How Scientists Communicate With Coma Victims

For decades people have spoken to people in vegetative states, hoping their voices will be heard. But these days researchers are going much further than that: in controversial experiments, a group of scientists are working out how to communicate with people in comas.

Nature has a wonderful feature piece which centers around Adrian Owen, a maverick in the field of neuroscience. The article describes one of Owen's early successful experiments:

"The patient was only 24 years old when his life was devastated by a car accident. Alive but unresponsive, he had been languishing in what neurologists refer to as a vegetative state for five years, when Owen, a neuro-scientist then at the University of Cambridge, UK, and his colleagues at the University of Liège in Belgium, put him into a functional magnetic resonance imaging (fMRI) machine and started asking him questions.

"Incredibly, he provided answers. A change in blood flow to certain parts of the man's injured brain convinced Owen that patient 23 was conscious and able to communicate. It was the first time that anyone had exchanged information with someone in a vegetative state."

That was less than two years ago. Now, having been poached from Cambridge, UK, by the University of Western Ontario in London, Canada, his team of scientists are making rapid advances. The feature sheds some light on the current work:

"One goal is to identify other brain systems, such as smell or taste, that might be intact and usable for communication. Imagining sucking a lemon, for example, can produce a pH-level change in the mouth and a recognizable brain signal. Owen has shown that registering jokes provokes a characteristic response in healthy people and plans to try it on patients in a vegetative state. He hopes that he can use these tests to find some level of responsiveness in patients who cannot produce the tennis and navigation patterns of activity because of their level of brain damage.

"The studies will also explore whether these patients have the capacity for greater intellectual depth. Owen thinks that some people in a vegetative state will eventually be able to express hopes and desires, perhaps like French magazine editor Jean-Dominique Bauby, who dictated his memoirs by repeatedly winking one eye. "I don't see a reason why they could not have a similar richness of thought, although undoubtedly some will not," Owen says."

Perhaps unsurprisingly, many scientists are skeptical of Owen's work. Were his early successes just fluke? Are his hopes for the future wildly optimistic? Maybe. But while his experiments continue to point in the right direction, we'd be fools not embrace his work. You can, and should, read the feature in full here. [Nature]

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