Clinical, biomarker, and research tests among US government personnel and their family members
Abstract
Clinical, biomarker, and research tests among US government personnel and their family members involved in anomalous health incidents Chan L, Hallett M, Zalewski CK, et al; NIH AHI Intramural Research Program Team. Clinical, biomarker, and research tests among US government personnel and their family members involved in anomalous health incidents. JAMA. Published March 18, 2024. doi:10.1001/jama.2024.2413 Key Points Questions Do US government officials and their family members involved in anomalous health incidents (AHIs) differ from control participants with respect to clinical, biomarker, and research assessments? Findings In this exploratory study that included 86 participants reporting AHIs and 30 vocationally matched control participants, there were no significant differences in most tests of auditory, vestibular, cognitive, visual function, or blood biomarkers between the groups. Participants with AHIs performed significantly worse on self-reported and objective measures of balance, and had significantly increased symptoms of fatigue, posttraumatic stress disorder, and depression compared with the control participants; 24 participants (28%) with AHIs presented with functional neurological disorders. Meaning In this exploratory study, there were no significant differences between individuals reporting AHIs and matched control participants with respect to most clinical, research, and biomarker measures, except for self-reported and objective measures of imbalance; symptoms of fatigue, posttraumatic stress, and depression; and the development of functional neurological disorders in some. Abstract Importance Since 2015, US government and related personnel have reported dizziness, pain, visual problems, and cognitive dysfunction after experiencing intrusive sounds and head pressure. The US government has labeled these anomalous health incidents (AHIs). Objective To assess whether participants with AHIs differ significantly from US government control participants with respect to clinical, research, and biomarker assessments. Design, Setting, and Participants Exploratory study conducted between June 2018 and July 2022 at the National Institutes of Health Clinical Center, involving 86 US government staff and family members with AHIs from Cuba, Austria, China, and other locations as well as 30 US government control participants. Exposures AHIs. Main Outcomes and Measures Participants were assessed with extensive clinical, auditory, vestibular, balance, visual, neuropsychological, and blood biomarkers (glial fibrillary acidic protein and neurofilament light) testing. The patients were analyzed based on the risk characteristics of the AHI identifying concerning cases as well as geographic location. Results Eighty-six participants with AHIs (42 women and 44 men; mean [SD] age, 42.1 [9.1] years) and 30 vocationally matched government control participants (11 women and 19 men; mean [SD] age, 43.8 [10.1] years) were included in the analyses. Participants with AHIs were evaluated a median of 76 days (IQR, 30-537) from the most recent incident. In general, there were no significant differences between participants with AHIs and control participants in most tests of auditory, vestibular, cognitive, or visual function as well as levels of the blood biomarkers. Participants with AHIs had significantly increased fatigue, depression, posttraumatic stress, imbalance, and neurobehavioral symptoms compared with the control participants. There were no differences in these findings based on the risk characteristics of the incident or geographic location of the AHIs. Twenty-four patients (28%) with AHI presented with functional neurological disorders. Conclusions and Relevance In this exploratory study, there were no significant differences between individuals reporting AHIs and matched control participants with respect to most clinical, research, and biomarker measures, except for objective and self-reported measures of imbalance and symptoms of fatigue, posttraumatic stress, and depression. This study did not replicate the findings of previous studies, although differences in the populations included and the timing of assessments limit direct comparisons. Open access paper: jamanetwork.com
AI evidence extraction
Main findings
In an exploratory study (86 AHI participants vs 30 vocationally matched controls), there were no significant differences between groups in most auditory, vestibular, cognitive, visual, or blood biomarker measures. AHI participants had worse objective and self-reported balance/imbalance and higher symptoms of fatigue, depression, and posttraumatic stress; 28% presented with functional neurological disorders. Findings did not differ by incident risk characteristics or geographic location.
Outcomes measured
- Auditory function tests
- Vestibular function tests
- Balance (self-reported and objective measures)
- Visual function tests
- Neuropsychological/cognitive assessments
- Blood biomarkers (glial fibrillary acidic protein; neurofilament light)
- Symptoms: fatigue
- Symptoms: depression
- Symptoms: posttraumatic stress disorder
- Neurobehavioral symptoms
- Functional neurological disorders
Limitations
- Exploratory study design
- Timing of assessments varied; participants evaluated a median of 76 days (IQR, 30-537) from the most recent incident
- Authors note differences in populations and timing limit direct comparisons with previous studies
View raw extracted JSON
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"population": "US government personnel and family members reporting anomalous health incidents (AHIs) and vocationally matched US government control participants",
"sample_size": 116,
"outcomes": [
"Auditory function tests",
"Vestibular function tests",
"Balance (self-reported and objective measures)",
"Visual function tests",
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"Blood biomarkers (glial fibrillary acidic protein; neurofilament light)",
"Symptoms: fatigue",
"Symptoms: depression",
"Symptoms: posttraumatic stress disorder",
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"Functional neurological disorders"
],
"main_findings": "In an exploratory study (86 AHI participants vs 30 vocationally matched controls), there were no significant differences between groups in most auditory, vestibular, cognitive, visual, or blood biomarker measures. AHI participants had worse objective and self-reported balance/imbalance and higher symptoms of fatigue, depression, and posttraumatic stress; 28% presented with functional neurological disorders. Findings did not differ by incident risk characteristics or geographic location.",
"effect_direction": "mixed",
"limitations": [
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"Timing of assessments varied; participants evaluated a median of 76 days (IQR, 30-537) from the most recent incident",
"Authors note differences in populations and timing limit direct comparisons with previous studies"
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"evidence_strength": "low",
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"peer_reviewed_likely": "yes",
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AI can be wrong. Always verify against the paper.
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