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Plot Thickens In Dispute Over Consciousness In Vegetative Patients

"Brain function in coma, vegetative state, and related disorders". The Lancet Neurology 3 (9): 537–546. | date 2011-11-30 | (Neurowiki via Wikimedia Commons)

“Brain function in coma, vegetative state, and related disorders”. The Lancet Neurology 3 (9): 537–546. | date 2011-11-30 | (Neurowiki via Wikimedia Commons)


In late November, we reported on some striking experiments that suggested there may be shreds of consciousness in patients who appear to be in a long-term “persistent vegetative state.”

Health columnist Judy Foreman wrote:

The recent work by [University of Western Ontario researcher Adrian] Owen, and others, using fMRI brain scanning technology shows that some patients diagnosed as being in a persistent vegetative state may actually have some degree of consciousness and be able to communicate, that is, by sheer thinking, be capable of answering comparatively simple questions such as “are you in pain?”

Owen’s work found signs of consciousness in a seemingly vegetative patient, Scott Routley:

Essentially, Owen trained Routley to answer questions through a kind of game. When he asked Routley to imagine himself playing tennis, a particular part of his brain, the premotor cortex, lit up on the fMRI brain scans “with a very big signal.” (The premotor cortex sends signals to the motor cortex, which actually signals muscles to move.) Routley learned that imagining to play tennis, thus lighting up this part of his brain, meant “yes.”

Now, the plot thickens: New York-based researchers are calling some of Owen’s findings into question — not those MRI scans, but “bedside” brain-wave checks using EEG readings. The Neuroskeptic blog reports on the back-and-forth here beneath the pithy headline “Another Scuffle In The Coma Ward.” It posts an example of the brain-wave data in dispute and explains: Continue reading

When The Vegetative Patient May Be Able To Communicate

By Judy Foreman
Guest Contributor

One of the most vexing emotional and ethical issues in all of medicine is the decision by family members to “pull the plug,” that is, to take a severely ill, non-communicate relative off of the life-support systems keeping him or her alive.

What makes this decision so hard, of course, is, absent a really clear statement ahead of time from the patient about end-of-life wishes, family members basically have to guess. But there may be – not yet, but someday – a way to make this agonizing guesswork a bit easier, thanks to a stunning series of recent experiments by Adrian Owen, who holds the prestigious Canada Excellence Research Chair in cognitive neuroscience and neuroimaging at the University of Western Ontario.

(Digital Shotgun/flickr)

The recent work by Owen, and others, using fMRI brain scanning technology shows that some patients diagnosed as being in a persistent vegetative state may actually have some degree of consciousness and be able to communicate, that is, by sheer thinking, be capable of answering comparatively simple questions such as “are you in pain?” (Obviously, that’s a much simpler question than “do you want to die?”)

The particular patient generating the latest excitement is 39-year old Scott Routley who, 12 years ago, had a car accident that left him with a severe brain injury. By standard tests, doctors thought he was in a persistent vegetative state, or PVS. Continue reading