5 February, 2010
London, England
A man in a deeply unconscious state for five years has been able to communicate with doctors using just his thoughts in a study scientists say is a “game changer” for care of vegetative state patients.
British and Belgian researchers used a brain scanner called functional magnetic resonance imaging to show the man, who suffered a severe traumatic brain injury in a road accident in 2003, was able to think “yes” or “no” answers to questions by wilfully changing his brain activity.
Experts say the result means all patients in coma–like states should be reassessed and it may change the way they are cared for in future.
After detecting signs of awareness, the doctors scanned the man’s brain while he was asked to say “yes” or “no” to questions such as “is your father’s name Thomas?” The results showed that by changing his brain activity, the man communicated his answer. “We were astonished when we saw the results of the scan and that he was able to correctly answer the questions that were asked by simply changing his thoughts,” said Adrian Owen, co–author of the study from the Medical Research Council.
“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.”
The man, now 29 years old, was one of 23 patients diagnosed as being in a vegetative state who were scanned using functional magnetic resonance imaging (fMRI). The scans detected signs of awareness in four of the patients, the experts wrote in their study published in the New England Journal of Medicine on Wednesday.
The fMRI method used can decipher the brain’s answers to questions in healthy people with 100% accuracy, but it has never been tried before in patients unable to move or speak.
Nicholas Schiff, a neurologist from Weill Cornell Medical College in New York, said the findings were a “game changer” that could “have a profound impact across medicine”.
In comments sent by email, he said the results called for the reassessment of all patients currently in so–called “minimally conscious” or “vegetative” states.
Allan Ropper of Brigham and Women’s Hospital in Boston said the study suggested such scans may be one more test doctors can use on people who recover from a coma but remain unresponsive.
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