An “Unconscious” Man Talks

Functional magnetic resonance images of a vegetative patient’s brain communicate to doctors that he’s conscious and not in pain.

By Beth Marie Mole | November 14, 2012

fMRI showing two distinct patterns of brain activity.Wikimedia, National Institute of Mental HealthScott Routley, a 39-year-old Canadian patient that doctors had considered vegetative and incapable of communicating following a car crash 12 years ago, was able to tell doctors that he’s not in pain via functional magnetic resonance imaging (fMRI) of his brain. The breakthrough, reported this week (November 13) by BBC News, marks the first time that a clinically vegetative patient has been able to answer questions pertinent to their condition.

"Scott has been able to show he has a conscious, thinking mind,” neuroscientist Adrian Owen of the University of Western Ontario told the BBC. “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."

To communicate with Routley, Owen and his team used their previously developed fMRI communication method, which monitors real-time brain activity—by visualizing the flow of oxygenated blood through the brain—as the patient answers specific questions. In the previous study, they found that if they asked patients to imagine playing tennis or walking through their house, the fMRI would show two distinct, reproducible patterns. Using “playing tennis” and “walking through the house” as proxies for “yes” and “no,” for example, Routley could answer the researchers’ questions about his care. Their previous work on similar patients also included a fact-based quiz, which suggested that the communication system allowed the patients to accurately communicate through their thoughts.

"Asking a patient something important to them has been our aim for many years,” Owens said. “In future, we could ask what we could do to improve their quality of life.” 


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