'Vegetative' patient communicates

 

A crash victim thought to have been in a vegetative state for more than a decade has been able to tell scientists he is not in pain.

Canadian Scott Routley, from London, Ontario, communicated with researchers via a brain scan, proving that he is conscious and aware.

It is believed to be the first time such a severely brain damaged patient has been able to provide clinically relevant information to doctors.

British neuroscientist professor Adrian Owen, who leads the research team at the Brain and Mind Institute of Western Ontario, said: “Scott has been able to show he has a conscious, thinking mind. We have scanned him several times and his pattern of brain activity shows he is clearly choosing to answer our questions. We believe he knows who and where he is.”

Prof Owen was speaking on a BBC Panorama programme to be broadcast tonight.

He said the breakthrough could lead to improvements in the treatment of severely brain damaged patients who cannot move or speak.

“Asking a patient something important to them has been our aim for many years,” he told the programme.

“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.”

Prof Owen’s team uses functional magnetic resonance imaging (fMRI) brain scans to detect hidden awareness in patients and open up channels of communication.

The scans produce images of “active” regions of the brain by tracking the flow of oxygen-rich blood.

Patients are asked to imagine playing tennis or walking around their home — two thought processes that produce distinct patterns of activity in different parts of the brain.

By monitoring the activity on an fMRI scanner, the researchers can ask yes or no questions. One type of brain activity is taken as a “yes” and the other as a “no”.

Mr Routley suffered traumatic brain injuries when his car was in collision with a police vehicle. Until Prof Owen’s intervention, he was assumed to have been in a vegetative state for more than 12 years.

Vegetative state patients are not aware of their surroundings or capable of conscious thought.

Neurologist Professor Bryan Young, from University Hospital in London, Ontario, who has cared for Mr Routley for 10 years, said the scan results overturned all previous assessments of the injured man’s condition.

“He had the clinical picture of a typical vegetative patient — no emotional response, no fixation or following with his eyes,” said Prof Young.

“He didn’t have any spontaneous movements that looked meaningful and I was quite impressed and amazed that he was able to show these cognitive responses with fMRI.”

Prof Owen has previously shown that nearly one in five vegetative patients may in fact be conscious.

Another of his patients, road accident victim Steven Graham, was able to answer “yes” when asked if he knew about his two-year-old niece Ceili. Since she born after his car accident, this demonstrated that he was able to create and store memories.

The Panorama team spent more than a year filming several vegetative and minimally conscious patients taking part in pioneering research at the Brain and Mind Institute and Addenbrooke’s Hospital in Cambridge.

The programme, The Mind Reader: Unlocking My Voice, airs tonight at 10.35pm on BBC One.

The Irish Times Logo
Commenting on The Irish Times has changed. To comment you must now be an Irish Times subscriber.
SUBSCRIBE
GO BACK
Error Image
The account details entered are not currently associated with an Irish Times subscription. Please subscribe to sign in to comment.
Comment Sign In

Forgot password?
The Irish Times Logo
Thank you
You should receive instructions for resetting your password. When you have reset your password, you can Sign In.
The Irish Times Logo
Please choose a screen name. This name will appear beside any comments you post. Your screen name should follow the standards set out in our community standards.
Screen Name Selection

Hello

Please choose a screen name. This name will appear beside any comments you post. Your screen name should follow the standards set out in our community standards.

The Irish Times Logo
Commenting on The Irish Times has changed. To comment you must now be an Irish Times subscriber.
SUBSCRIBE
Forgot Password
Please enter your email address so we can send you a link to reset your password.

Sign In

Your Comments
We reserve the right to remove any content at any time from this Community, including without limitation if it violates the Community Standards. We ask that you report content that you in good faith believe violates the above rules by clicking the Flag link next to the offending comment or by filling out this form. New comments are only accepted for 3 days from the date of publication.