Dr. Michael Hoffer’s Work on Diagnosing “Havana Syndrome” Patients

Background and Role in the Havana Syndrome Investigation

Dr. Michael E. Hoffer – a former U.S. Navy military physician and now a professor of otolaryngology and neurological surgery at the University of Miami – was one of the first doctors to evaluate American personnel affected by the mysterious incidents in Havana, Cubanpr.orgnewyorker.com. In early 2017, the U.S. State Department contacted Dr. Hoffer, who has extensive experience in treating blast-related ear and brain trauma, saying “we have a problem” and requesting his helpnpr.orgnewyorker.com. Dr. Hoffer and a colleague set up a screening clinic at the U.S. Embassy in Havana in February–May 2017, where they conducted initial evaluations of diplomats and intelligence officers reporting strange auditory phenomena and neurological symptomsnpr.orgnewyorker.com. In total, Dr. Hoffer’s team screened approximately 140 individuals; of these, 25 people reported acute onset symptoms (often after hearing a high-pitched sound or feeling a pressure wave) and were classified as “affected”npr.orgnpr.org. Ten others who were co-located with patients (e.g. family or roommates) but did not report symptoms were used as comparison “controls”nationaldefensemagazine.orgnationaldefensemagazine.org.

Symptoms and context: Those 25 affected individuals consistently described an abrupt sequence: a loud, high-frequency noise or a pressure sensation, followed by ear pain, tinnitus (ringing in ears), vertigo/dizziness, and cognitive difficultiesnationaldefensemagazine.orgnpr.org. Many said the phenomenon seemed directional or localized – for example, the “beam” of effects would follow them within a room and stop at the doorwaynationaldefensemagazine.orgpmc.ncbi.nlm.nih.gov. All 25 noticed balance problems (unsteadiness) and cognitive impairment immediately afterwardpmc.ncbi.nlm.nih.gov. Notably, these symptoms appeared without any visible external injuries, distinguishing them from typical blunt head trauma.

Dr. Hoffer’s early involvement gave him a unique opportunity to observe the cases before media coverage or treatments could influence themnationaldefensemagazine.org. He even visited the homes and locations where incidents occurred to gather environmental contextnationaldefensemagazine.org. Based on his military background with blast injuries, Dr. Hoffer immediately suspected that the vestibular system (inner ear balance organs) was injured in these patients, causing the dizziness and cognitive fognpr.org. As he later recalled, “their vestibular systems were damaged by something”npr.orgnpr.org – though at the time he could not say what the injurious agent was. He quickly ruled out typical concussion from blunt impact, noting that none had head injuries and the clinical picture “was not it” for a standard traumatic brain injury (TBI)nationaldefensemagazine.orgnationaldefensemagazine.org.

Comprehensive Diagnostic Assessments and Findings (2017–2018)

After the initial screening in Havana, Dr. Hoffer led a full clinical evaluation of the affected group upon their return to the U.S. In mid-2017, 25 symptomatic patients and 10 exposure‐companions were brought to the University of Miami for an interdisciplinary assessmentnationaldefensemagazine.orgpmc.ncbi.nlm.nih.gov. Dr. Hoffer’s team – which included specialists in otolaryngology, neurology, audiology, and neuropsychology – conducted a battery of quantitative tests focusing on inner-ear and neurological functionpmc.ncbi.nlm.nih.govpmc.ncbi.nlm.nih.gov. Key components of the diagnostic protocol included:

