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New Discovery Regarding Brain Injury Patients in “Vegetative” Conditions

The most serious brain injuries–often related to car accidents–sometimesthrow those affected into a “vegetative state.” As most know from high-profile cases, this condition signifies a virtual inability to interact with the outside world. Those in a vegetative state are essentially stagnant, unable to move voluntarily, communicate, or otherwise engage with those around them. It refers to an unconcious mind. This is often a permanent condition, leading families to make very difficult quality of life and long-term care choices.

However, a new case discussed by BBC News is raising many eyebrowns, as it stems from a patient in a vegetative state who was apparently able to communicate with doctors who were using an fMRI machines to measure the patient’s brain when asked questions. An examination of the brain apparently allowed the doctors to identify the patient’s response.

Communicating Through Brain Waves?
The patient in this case suffered a serious brain injury as the result of a car accident. The accident occurred more than a decade ago, and he has been in his current condition ever since. In the twelve years since the accident, assessments of his condition did not show any signs of communication ability or awareness of his surroundings.

However, in a trial run from a team of researchers, the patients was asked questions while being given an fMRI to monitor brain activity. The analysis of the brain activity allows doctors to determine what his response was (if any) to the questions–regardless of whether he can communicate externally. Amazingly, the doctors were able to tell from the scan that the man was clearly “answering” the questions posed to him, even though he could not verbalize the answer. For example, when he was asked whether he was in any pain, the man’s brain activity clearly indicated that he intended to answer “No.” This result is shocking, because it goes against what the man’s neurologists thought possible for a decade. It is also a reminder of how far we have come in brain injury research and basic understanding in that professionals can analyze scans and understand what they indicate even without a patient’s ability to explain.

Researchers indicate that the MRI test is an obvious indicator that the man is not actually “vegetative,” even though outward signs suggest otherwise. It is important to note that this research does not mean that all “vegetative” patients have the ability to communicate and are aware of their surroundings. However, it does mean that careful analysis must be conducted to determine the full extent of one’s functioning.

For example, another patient examined by researchers in this effort was able to indicate that he had formed new memories even after his brain injury. This second patient was similarly given an MRI while being asked questions. Researchers asked if his sister had a daughter–the scans indicated that the man answered “yes.” The daughter was not born until after the brain injury, indicating that the patient was engaged with his surroundings and aware of changes.

Summarizing the findings, the lead researchers explained that “asking a patient something important to them has been our aim for many years. In future we could ask what we could do to improve their quality of life. It could be simple things like the entertainment we provide or the times of day they are washed and fed.”

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