Some Patients in Vegetative State Can Communicate
February 4, 2010
(ChattahBox) – An estimated 9,000 to 37,000 people in the United States are in a persistently vegetative or minimally conscious state; defined as patients with severe brain damage who were in a coma, but then progressed to a state of wakefulness without detectable awareness. In a study certain to rekindle debate over switch off life support machines for those with grievous brain injuries, researchers report that five out of 54 patients thought to be in a persistent vegetative state showed brain activity indicating awareness, intent and, in at least one case, a wish to communicate.
Not only can those in persistent vegetative states (PVS) understand what others are saying, but they can also offer simple responses to basic biographical questions. Experts using brain scans called functional magnetic resonance imaging at medical centers in England and Belgium, found five vegetative state patients who appeared able, when prompted by researchers, to imagine themselves playing tennis, and four of them demonstrated the ability to imagine themselves walking through the rooms of their homes.
Dr. Adrian Owen, who carried out the groundbreaking research, and his team concluded it’s possible to talk to patients by tapping into their brain activity using a hi-tech functional MRI to measure their “yes” and “no” answers to questions.
One of those patients — a 22-year-old man who had been unresponsive for five years after an automobile crash — went on to respond to a series of simple questions with brain activity that clearly indicated yes or no answers, researchers said.
Doctors predict about one in five PVS patients might be able to communicate. The discovery will likely raise questions about when doctors should take patients off life support machines and could cause a stir in the assisted suicide debate. “Obviously this fits into the issue of when patients should be allowed to die,” Dr. Owen said. The director of the Care Not Killing Alliance says, however, that the breakthrough is unlikely to alter guidelines regarding assisted suicide, since patients in that state don’t have the mental capacity to make such vital decisions. The research was published online Wednesday in the New England Journal of Medicine.