Tuesday, June 22, 2010

What if a 'vegetative state' isn't?

The Economist reports that doctors are finding ways to communicate with those thought to be in an irreversible coma or 'vegetative state'.

Over the past four years, teams led by Adrian Owen at the Medical Research Council’s Cognition and Brain Sciences Unit in Cambridge, and Steven Laureys of the Coma Science Group at the University of Liège, have scanned 23 vegetative patients between them. Four were able to respond to yes-no questions correctly and consistently by following instructions to imagine playing tennis when they wanted to give one response, or walking round the house when they wanted to give the other.

. . .

If they are responsive, they are capable of communicating. So the problem is how to facilitate this, given that it is not practical to put them in a scanner every time someone wants to ask them a question. Damian Cruse of the Cambridge group thinks he may have found a solution in electroencephalography (EEG), a cheaper and more portable way of measuring brain activity via electrodes pasted to the patient’s scalp.

Dr Cruse and his colleagues first asked six healthy volunteers to imagine either squeezing their right hand or wiggling the toes of both feet when they were presented with an audible tone. They found that their volunteers’ brains’ responses to the two commands were clearly different. The imagined hand-squeezing produced a response on the left-hand side of the brain, while the toe-wiggling produced one over the centre of the head.

They then applied the same procedure to a patient with “locked-in” syndrome—conscious but almost entirely paralysed—who retains some control of his eye movements. His brain responses were the same as those in the healthy controls. Finally, they gave the instructions to a patient who had been diagnosed as being vegetative two years earlier. They found that, from the EEG signals alone, they could deduce which movement this patient had been instructed to imagine with 100% accuracy.

This result, though preliminary, suggests it might be possible to establish some sort of dialogue with people who had previously been considered all but brain-dead. That would be extraordinary. Given that solitary confinement is one of the harshest punishments known, and that such people are condemned to the worst sort of solitary imaginable, it would also be wonderful.

There's more at the link.

As a pastor, more than once I had to help families with loved ones in such a condition. It's heartbreaking for all concerned, particularly if decisions have to be made as to whether or not to continue life support. Hopefully this new approach can help in at least some such cases.



Anonymous said...

It certainly should pause an implementation of euthanasia on patients in those states.


Anonymous said...

For what it's worth, I seem to have seen a note that someone is working on an Open Source EEG. I don't know how much the 'real' thing costs but if some can put one together on the cheap, it would seem to go a long ways towards enabling these folks a communication link to the 'outside'.