• Detailed Vestibular and Eye Movement Testing: Patients underwent thorough video-oculography exams. Dr. Hoffer’s team used infrared video goggles (a portable system with a virtual-reality display) to record eye movements in response to various stimulinpr.orgnews.med.miami.edu. This measured vestibulo-ocular reflexes and ocular motor performance. Tests encompassed gaze stability (checking for nystagmus), smooth pursuit and saccades (rapid eye movements), optokinetic nystagmus, and anti-saccade tasks (a cognitive eye-movement test)pmc.ncbi.nlm.nih.gov. They also tested vergence (the eyes’ ability to converge and diverge) and pupil reactions during focusing. These measures probed both peripheral vestibular function and central neural processing. Notably, all eye movement tests were digitally recorded for computer analysis, enhancing objectivitypmc.ncbi.nlm.nih.gov.
• Balance and Otolith Function Tests: Every patient did a Subjective Visual Vertical (SVV) test – aligning a visual line to true vertical – which assesses the otolith organs (utricle and saccule) of the inner ear that sense gravity and linear accelerationpmc.ncbi.nlm.nih.govnpr.org. Abnormally large deviations in SVV indicate otolithic dysfunction. In Dr. Hoffer’s cohort, an exceptionally high proportion – 88% – had abnormal SVV results beyond the normal thresholdpmc.ncbi.nlm.nih.govnpr.org. A subset of patients also received rotational chair testing to evaluate semicircular canal function and Vestibular-Evoked Myogenic Potential (VEMP) tests (both cervical and ocular) to quantify otolith nerve pathway integritypmc.ncbi.nlm.nih.gov. The combination of a tilted SVV and abnormal VEMP responses pointed to asymmetric peripheral vestibular damage in the inner earpmc.ncbi.nlm.nih.gov.
• Hearing and Cognitive Evaluations: Standard audiological tests (audiogram, tympanometry, etc.) were done to check for hearing loss or middle-ear issues (only a minority showed hearing changes)pmc.ncbi.nlm.nih.govpmc.ncbi.nlm.nih.gov. Neurocognitive screening was performed by Dr. Bonnie Levin, the neuropsychologist on the team. In interviews and formal testing, patients often reported memory/concentration difficulties (“brain fog”). Dr. Levin identified a distinct pattern of cognitive deficits shared by the affected group, different from typical post-concussion syndromenationaldefensemagazine.org. One example was an elevated error rate on the anti-saccade eye movement task (reflecting frontal-executive function) – over half of the patients had abnormally high anti-saccade errorspmc.ncbi.nlm.nih.govnpr.org, consistent with impaired attention and executive processing.

Key findings: The University of Miami team published their results in a 2018 peer-reviewed study, “Acute Findings in an Acquired Neurosensory Dysfunction”, with Dr. Hoffer as lead authornews.med.miami.edu. This first clinical report on Havana Syndrome described a unique neuro-otological injury profile:

• Inner Ear Damage: 100% of the 25 affected patients showed objective evidence of a balance disorder involving the inner ear (vestibular system)pmc.ncbi.nlm.nih.gov. Every symptomatic individual was **“abnormal in at least one balance test,” and the abnormalities were marked (“super abnormal, not just barely” abnormal)nationaldefensemagazine.org. In particular, otolith organ dysfunction was universal – for example, virtually all had significant SVV deviations or VEMP asymmetries, indicating damage to gravity-sensing structurespmc.ncbi.nlm.nih.gov. These vestibular findings correlated with the patients’ complaints of vertigo and spatial disorientation.
• Cognitive Impairment: All patients also showed measurable cognitive deficits, especially in memory, attention, and visuospatial skillspmc.ncbi.nlm.nih.gov. The pattern of neurocognitive impairment was remarkably consistent across the group (as noted by Dr. Levin) and differed from typical mild TBI or PTSD profilesnationaldefensemagazine.org. Patients described “brain fog” and trouble concentrating, which aligned with their neuropsychological test resultsnews.med.miami.edu.
• No Findings in Controls: By contrast, the 10 individuals who were present in the same houses but did not experience the event showed no such abnormalities on testingnationaldefensemagazine.org. Nor did a larger cohort of over 100 embassy employees with no exposure reports – none of these showed the acute syndrome symptoms when examined with the same protocolpmc.ncbi.nlm.nih.gov. This bolstered the conclusion that the findings were associated with the mysterious exposure and not simply common among the general population.

Dr. Hoffer summarized that the cluster of symptoms and test findings was unlike any routine illness or injury. The combination of acute ear pain, vestibular dysfunction, cognitive issues, and even associated psychological symptoms (e.g. anxiety) did not resemble a garden-variety concussion or post-blast syndromenews.med.miami.edu. In a December 2019 statement to the National Academies, he emphasized: “Objective testing showed evidence of a balance disorder that affects the inner ear and a unique pattern of cognitive dysfunction… this does not resemble traumatic brain injury based on our team’s vast experience in this area.”news.med.miami.edu. In other words, although the patients’ symptoms mimicked concussion in some ways, the injury pattern was distinct, prompting the team to consider a novel mechanism of harm.

