2018.V20.N4.5"},{"key":"2023112414471489341_j_reveh-2021-0182_ref_018","doi-asserted-by":"crossref","unstructured":"Abouzari, M, Goshtasbi, K, Sarna, B, Lin, HW, Djalilian, HR. Proposal for a new diagnosis for U.S. diplomats in Havana, Cuba, experiencing vestibular and neurological symptoms. Med Hypotheses 2020;136:109499. https:\/\/doi.org\/10.1016\/j.mehy.2019.109499.","DOI":"10.1016\/j.mehy.2019.109499"},{"key":"2023112414471489341_j_reveh-2021-0182_ref_019","doi-asserted-by":"crossref","unstructured":"Hoffer, ME, Levin, BE, Snapp, H, Buskirk, J, Balaban, C. Acute findings in an acquired neurosensory dysfunction. Laryngoscope Invest Otolaryngol 2018;4:124\u201331. https:\/\/doi.org\/10.1002\/lio2.231.","DOI":"10.1002\/lio2.231"},{"key":"2023112414471489341_j_reveh-2021-0182_ref_020","doi-asserted-by":"crossref","unstructured":"Tumolo, J. \u2018Sonic Attacks\u2019 on U.S. diplomats in Cuba: auditory dysfunction remains unsolved mystery. Hear J 2019;72(4):22\u20136. https:\/\/doi.org\/10.1097\/01.hj.0000557739.97657.c8.","DOI":"10.1097\/01.HJ.0000557739.97657.c8"},{"key":"2023112414471489341_j_reveh-2021-0182_ref_021","doi-asserted-by":"crossref","unstructured":"Della Sala, S, McIntosh, RD, Cubelli, R, Kacmarski, JA, Miskey, HM, Shura, RD. Cognitive symptoms in US government personnel in Cuba: the mending is worse than the hole. Cortex 2018;108:287\u20138. https:\/\/doi.org\/10.1016\/j.cortex.2018.10.002.","DOI":"10.1016\/j.cortex.2018.10.002"},{"key":"2023112414471489341_j_reveh-2021-0182_ref_022","unstructured":"National Academies of Sciences, Engineering, and Medicine; Division on Engineering and Physical Sciences; Health and Medicine Division; Standing Committee to Advise the Department of State on Unexplained Health Effects on U.S. Government Employees and Their Families at Overseas Embassies. In: Pavlin, JA, Relman, DA, editors. An assessment of illness in U.S. government employees and their families at overseas embassies. Washington, DC: National Academies Press (US); 2020. PMID: 33411434."},{"key":"2023112414471489341_j_reveh-2021-0182_ref_023","doi-asserted-by":"crossref","unstructured":"Friedman, A, Calkin, C, Adams, A, Suarez, GA, Bardouille, T, Hacohen, N, et al.. Havana syndrome among Canadian diplomats: brain imaging reveals acquired neurotoxicity 2019. medRxiv preprint. https:\/\/doi.org\/10.1101\/19007096.","DOI":"10.1101\/19007096"},{"key":"2023112414471489341_j_reveh-2021-0182_ref_024","unstructured":"Technical Report by an Expert Group of the Cuban Academy of Sciences. An Assessment of the health complaints during Sojourns in Havana of foreign government employees and their families. Havana: Cuban Academy of Sciences; 2021."},{"key":"2023112414471489341_j_reveh-2021-0182_ref_025","unstructured":"Bartholomew, RE. The \u201cSonic attack\u201d on U.S. Diplomats in Cuba, Why the state departments claims don\u2019t add up. Skeptic Magazine 2018;23:12\u20135."},{"key":"2023112414471489341_j_reveh-2021-0182_ref_026","unstructured":"Nielsen, JM. Electromagnetic conflict: the implications of new methods of warfare and the need for international action. Brooklyn J Int Law 2020;45:809."},{"key":"2023112414471489341_j_reveh-2021-0182_ref_027","doi-asserted-by":"crossref","unstructured":"Vel\u00e1zquez-P\u00e9rez, L. The Enigma of US diplomats\u2019 health symptoms in Havana: call for a global scientific meeting. MEDICC Rev 2018;20:48.","DOI":"10.37757\/MR2018.V20.N4.11"},{"key":"2023112414471489341_j_reveh-2021-0182_ref_028","unstructured":"Bartholomew, RE. Havana syndrome skepticism: a report by the National Academy of Sciences says microwaves caused an array of mysterious health complaints at the American Embassy in Cuba. Here\u2019s why we should be skeptical. It was probably psychogenic. Altadena, CA: Skeptic; 2021, vol 26. p.\u00a036+."},{"key":"2023112414471489341_j_reveh-2021-0182_ref_029","doi-asserted-by":"crossref","unstructured":"Kirk, JM. The strange case of the Havana \u2018Sonic Attacks\u2019. Int J Cuban Stud 2019;11:24\u201342. https:\/\/doi.org\/10.13169\/intejcubastud.11.1.0024.","DOI":"10.13169\/intejcubastud.11.1.0024"},{"key":"2023112414471489341_j_reveh-2021-0182_ref_030","unstructured":"Friedman, A, Calkin, C, Bowen, C. Havana syndrome: neuroanatomical and neurofunctional assessment in acquired brain injury due to unknown etiology. https:\/\/www.scribd.com\/document\/426438895\/Etude-du-Centre-de-traitement-des-lesionscerebrales-de-l-Universite-de-Dalhousie#download\/ [Accessed 26 Sep 2021]."},{"key":"2023112414471489341_j_reveh-2021-0182_ref_031","doi-asserted-by":"crossref","unstructured":"Whitney, SL, Hoppes, CW, Lambert, KH, Klatt, BN. Physical therapy treatment of a person exposed to directed energy: a case report. Mil Med 2021;usab256. https:\/\/doi.org\/10.1093\/milmed\/usab256.","DOI":"10.1093\/milmed\/usab256"},{"key":"2023112414471489341_j_reveh-2021-0182_ref_032","unstructured":"https:\/\/www.utsouthwestern.edu\/education\/medical-school\/departments\/psychiatry\/research\/havana-syndrome-conference.html\/ [Accessed 31 Mar 2022]."}],"container-title":["Reviews on Environmental Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/reveh-2021-0182\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/reveh-2021-0182\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T14:49:07Z","timestamp":1700837347000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/reveh-2021-0182\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,15]]},"references-count":32,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,7,19]]},"published-print":{"date-parts":[[2023,12,15]]}},"alternative-id":["10.1515\/reveh-2021-0182"],"URL":"https:\/\/doi.org\/10.1515\/reveh-2021-0182","relation":{},"ISSN":["0048-7554","2191-0308"],"issn-type":[{"value":"0048-7554","type":"print"},{"value":"2191-0308","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,15]]}}}