Major Breakthrough For Brain Injured Patients In Vegetative State

05/02/2010

New research has allowed scientists to communicate with patients in a vegetative state following severe brain injuries.

Patients in a “vegetative state” have usually emerged from a coma, but typically appear to have no awareness and do not have any control over their bodies. Until now, it was not possible to tell whether the patient did in fact have any awareness.

Scientists in the UK and Belgium have now discovered that by using a process known as functional magnetic resonance imaging (fMRI) to scan the patients’ brains in real time, the scientists can then put questions to the patients and read the patients’ answers from the scans.

It works by looking at different parts of the brain – if the patient is asked to imagine playing tennis, the part of the brain used for motor control can be seen on the scan being used by the patient. If the patient is asked to imagine walking from room to room in their house, the navigational part of the brain is used. The scientists then ask the patient a question, and if the answer is “yes”, the patient is asked to imagine playing tennis, and if it is “no”, the patient is asked to imagine walking from room to room. The answers given had 100% success rate.

The ability to communicate with someone in a vegetative state means that clinical issues, such as whether the patient is in pain and requires medication, can be addressed. It is also likely to be a huge comfort to the family, who are often in limbo, not knowing whether their loved one is able to hear and understand them or not. It also raises ethical and legal issues over finding out the patients’ wishes. The ability to communicate may mean the patient can express their wish to die, but the extent of their brain damage may mean that they potentially lack the understanding to make a decision which has irreversible consequences.

It is clear that this research is an important and exciting development in this field. It is also just the start, and further work is now to be carried out in order to potentially use this technology to allow the patient to express their thoughts and wishes, control their environment to some extent and essentially improve their quality of life.

John Davis, partner with Irwin Mitchell Solicitors said:

"We are often asked to advise on the legal issues concerning people in vegetative states. This is an exciting development which is of potentially huge importance. In the future we hope to be able to find out more about the actual wishes of the people that we are acting for rather than having to rely on others to provide this information. We are committed to doing all that we can to protect the interests and  improve the quality of life  of the individuals we act for; this research may well be a significant development which will help us to do this better"

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