Diagnostic Tools and Techniques Developed by Dr. Hoffer

A notable aspect of Dr. Hoffer’s work is the technological innovation he applied to diagnosing these patients. Leveraging his background in military medicine and balance disorders, Dr. Hoffer helped develop new tools to detect subtle neurovestibular injuries in the field. Key diagnostic methods he described or pioneered include:

• Portable Eye-Tracking “Goggles”: Dr. Hoffer collaborated with engineers to miniaturize advanced vestibular test equipment into a headset devicenews.med.miami.edu. This resulted in a set of VR-based infrared goggles that patients wear while visual stimuli are presented. The device objectively measures eye and pupil movements in response to controlled tasks – such as focusing on moving dots or lines – to provoke vestibulo-ocular reflexes and vergence responsesnews.med.miami.edu. In both his sports concussion work and the Havana cases, Hoffer used this tool to rapidly screen for dysfunction at the point of care. “We took the goggles right to the athletes on the field… [and] to [the Havana] individuals,” he noted, enabling immediate diagnosis of head injury on-sitenews.med.miami.edunews.med.miami.edu. The goggles essentially serve as a field-deployable vestibular lab, detecting patterns like nystagmus or disconjugate eye movements that indicate brain/ear injury. This technology was so promising that in 2022 the University of Miami received a U.S. patent for it (Hoffer is a co-inventor). The patent, titled “Method and Apparatus for mTBI Diagnosis Implementing Eye and Pupil Movement Analysis in Objective Vergence Testing,” covers the use of VR display goggles to identify concussions via eye-tracking algorithmsnews.med.miami.edu. Patients simply put on the headset and follow visual prompts; abnormal ocular motor responses (e.g. inability to track targets or asymmetric pupil reactions) are automatically flaggednews.med.miami.eduinside.upmc.com. Dr. Hoffer has highlighted that this portable test does not require a neurologist on-site – even a coach or medic with minimal training could administer it – making concussion and neurotrauma screening far more accessiblenews.med.miami.edunews.med.miami.edu. During the Havana evaluations, these goggles were used to record eye movement data, which later allowed detailed retrospective analysis of the Embassy patients versus other groupsinside.upmc.cominside.upmc.com.
• Structured Clinical Protocols: Dr. Hoffer’s diagnostic approach for Havana Syndrome became a standardized protocol that could be replicated. As described in his paper, every patient underwent the same structured history intake and targeted exam, followed by the core battery of tests (eye movements, reaction times, SVV alignment, etc.)pmc.ncbi.nlm.nih.govpmc.ncbi.nlm.nih.gov. This produced a rich dataset (hundreds of data points per patient) which Hoffer’s team could analyze and compare to normative values. For example, they set conservative cutoff criteria for test “failure” based on the lower 5th percentile of a large control populationpmc.ncbi.nlm.nih.gov. An SVV tilt ≥3.2° or anti-saccade error rate ≥43% was considered definitively abnormal (beyond what 95% of healthy people exhibit)pmc.ncbi.nlm.nih.gov. By using such stringent thresholds, Hoffer ensured that only clear, significant deficits were counted – hence his remark that they labeled patients “abnormal” only if they were “super abnormal, not just barely” outside the normnationaldefensemagazine.org. This meticulous approach reduced false positives (important since stress or fatigue can sometimes affect these tests). Indeed, critics have noted that anxious or sleep-deprived individuals might perform poorly on balance or cognitive tasksnpr.org, but Hoffer’s criteria required deficits well beyond mild lapsesnationaldefensemagazine.org. His methodology has been presented in medical forums and shared as a potential clinical protocol for future unexplained neurologic casesinside.upmc.cominside.upmc.com.
• Data Collection and Analysis: In line with modern “deep data” medicine, Dr. Hoffer’s team collected extensive quantitative data which they analyzed collaboratively. He has mentioned using tools like machine learning to interpret the multitude of measurements for each patientnews.med.miami.edunews.med.miami.edu. Additionally, for the Havana project, he partnered with experts like Dr. Carey Balaban (a vestibular researcher and bioengineer at Univ. of Pittsburgh) and Dr. Alexander Kiderman (of Neuro Kinetics, Inc.) who designed software and hardware for analyzing the eye-tracking resultspmc.ncbi.nlm.nih.gov. This partnership allowed the team to extract subtle “signatures” from the eye movement videos. For example, later analysis of the raw data uncovered a distinctive pattern in convergence eye movements unique to the Havana patients (discussed below)inside.upmc.cominside.upmc.com. By publishing detailed data and algorithms, Dr. Hoffer has contributed to the technical documentation on how to diagnose these cases. The aim is that other clinicians can replicate tests like SVV or eye-tracking and compare results against the benchmark “Havana cohort” data to recognize similar cases going forwardinside.upmc.cominside.upmc.com.

