Cuban epidemic neuropathy: lessons learned from scientific and political controversies
- 1Instituto de Neurología y Neurocirugía
- 2Centro de Estudios Demográficos de la Universidad de La Habana
Abstract
Introduction: Cuban epidemic neuropathy (CEN), which emerged in the early 1990s during Cuba’s Special Period, was one of the largest neurological epidemics of the 20th century and became the subject of a scientific and political controversy.
Objective: To revisit the epidemic and examine the lessons learned from the scientific debates, institutional responses, and political context that shaped its investigation and management.
Development: This perspective integrates epidemiological, clinical, neuropathological, therapeutic and health evidence, to analyze competing etiological hypotheses and the influence of geopolitical and institutional factors on scientific interpretation. Accumulated evidence—including severe dietary restriction, depletion of B-group vitamins and other nutrients, increased metabolic demands, tobacco and alcohol exposure, and axonal pathology—supports a multifactorial toxic–nutritional model, over a viral agent. Nutritional depletion may have reduced mitochondrial metabolic reserve, antioxidant and detoxification capacity, and increased oxidative stress. Mitochondrial dysfunction and oxidative injury provide a convergent mechanism for selective vulnerability of the optic nerve and peripheral axons. Therapeutic implications underscore the benefit of early nutritional intervention even when the specific contributions of individual nutrients or toxins remain uncertain. The scientific controversy illustrates how geopolitical and institutional factors influenced the interpretation of science, research priorities, communication, and public health decision-making.
Conclusion: CEN demonstrates the importance of multidisciplinary evidence, scientific independence, transparent communication, early intervention, and recognition of social determinants in neurological epidemics. These lessons remain highly relevant as Cuba today confronts renewed economic hardship and disturbing geopolitical challenges in progress.
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BibTeX
@article{gonzalezquevedo2026cuban,
title = {{Cuban epidemic neuropathy: lessons learned from scientific and political controversies}},
author = {Alina González-Quevedo and Rosaralis Santiesteban Freixas and Francisco H. Figaredo Curiel},
journal = {Frontiers in Pharmacology},
year = {2026},
month = oct,
doi = {10.3389/fphar.2026.1927625},
url = {https://www.frontiersin.org/articles/10.3389/fphar.2026.1927625/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Cuban epidemic neuropathy: lessons learned from scientific and political controversies
AU - Alina González-Quevedo
AU - Rosaralis Santiesteban Freixas
AU - Francisco H. Figaredo Curiel
PY - 2026
DA - 2026/10/14
JO - Frontiers in Pharmacology
DO - 10.3389/fphar.2026.1927625
UR - https://www.frontiersin.org/articles/10.3389/fphar.2026.1927625/full
AB - Introduction: Cuban epidemic neuropathy (CEN), which emerged in the early 1990s during Cuba’s Special Period, was one of the largest neurological epidemics of the 20th century and became the subject of a scientific and political controversy. Objective: To revisit the epidemic and examine the lessons learned from the scientific debates, institutional responses, and political context that shaped its investigation and management. Development: This perspective integrates epidemiological, clinical, neuropathological, therapeutic and health evidence, to analyze competing etiological hypotheses and the influence of geopolitical and institutional factors on scientific interpretation. Accumulated evidence—including severe dietary restriction, depletion of B-group vitamins and other nutrients, increased metabolic demands, tobacco and alcohol exposure, and axonal pathology—supports a multifactorial toxic–nutritional model, over a viral agent. Nutritional depletion may have reduced mitochondrial metabolic reserve, antioxidant and detoxification capacity, and increased oxidative stress. Mitochondrial dysfunction and oxidative injury provide a convergent mechanism for selective vulnerability of the optic nerve and peripheral axons. Therapeutic implications underscore the benefit of early nutritional intervention even when the specific contributions of individual nutrients or toxins remain uncertain. The scientific controversy illustrates how geopolitical and institutional factors influenced the interpretation of science, research priorities, communication, and public health decision-making. Conclusion: CEN demonstrates the importance of multidisciplinary evidence, scientific independence, transparent communication, early intervention, and recognition of social determinants in neurological epidemics. These lessons remain highly relevant as Cuba today confronts renewed economic hardship and disturbing geopolitical challenges in progress.
SN - 1663-9812
ER -