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Brain scan study allows "vegetative" patient to respond

February 9th, 2010
03:29 PM ET

I'd never been through an MRI scan before, and this one was anything but routine.

Our assignment was to find a way to illustrate a complex story about patients diagnosed as "vegetative" showing signs of awareness when in a functional MRI scanner.

The story emerged from a study published in the New England Journal of Medicine.

Producer Jonathan Wald immediately set to work ringing hospitals, neurosurgeons, and research centers.

Eventually, we got through to one of the authors of the study.

Dr. Adrian Owen offered to question me while inside the fMRI scanner at the MRC Cognition and Brain Sciences unit at Cambridge– much like what the patients in his study had gone through.

Twenty-three of those patients were believed to be in a so-called "vegetative state;" unresponsive and unaware of their surroundings.

But when asked to imagine playing tennis (meant to activate parts of the brain associated with movement), and walking through the rooms of their homes (meant to activate regions associate with spatial navigation), four of the patients' brains showed a similar response to those of healthy control subjects.

The researchers then went on to ask one of them a series of yes and no questions, imagining tennis for yes, and walking through the house for no.

Incredibly, using only his thoughts, he was able to answer.

We set out to illustrate how the tests were done. So cameraman Andrew Bobbin and I took a pre-dawn train from London to the MRC in Cambridge, in order to use the fMRI scanner early in the morning, the only time it was free.

Dr. Owen had me remove all the metal from my pockets, take off my shoes and jacket, and lie down on the machine. Next, a sort of mirrored visor was placed over my eyes, in which I could see a blue digital rectangle, and I was lowered into the machine.

[cnn-photo-caption image= http://i2.cdn.turner.com/cnn/2010/images/02/09/t1larg.jpg caption ="MRI scan shows different responses in the brain after the patient is asked different questions."]

For the first ten minutes or so, I was asked to alternate between imagining standing in one spot swinging a tennis racket, and resting under the sun, doing nothing. Next, I was told to imagine walking through the rooms of my house. Only then did we get to the questions.

Dr. Owen asked, "Do you have any brothers or sisters"? He then spoke into the microphone, saying either "answer" - to which I would imagine tennis for yes and navigating my house for no - or "rest".

Though I generated clear enough signals for Dr. Owen to decipher my "yes" answer, it surprised me how difficult it was to think in such a disciplined way for five minutes or so.

For example, I'd be thinking of walking through my childhood home, then suddenly veer off into the neighbors yard and start remembering their old hound dog, or walk into my old bedroom and wonder if that closet door is still broken.

And then, I thought, what a different experience this would be if you were one of the patients in the study. When I was asked every so often if I understood and if I were doing ok, I could respond with no problem.

Not so for the study's patients.

What's more, for those patients diagnosed as "vegetative" but who now appear to be aware, this must have seemed one of the most important tests in their lives.

It was a chance to show not just their loved ones, but the world that they were still inside there - conscious!

Dr. Owen went on to ask a second question, and then we were out of time.

There are many reasons to be cautious about the results of this study, I've been told by doctors and scientists. Further tests need to be done, only those suffering from traumatic injuries responded like the healthy subjects, and only a small percentage of the "vegetative" patients showed signs of cognition.

But none of that has stopped me from wondering at the difference this could potentially make in the lives of some patients, and the possibilities for the future.

We'd like to know what you think - please leave comments or questions below.

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soundoff (18 Responses)
  1. John

    YOU are not you body. When will Christians finally give up their
    anthropomorphic fantasy about God and the nature of man. Vedic (ancient Hindu) and Buddhist scripture have taught this for millenia. "We" are not the body that is supposedly made in "God's image". "We" in fact are consciousness/bliss or "aliveness" incarnate in the body; the body being a vehicle and the mind being the interface between "our self" and the world – neither one being "that which we are" in truth. I think this new research walks a mile in proving. It is no wonder religious zealots of all denominations hate science so much – it is the one thing that can thoroughly destroy their dogma and their cash flow.

    February 9, 2010 at 5:01 pm | Reply
  2. emmarcee

    John, you idiot. This one just shows that the so called "consciousness" (which is a misnomer in itself) stems from the mechanics of brain. That is why the researchers were able to find it through the functional MRI. Go home and save your brothers from dirt. Then try to correct others.

    February 9, 2010 at 5:19 pm | Reply
  3. JV

    Unfortunately your test is meaningless because you did not attempt to see what happens during the "imagination" test without trying. That is, DON'T try to imagine anything and see if your brain gives the same response to the two different imagination cues. If the test were to give the same response even without you trying, then this would show that the veg. patients did not have to use "will" to elicit those patterns. However, if you failed to show the pattern without "willing" it then perhaps the veg. patients had to "will" it as well. Of course, there could be a fundamental difference in how easy it is to elicit those patterns in a healthy person vs. a veg. patient for so many reasons that, even if the test were performed well, it would be difficult to conclude "will" in a veg. patient. In other words, this story is meaningless because of faulty reasoning. Why aren't journalists for the world's foremost news source required to display basic problem solving and logical reasoning abilities? Now, the real question is whether we can diagnose "John" as a schizophrenic based on a brain scan, instead of just his message about spirituality.

    February 9, 2010 at 5:23 pm | Reply
  4. Carmella Bryant

    To me, the discipline required, of maintaining a focus on standing
    with a tennis racquet in my hand, would be challenging. Also, to
    keep in mind that I am in my bedroom and not be distracted by some
    other place, would be very difficult. Maybe I should start practicing
    meditation or some other mental exercise in case I ever have to
    pass the test.