Public Statements and Hypotheses by Dr. Hoffer

Throughout the investigation, Dr. Hoffer has been an outspoken voice affirming that something real and injurious happened to the affected individuals, even as some skeptics questioned the evidence. He has shared his observations and hypotheses in various forums:

• Targeted “Neuro-Weapons” Hypothesis: Early in the investigation, Dr. Hoffer and colleagues speculated that the cause might be an external directed energy device – essentially a “neurological weapon.” In media interviews in 2017–2018, Hoffer did not shy away from suggesting that a weapon using sonic or electromagnetic energy could have caused the injuriesnpr.org. At a televised news conference, his team raised the possibility of “a weapon that used sound waves or microwaves or some other form of electromagnetic energy” to explain the patients’ reportsnpr.org. Dr. Hoffer noted the odd localization of the effect (inside rooms, stopping at doorways) and the fact that many victims were clustered in certain residences or even specific offices at the embassynationaldefensemagazine.orgnationaldefensemagazine.org. “I thought they were being targeted. I still believe they were being targeted,” Hoffer told National Defense magazinenationaldefensemagazine.orgnationaldefensemagazine.org. He recounted how some patients felt the directed “beam” would track their movements indoors but cease once they escaped the immediate area – indicating a deliberate aiming of some devicenationaldefensemagazine.orgpmc.ncbi.nlm.nih.gov. This led Hoffer to strongly suspect a hostile actor: “They were really good at targeting…people were hit from all branches of State, but certain branches more than others,” he observed, implying that specific personnel (possibly intelligence officers) were preferentially affectednationaldefensemagazine.orgnationaldefensemagazine.org. Dr. Hoffer’s belief in a “neuro-weapon” was further supported by his collaboration with Dr. Giordano and Dr. Balaban (who had DoD backgrounds). In late 2018, the trio briefed the Pentagon on the case, discussing how directed energy (ultrasonic or radiofrequency) could create cavitation bubbles in body fluids that damage the inner ear and brain – one theoretical mechanism for the injuriesnationaldefensemagazine.orgnationaldefensemagazine.org. While they couldn’t prove the exact method, their report rated ultrasound or pulsed RF energy as “very possible” causes (and a microwave-only attack as less likely)nationaldefensemagazine.org. Dr. Hoffer has consistently maintained that the pattern of injuries was not coincidence and most likely came from a man-made source targeting U.S. personnelnationaldefensemagazine.orgnationaldefensemagazine.org.
• Reassuring the Public and Patients: In public Q&As and podcasts, Dr. Hoffer has been careful to call the phenomenon an “occurrence” or “incident” rather than a true syndrome, since a definitive cause remains unconfirmednews.med.miami.edu. He emphasizes that, whatever the cause, “it’s not technically a syndrome” in the medical sensenews.med.miami.edu – meaning it’s not a new disease without precedent, but rather a collection of known injury types (vestibular and neurologic trauma) with a specific trigger. Importantly, Hoffer has validated patients’ experiences. On CNN in 2022, he spoke alongside Dr. Douglas Smith (Penn) to explain why they believe the injuries are very real and not psychosomaticcnnpressroom.blogs.cnn.comcnnpressroom.blogs.cnn.com. This stance has been crucial for affected diplomats seeking acknowledgment and care. He has also indicated that early diagnosis and rehab are effective – many patients improved with balance therapy and cognitive rehabilitation once the problem was identifiednews.med.miami.eduinside.upmc.com. Dr. Hoffer often points out that if such incidents happen again, having a diagnostic “game plan” will lead to faster treatment and better outcomesinside.upmc.cominside.upmc.com.
• Collaboration and Ongoing Investigation: Dr. Hoffer has shared his findings with scientific committees and investigative panels. In Dec 2019, he presented his team’s data to the National Academies of Sciences, Engineering, and Medicine (NASEM) committee studying the embassy illnessesnews.med.miami.edunews.med.miami.edu. He expressed hope that a multidisciplinary analysis would “lead to a better understanding of the problem and illuminate the path forward.”news.med.miami.edu. He also acknowledged to the NAS that it was “too early…to draw definitive conclusions” about cause, underscoring his focus on objective diagnosis over speculationnews.med.miami.edu. Dr. Hoffer’s input clearly influenced the NAS panel’s 2020 report, which later concluded directed pulsed microwave energy was a plausible cause of the diplomats’ injuriescnnpressroom.blogs.cnn.com – a finding in line with what Hoffer and colleagues had hypothesized. Throughout, he has balanced open-mindedness with the conviction that those affected suffered a genuine physiological injury, not mass hysteria. “I’m confident something happened,” he insists – the challenge is to pinpoint exactly whatnpr.orgnpr.org.

