Chicago - Advanced brain scans found perplexing differences in U.S. diplomats who say they developed concussion-like symptoms after working in Cuba, a finding that only heightens the mystery of what may have happened to them, a new study says.

Extensive imaging tests showed the workers had less white matter than a comparison group of healthy people and other structural differences, researchers said.

While they had expected the cerebellum, near the brain stem, to be affected given the workers’ reported symptoms — balance problems, sleep and thinking difficulties, headaches and other complaints — they found unique patterns in tissue connecting brain regions.

Ragini Verma, a University of Pennsylvania brain imaging specialist and the lead author, said the patterns were unlike anything she’s seen from brain diseases or injuries.

“It is pretty strange. It’s a true medical mystery,” Verma said.

Co-author Dr. Randel Swanson, a Penn specialist in brain injury rehabilitation, said “there’s no question that something happened,” but imaging tests can’t determine what it was.

An outside expert, University of Edinburgh neurologist Jon Stone, said the study doesn’t confirm that any brain injury occurred nor that the brain differences resulted from the strange experiences the diplomats said happened in Cuba.

Cuba has denied any kind of attack, which has strained relations with the United States.

The results were published Tuesday in the Journal of the American Medical Association. A journal editorial says the study may improve understanding of the reported symptoms, but that the relevance of the brain differences is uncertain.

In a statement, the U.S. State Department said it “is aware of the study and welcomes the medical community’s discussion on this incredibly complex issue. The Department’s top priority remains the safety, security, and well-being of its staff.”