Brain Scan Gives Vegetative State Patients Ability to Communicate

In 2003, the patient, a 29-year-old man, sustained a severe traumatic brain injury in a road traffic accident. He remained physically unresponsive and he was presumed to be in a vegetative state. Utilizing functional magnetic resonance imaging (fMRI), the patient's brain activity was mapped while he was asked to answer "yes” or "no” to questions such as "Is your father's name Thomas?” The patient could communicate answers by willfully changing his brain activity.

In the three-year study, 23 patients diagnosed as being in a vegetative state were scanned using fMRI, which was able to detect signs of awareness in four of these cases (17%). The fMRI technique used can decipher the brain's answers to questions in healthy, nonvegetative, participants with 100% accuracy, but it has never before been tried in a patient who cannot move or speak.

This new method of using fMRI was developed by Dr. Adrian Owen and his team at the MRC Cognition and Brain Sciences Unit in Cambridge (UK), an internationally leading center for research in cognitive sciences and neurosciences, with close links to clinical research. Dr. Owen, coauthor of the research from the Medical Research Council, said, "We were astonished when we saw the results of the patient's scan and that he was able to correctly answer the questions that were asked by simply changing his thoughts. Not only did these scans tell us that the patient was not in a vegetative state but, more importantly, for the first time in five years, it provided the patient with a way of communicating his thoughts to the outside world.”

Dr. Steven Laureys, coauthor from the University of Liège, confirmed, "So far these scans have proven to be the only viable method for this patient to communicate in any way since his accident. It's early days, but in the future we hope to develop this technique to allow some patients to express their feelings and thoughts, control their environment and increase their quality of life.”

Dr. Martin Monti, coauthor from the Medical Research Council, added, "The fact that this patient was able to communicate with scientists using his brain activity suggests that this technique could be used to address important clinical questions. For example, patients who are aware, but cannot move or speak, could be asked if they are feeling any pain, allowing doctors to decide when painkillers should be administered.”

The study was published in the February 3, 2010, issue of the New England Journal of Medicine.

The Medical Research Council has improved the health of people in the United Kingdom and worldwide by supporting the highest quality science. The MRC invests in world-class scientists and has produced 29 Nobel Prize winners and sustains a flourishing environment for internationally recognized research. The MRC's Cognition and Brain Sciences Unit in Cambridge investigates fundamental human cognitive processes, such as attention, memory, language, and emotion. Experimental techniques include state of the art brain imaging technology, neuropsychological studies of patient populations, computational simulations, and behavioral experiments on healthy volunteers. Findings from these studies are translated back into the clinical domain informing our basic understanding of human disease and strategies for patient rehabilitation.

The Coma Science Group at Liège University's Cyclotron Research Center aims to improve the medical care and understanding of disorders of consciousness following an acute insult such as coma, vegetative state, minimally conscious state, or locked-in syndrome.

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