Follow-up Research and Diagnostic Advances (2019–2021)

Building on the initial 2018 study, Dr. Hoffer and collaborators pursued further research to refine diagnostic criteria and distinguish “Havana Syndrome” from other conditions. One significant follow-up was a 2020 study in Frontiers in Neurology (Neuro-Ophthalmology section) led by Dr. Carey Balaban with Dr. Hoffer as a co-author. This study performed a retrospective quantitative analysis of eye-tracking data from the original evaluationsinside.upmc.cominside.upmc.com. By comparing the Havana patients’ eye and pupil reflex patterns to those of other groups, the researchers identified a distinct neurological signature:

• Distinctive Eye Movement Pattern: The team analyzed video recordings of pupil size changes and binocular convergence (eyes turning inward) during visual tasks. They compared 19 Havana Embassy individuals to 17 patients with known mild TBIs (concussions) and to a control group of 62 healthy subjectsinside.upmc.com. The result: the Havana group’s responses were markedly different from both normal and concussed individualsinside.upmc.com. Specifically, the embassy patients showed an abnormal pattern of coupled eye convergence and pupil constriction when focusing on a near target, unlike anything seen in mild TBI casesinside.upmc.com. In essence, their eyes responded in a unique way to depth-of-focus changes – a physiological marker that could potentially serve as a “fingerprint” of the Havana exposure. The study’s lead author noted, “The patterns of response in [the Havana group] were clearly distinct from those with concussions or other mTBI.”inside.upmc.com This provided objective evidence that the Havana injury is not just a routine concussion, but a specific neurosensory dysfunction.
• Validated Screening Tool: From this work, Dr. Hoffer and colleagues reported that they now have an “objective neurological screening platform” for such casesinside.upmc.com. The combination of tests they refined can differentiate Havana-syndrome patients from both healthy individuals and typical head injuries with high confidenceinside.upmc.cominside.upmc.com. Dr. Hoffer stated that this standardized diagnostic battery could be deployed **“in an overseas clinic or…in the field should a similar incident occur in the future.”*inside.upmc.com. In practice, this means if diplomats or soldiers suddenly develop comparable symptoms, doctors could use Hoffer’s test protocol (including the portable goggles and convergence analysis) to quickly identify the characteristic injury pattern and triage patients for treatmentinside.upmc.cominside.upmc.com. This is a direct outcome of Dr. Hoffer’s focus on tech-enabled diagnostics.
• Publications and Data Sharing: All of Dr. Hoffer’s major findings have been made publicly available through peer-reviewed literature and press releases. Aside from the 2018 Laryngoscope Investigative Otolaryngology papernews.med.miami.edu and the 2020 Frontiers in Neurology paperinside.upmc.com, his work is summarized in forums like the Medical Research Archives (where colleagues cited Hoffer’s criteria for Havana Syndrome case definition)esmed.orgesmed.org. He has also contributed to Department of Defense reports and briefings, given the national security implications. By 2023, Dr. Hoffer continues to publish on head trauma and serves in leadership roles (e.g. President of the Triological Society), advocating for ongoing research in balance disordersnews.med.miami.edunews.med.miami.edu.

Comparison with Other Diagnostic Approaches to Havana Syndrome

Dr. Hoffer’s diagnostic approach aligns with some experts’ methods and diverges from others, reflecting a broader debate on the nature of “Havana Syndrome.” Below is a comparison:

