Clinical, Biomarker, and Research Tests Among US Government Personnel and Their Family Members Involved in Anomalous Health Incidents.
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Chan Leighton, Hallett Mark, Zalewski Chris K, Brewer Carmen C, Zampieri Cris, Hoa Michael, Lippa Sara M, Fitzgibbon Edmond, French Louis M, Moses Anita D, van der Merwe André J, Pierpaoli Carlo, Turtzo L Christine, Yonter Simge, Shahim Pashtun, NIH AHI Intramural Research Program Team, Moore Brian, Stamps Lauren, Flynn Spencer, Fontana Julia, Tata Swathi, Lo Jessica, Fernandez Mirella A, Joseph Annie-Lori, Matsubara Jesse, Goldberg Julie, Nguyen Thuy-Tien D, Sasson Noa, Lely Justine, Smith Bryan, King Kelly A, Chisholm Jennifer, Christensen Julie, Magone M Teresa, Cousineau-Krieger Chantal, Hafiz Rakibul, Nayak Amritha, Irfanoglu Okan, Attaripour Sanaz, Lai Chen, Smith Wendy B
Аннотация
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.