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February 2010
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Making the ‘unconscious’ speak

A person in a vegetative state can breathe without help, have intact reflexes but lack awareness. In the vegetative state patients can open their eyelids occasionally and demonstrate sleep-wake cycles, but completely lack cognitive function. Researches have now demonstrated that some people who appear to be vegetative are in fact minimally conscious and they may feel some pain, experience emotion and communicate to a limited extent. Earlier tests were not perfect and it could not be established whether a person in a vegetative state is aware or not. That’s why scientists turned to brain imaging. They are not only able to establish that some people in vegetative state are conscious but they are able to make them communicate with outside world.

In 2006, Adrian Owen of the University of Cambridge led a team of researches to conduct an experiment on a woman who was in a vegetative state. They asked her to imagine herself in a given situation and proved that she understood the commands by measuring her brain activity.

Later Owen’s team repeated the experiments on many patients and now they have been able to make a man who was diagnosed with VS to answer yes and no to specific questions by imagining himself in some activities. They used functional MRI to measure the person’s brain activity. This 29 year old man had been in a car accident and had suffered brain injury. The scientists asked him several questions and he was able himself in that activity. His brain scan was later analysed by the scientists who concluded that his SMA or the parahippocampal gyrus lit up in response to five of the six questions. A healthy person’s mind behaves in the similar way.

Scientists are now very optimistic that in this way they will be able to make a person in a vegetative state communicate with the outside world.

There are many challenges. For example, though a person in a vegetative state respond to specific questions, they can’t yet start a conversation of their own. Also MRI scans are expensive and take many hours to analyse.

In the meantime, a person in a vegetative can now communicate whether they are in pain or would like to try new drugs that are being tested for their ability to bring patients out of a vegetative state.

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