Man in a Vegetative State ‘Talks’ to His Doctors

Using “yes” or “no” questions, researchers ask a vegetative man if he is in pain

A functional magnetic resonance image of a brain.
A functional magnetic resonance image of a brain. Kelley

According to the CBC, 39-year-old Scott Routley, who 12 years ago was put into a vegetative state by a car accident has learned to communicate with his doctors by way of an elaborate brain-imaging system. Routley is alive and not on a respirator but is generally unaware of the world around him. Using functional magnetic resonance imaging, a brain-scanner that looks for blood flowing around the brain, Adrian Owen and colleagues at the University of Western Ontario asked Routley if he was in pain. Routley said “no.”

Or, rather, his brain showed activity that Owen and his colleagues interpreted to mean that he said “no.”

The process devised by Owen to obtain his answer is by no means simple. There are no “yes” and “no” regions of the brain that light up under an fMRI to let neurologists know what you’re thinking. Instead, Owen designed his own. Nature:

It was June 2006. Wimbledon was on, and in a headline-stealing study, Owen took fMRI scans of a 23-year-old woman in a vegetative state while he asked her to imagine playing tennis and walking through the rooms of her house. When healthy, conscious adults imagine playing tennis, they consistently show activation in a region of the motor cortex called the supplementary motor area, and when they think about navigating through a house, they generate activity in the parahippocampal gyrus, right in the centre of the brain.

Building off these differences in how the brain processes different imaginings, Owens devised a yes-no scheme: “magine playing tennis for yes, navigating the house for no.”

Using the new approach, Owen and his colleagues have been asking vegetative patients simple factual and subjective questions, such as whether or not they are in pain, says Nature.

Owen told the BBC:

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.

The approach is by no means controversy-free, with researchers questioning whether the patients are really showing signs of conciousness, or if they are just “knee-jerk” reactions. The other dilemma, says the BBC, is what do to if Owen’s research pans out. What do we do with the information we can gather from vegetative patients? What kinds of questions are right to ask, and how should we act on the answers we receive?

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