...at some point, this medical advance may even improve contributions from Jonah!:
Brain-Damaged Patient Reaches Outside World by Mapping Thoughts
By Andrea Gerlin
Feb. 3 (Bloomberg) -- A man in Belgium, presumed for five years to be in a vegetative state, communicated with doctors through a brain scan that mapped his thoughts, a tool that may offer some people who cannot move or speak a line to the outside world.
The patient effectively answered “yes” or “no” to questions posed by researchers using a technique known as functional magnetic resonance imaging, according to a report in today’s New England Journal of Medicine.
The 29-year-old, who had suffered a head injury in a road accident in 2003, showed activity in one of two specific regions of his brain on five of six autobiographical questions put to him. He was one of 54 patients with little or no consciousness in the study. Five showed some activity in one or two regions of the brain when asked to imagine specific tasks; 49 didn’t show any activity when asked to think of the same tasks.
“Some patients who appear behaviorally to be vegetative may not be,” said Adrian Owen, one of the report’s authors and a professor at the Medical Research Council Cognition and Brain Sciences Unit in Cambridge, England, in a telephone interview. “They may be able to give yes-or-no responses.”
About four in 10 patients who are classified as having consciousness disorders -- vegetative and minimally conscious states being two of these -- are misdiagnosed, according to the paper. The technique the researchers used may enable doctors to better define their levels of awareness and to establish basic communication.
Quality of Life
Smaller, less expensive bedside imaging machines may allow some patients diagnosed with limited consciousness to engage in minimal communication, improving their quality of life, Owen said. The information they communicate could enable doctors and nurses to know if they are in pain and need painkillers or relatives to better interpret the extent of their awareness.
Twenty-three of the study patients were diagnosed as being in a vegetative state and 31 were in a minimally conscious state. Patients in a vegetative state can’t respond to stimuli after emerging from a coma and opening their eyes. Minimally conscious patients show limited and erratic verbal responses and movement.
Functional MRI enables doctors to see inside the body without using radiation and measures brain activity by mapping blood flow, or oxygen use, in different parts of the organ. In the study, conducted in Cambridge and Liege, Belgium, the patients were asked to imagine playing tennis or walking through familiar streets or from room to room at home.
In a separate group of healthy patients, imagining a tennis game activated a part of the brain called the pre-motor cortex and imagining walking the streets or through a house activated another structure called the parahippocampal gyrus. The five brain-injured patients who responded to the test had activity in one or both areas when asked questions, the researchers said.
The road accident victim correctly answered all but the last of six additional autobiographical questions, including one referring to his father’s name, the researchers reported. No activity was detected when he was asked the final question.
In an accompanying editorial, neurologist Allan H. Ropper of Brigham and Women’s Hospital in Boston said the study’s results would make it difficult for doctors to tell families that their unresponsive relatives are not “in there somewhere.” The new data suggest that functional MRI should be added to traditional methods of diagnosing patients with consciousness disorders, Ropper wrote.
In words of caution, Ropper said brain activity was detected in a small number of patients in the study, only in some patients whose brain injuries were from trauma, and in none who had suffered strokes or oxygen deprivation. The activity didn’t prove the presence of more complex thought processes, he said.
“Persons who look to this study to justify continued and unqualified life support in all unresponsive patients are missing the focus of the findings,” Ropper wrote.
...majestically enthroned amid the vulgar herd...
Hey this is a nice article..
As is so often the case, Mr. Frank Zappa was there a long time ago:
No one will know
If you don't want to let 'em know
No one will know
'Less it's you that might tell 'em so
Call and they'll come to you
Covered with dew
Of responding to you
Shiny & proud by your side
Holding your hand
While the neighbors decide
Why is a vegetable
Something to hide?