• University of Miami (Dr. Hoffer) vs. University of Pennsylvania (Dr. Smith) Approaches: The Pennsylvania team, led by Dr. Douglas Smith, became involved a few months after Dr. Hoffer. At the State Department’s request, Penn’s Center for Brain Injury and Repair conducted more extensive neurological exams on affected individuals starting mid-2017newyorker.comnewyorker.com. The Penn team’s focus was on brain imaging and neurocognitive outcomes. They performed MRI scans, including advanced neuroimaging like diffusion tensor imaging, to look for structural changes in the brainnewyorker.comcnnpressroom.blogs.cnn.com. In a 2018 JAMA report (Swanson et al.), the Penn/State Dept. doctors described findings consistent with “persistent concussive injury” in 21 diplomats (e.g. balance issues, eye movement abnormalities, and cognitive complaints)pmc.ncbi.nlm.nih.gov. Later, a 2019 JAMA study (Verma et al.) reported subtle differences in brain white matter and connectivity in some patientsesmed.org. Dr. Smith often referred to the condition with terms like “immaculate concussion”, highlighting its concussion-like symptoms without head impactnewyorker.comnewyorker.com. Alignment: Hoffer and Smith both concluded that patients sustained real brain injuries and both ruled out psychogenic causes. They collaborated to an extent – for example, Hoffer’s initial data review in July 2017 convinced the State Dept. to send patients to Dr. Smith’s specialized clinicnewyorker.comnewyorker.com. Differences: Hoffer’s work placed greater emphasis on acute-phase vestibular testing and peripheral inner-ear damage, whereas Smith’s team (seeing patients on average 6 months post-incident) emphasized cognitive deficits and MRI findings consistent with diffuse brain injurypmc.ncbi.nlm.nih.govnewyorker.com. In practice, Hoffer’s diagnostic protocol is more bedside and device-based (goggles, balance tests), while the Penn protocol leaned on imaging and longer-term neuropsychological evaluation. Notably, Hoffer’s 2020 eye-tracking study actually differentiated the Havana cohort from typical post-concussion patientsinside.upmc.com – suggesting the possibility that Havana Syndrome is a distinct entity, not just a variant of mTBI, a nuance that the Penn team initially had less data to establish.
• Alignment with National Academies and Others: The National Academies’ 2020 report ultimately concurred that the pattern of findings was consistent with a directed physical phenomenon, likely pulsed microwave energy, and not a mass psychogenic illnesscnnpressroom.blogs.cnn.com. This aligns with Hoffer’s early hypotheses of a directed-energy mechanism, though Hoffer had slightly favored ultrasonic/acoustic possibilities in 2018nationaldefensemagazine.org. Both agree on the need for preventive measures and further research on such directed-energy threats. On the other hand, Cuban investigators and some outside neurologists have been more skeptical. They pointed out that Hoffer’s published data lacked access to raw results and that some vestibular tests (like the Subjective Visual Vertical) can be failed by individuals under stress or with migraine – factors that don’t require a secret weaponnpr.orgnpr.org. These skeptics (e.g. Dr. Sergio Della Sala, Dr. Mitchell Valdés-Sosa) argue that neither Hoffer’s nor Smith’s studies definitively proved an attack occurred, citing absence of known pathology on standard tests in many casesnpr.orgnpr.org. Dr. Hoffer has responded by emphasizing the uniqueness and consistency of the objective abnormalities in his cohort, and the near-zero rate of such findings in controls, which makes a psychosomatic explanation improbablenationaldefensemagazine.orgnpr.org. Furthermore, subsequent independent studies have reinforced that something physical is at play – for example, a 2019 study of Canadian diplomats in Havana found brain white-matter changes and suggested low-dose neurotoxin exposure as one hypothesisesmed.org. While that cause differed (pesticides vs. energy weapon), the notion of a real exposure causing measurable changes echoes Hoffer’s stance that “these people were injured by something”npr.orgnpr.org.

In summary, Dr. Michael Hoffer’s diagnostic techniques are characterized by cutting-edge vestibular function testing, rapid deployment of technology (VR eye-tracking goggles), and an insistence on objective criteria. His findings of inner-ear damage and cognitive dysfunction in a tight cluster of patients helped legitimize “Havana Syndrome” as a genuine medical phenomenonnews.med.miami.edupmc.ncbi.nlm.nih.gov. This approach both complements and enhances other investigative methods – adding a layer of peripheral nervous system assessment to the largely central-neurologic evaluations of other teams. By publicly sharing his research and tools (from peer-reviewed papers to patents and press briefings), Dr. Hoffer has provided a foundation for diagnosing and treating individuals with this mysterious condition, as well as a framework for investigating future incidents.

Sources: Dr. Hoffer’s peer-reviewed studies and conference presentationspmc.ncbi.nlm.nih.govnews.med.miami.edu; media interviews and podcasts featuring Dr. Hoffernpr.orgnews.med.miami.edu; University of Miami press releases and Q&Asnationaldefensemagazine.orgnews.med.miami.edu; National Academies and CNN reportsnews.med.miami.educnnpressroom.blogs.cnn.com; and technical descriptions of his diagnostic devicesnews.med.miami.eduinside.upmc.com, as cited above. Each of these connected sources documents Dr. Hoffer’s contributions – from developing novel vestibular testing goggles to outlining clinical protocols – in the effort to understand and manage the condition known as “Havana Syndrome.”