    February 9, 2010 at 5:32 pm | Reply
  5. Reed Kelly

    Since hearing is still possible, I wonder if an EEG or related technology could be used in conjunction with audio feedback to allow patients to train a device to create primitive speech. EEG may not be strong enough to produce similar results, but I suspect that it would be less expensive to leave on the patient.

    February 9, 2010 at 6:13 pm | Reply
  6. Anna

    This may sound cruel to us, but when is someone going to ask them if they want to continue living? I can't imagine the sheer torture of being conscious and trapped in my body, unable to even blink.

    February 9, 2010 at 6:46 pm | Reply
  7. Eric

    And reporting has proved your brain is dead

    February 9, 2010 at 6:53 pm | Reply
  8. TarnyCat

    Wow..Emmarcee doesn't like John.
    Certainly there's no way to prove it one way or another but this study does seem to indicate the socalled consciousness factor remains active without the body. But is it dependent on the mechanics of the brain? Well Emarce what proof do you have that the brain pre-exists consciousness? And why cant the truth be that consciousness merely seats itself in the brain while incarnate and uses (brain) to "interface" with the physical world?

    February 9, 2010 at 7:04 pm | Reply
  9. E Brennan

    This sounds very interesting. I hope they test and develop this technology further. It makes me wonder what would have happened if they had connected this stuff up with Terri Schiavo. Her husband and his fav death doctor would have gotten some answers from her that they might not have wanted to "see".

    In regards to "John", true Christians who know the Word and trust God don't fear nor hate observational and experimental science. Yet it seems to be a certain "scientific" subculture that wants to ignore the science that explores the possibility of Creation and/or Intelligent Design. This is another discussion for another time tho.

    And John, I wish i had the "cash flow" you accuse Christians of being worried about losing.

    Finally, I have no problem with physical evidence of our thinking via the MRI. We were created in the image of God. That image is composed of a spiritual/soulish sense that is infused with a moral awareness. Our spiritual selves were fused at Creation with our physical bodies, including our brains, to result in a being different than all others on this planet. This was done with a divine plan in mind, which is discussed within the pages of the Holy Bible. I don't mean to make this sound confusing. Suffice it to say that we are lving beings both in the physical sense, and in the non-physical spiritual sense. Our bodies do what our minds want them to do, and our minds follow the dictates of our hearts (spirits). Unfortunately, because we are fallen (read "sinful"), our image is marred and therefore does not reflect the Creator as we were made to. This too is another topic for another time.

    Bottom line, John, this news does not affect or bother me, a Christian.

    February 9, 2010 at 7:19 pm | Reply
  10. E Brennan

    Anna, i can understand your sentiment and i can bet there will be many who will not to "go on". Yet, there are those with the Stephen Hawking kind of mindset who would use their enhanced and improved situation to go on and live, and reach and positively influence others with their thoughts. So let's not be too worried about this new technology.

    February 9, 2010 at 7:23 pm | Reply
  11. Victor Lutchman

    Just a case in point in support of the Catholic Church's stance on the sanctity of life.
    Regardless of what may appear to man as lost or gone, mans ignorance of all, including science, play the role of God and decide who must live and who must die.
    It is really very simple.
    Life belongs to God - to give and to take.

    February 9, 2010 at 7:33 pm | Reply
  12. emmarcee

    Anna, Yes, it sounds cruel. has it ever occured to you that the so called "vegetable" person may have real feelings and thoughts? No, but now this shows the person has feelings really. Now, the time when we will be able to figure out what they are thinking may not be that far. may be 10 - 15 years? So then what is the difference between this person and hawking? Also, there have been evidence to point that people's minds adjust to the predicament they are in. There is nothing to suggest that the locked in people really want "death" as their option. Of course unless they are going through some kind of agony and pain without resolution. Most of them are not.

    February 9, 2010 at 8:07 pm | Reply
  13. Albert

    To John,

    You speak about christianity as if you invented it and know the bible in out. Either you are doing this to gain some attention, or are trying to subscribe to herd mentality of people who live their lives by the media and the da vinci code.

    To understand what christianity is, you need to live it and not base out of the useless theories, arguments and counter arguments floating around. Read about the lives of the saints who were skinned alive or burnt alive for you and me and you'll see what i mean.

    I'm not saying all this to convince you, because i know you won't get convinced.... because faith can NEVER be obtained by reasoning. Guaranteed.

    I'm just tired of the moronic theories you guys spread. Why do people like you think that there is no order in the way god works?

    Don't talk about hinduism, because you don't seem to know enough about that as well.

    Hoping you find peace in your life.

    February 9, 2010 at 8:50 pm | Reply
  14. Para antonia reenviar

    para antonia por favor

    February 9, 2010 at 8:59 pm | Reply
  15. ALAN

    This is why it is essential NOT to turn off a life support system as the brain does mend itself over time.

    February 9, 2010 at 9:29 pm | Reply
  16. Bill

    Seems to me that you weren't in need of proof for the living status of your brain.

    February 9, 2010 at 10:06 pm | Reply


    February 10, 2010 at 2:34 am | Reply
  18. Barbara

    In most cases I feel the closest family members will know the patient's wishes ahead of time. Before my husband died we had discussed a living will, feeding tubes, ventilation machines etc. I knew exactly what his wishes were and I would never depart from them. He, by no means wanted to be kept alive by any machine wether it was tubes, ventalation or whatever else the medical protocol might be at that time. My daughters and I were firm and we all knew exactly what he wanted. As adults we are asked our entire lives to make decisions, what job to take, what car to buy, what neighborhood to live in. The decision to stay alive by machines is far more improtant and should be honored just like any other life-changing event in their lives.

    February 10, 2010 at 5:28 pm | Reply

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