Monday, September 9, 2013

‘Vegetative’ patients can hear those bedside discussions about them

A shocking experiment reveals that they not only hear but understand and respond

Sep 6, 2013
The Christians
Functional MRI scans show people in ‘vegetative’ states can answer questions and even play tennis in their mind.
Functional MRI scans show people in ‘vegetative’ states can answer questions and even play tennis in their mind.
There is something disturbing about medical terminology that associates humans with vegetables. Now, according to new research, some patients that doctors have long described as being in a “persistent vegetative state” (PVS) – inert but living victims of major brain injury – may actually be acutely aware of their circumstances. Using imaging technology they can even answer questions about who and where they are.

Researchers at Western University in Ontario, Canada scanned the brains of three brain-injured patients using functional MRI technology, and reported their startling findings in JAMA Nature in August. One has been classified PVS for 12 years, and the other two were classified as in a “minimally conscious state” (MCS).

Yet the MRI scans showed that all three could focus and follow instructions in the same way as healthy controls. Two of the patients could respond accurately to yes/no questions such as “Is your name Steven?” and “Are you in a supermarket?” and “Are you in a hospital?” (One patient was not questioned.)

“The patient’s brain activity in the communication scans not only further corroborated that he was, indeed, consciously aware but also revealed that he had far richer cognitive resources than could be assumed based on his clinical diagnosis,” the study says.

Is that why they scream?

The researchers believe it is the first study of its kind to “communicate” with mentally non-responsive patients. Indeed, the findings horrifyingly suggest that a large number – thousands – of the hundreds of thousands of PVS and MCS patients that hospital staff have treated over time could hear and comprehend discussions it was assumed they could not. It also explains why some of them cry, smile, and scream without apparent reason.

Some have even survived to describe the horror. Kate Adamson’s book recounts the agony of being nearly starved to death, and operated on without adequate anaesthesia, because doctors misdiagnosed her unresponsiveness after a stroke as unawareness and decided to end her life by starvation – a common enough decision in hospitals.

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1 comment:

  1. The last week of my mother's life we cared for her at home. She was unable to speak although when asked a question she could sometimes squeeze my hand. We spoke constantly to her about what was happening all around her and made sure if any of us was upset we dealt with it out of her hearing range. I talked to her as if she was the same as always only I didn't expect a response. That last week was truly a gift to our family as we could and talked to her frequently about our fondest times spent with her and of our love for her.