MIAMI (AP) — American diplomats affected by mysterious health incidents in Cuba showed damage in the inner ear shortly after they complained of weird noises and sensations.

University of Miami doctors published details of those earliest exams in a medical journal Wednesday — but the report sheds no new light on a possible cause of symptoms that include dizziness, ear pain and ringing, and difficulty thinking and concentrating.

Miami's Dr. Michael Hoffer says his early findings confirm patients were injured and not suffering from mass hysteria.

The U.S. says 26 people associated with the embassy in Havana suffered "health attacks" that started in late 2016. Earlier this year, doctors at the University of Pennsylvania who also examined many of the patients reported they suffered concussion-like brain damage.

Cuba adamantly denies involvement.