"A man who was presumed to be in a vegetative state for five years has answered questions using his thoughts alone", reported The Times. It said the research could allow some patients who are 'locked in' by brain injuries to communicate.
The news is based on a three-year study in 54 patients in a vegetative or minimally conscious state. The patients brains were scanned with a technique called functional magnetic resonance imaging (fMRI) to detect signs of awareness. In one man, previously thought to be in a persistent vegetative state, the researchers were able to elicit the correct responses to five out of six questions.
These results confirm that some patients who meet the current criteria for being in a vegetative state are diagnosed incorrectly and retain thinking and awareness. It should be highlighted that this occurred in only one of the patients tested, and it is unknown how many people are likely to be in the same state.
The researchers say there is a high rate of error (approximately 40%) in diagnosing this group of patients. It appears the use of fMRI scanning may add another layer of safety in the diagnosis of consciousness following brain injury. However, the potential that the technique will lead to better care for patients in vegetative states, for example by allowing them to communicate their wishes, will need further research.
Where did the story come from?
This study was carried out by Dr Martin Monti and colleagues from the Medical Research Council Cognition and Brain Sciences Unit, the Impaired Consciousness Study Group and the Division of Academic Neurosurgery, all in Cambridge, along with international colleagues from the University of Liege and University Hospital of Liege in Belgium. The study was supported by several organisations and received grants from the Medical Research Council and the European Commission. The study was published in the peer-reviewed New England Journal of Medicine.
Some newspapers have incorrectly used the terms coma , vegetative state and locked in outside their technical definitions. For example, it is wrong to say that the study shows that 'patients in 'vegetative' state can think and communicate' or 'that one-in-five patients in a persistent vegetative state may be able to communicate,' as The Daily Telegraph does. The number of people who may be able to communicate usefully may be quite small. The newspapers reported that there are normally fewer than 100 patients in the UK in a permanent vegetative state (PVS) at any time.
