Brain scans of 17
vegetative patients have turned up only one other non-responsive patient with such a voluntary brain signal.
Vegetative patients probably do not feel pain, but imaging experiments indicate that minimally conscious patients do, even if they can not always react to it.
Neurologist Steven Laureys of the University of Liège in Belgium, who would later collaborate with Schiff and Giacino, showed that same year, 2002, that in
vegetative patients, mild electric shocks activated basic sense - perception regions but not the higher - level information processing networks (pdf) that the minimally conscious patients could access.
HIDDEN CONSCIOUSNESS Adrian M. Owen's article on imaging techniques developed to determine when seemingly
vegetative patients are actually conscious [«Is Anybody in There?»]
Consciousness can exist, but it can evade detection in
vegetative patients.
New research suggests that
some vegetative patients are capable of simple learning — a sign of consciousness in many who had failed other traditional cognitive tests.
Whyte's recent work has shown pharmaceuticals such as Ambien (zolpidem) help
vegetative patients regain consciousness, but it hasn't proved to be a silver bullet.
Brain Signal For Awareness: Minimally conscious and
vegetative patients show different patterns of neural activity.
Bug Lovers, Earth's Many Apocalypses, the Surprising Minds of
Vegetative Patients and Other New Science Books
Not exact matches
Childs, et al, «Accuracy of Diagnosis of Persistent
Vegetative State,» Neurology, 43 (August 1993): 1465 - 67, report that «of the 49
patients referred in coma or PVS, 18 (37 \ %) received a change in diagnosis at or shortly after admission» (1466).
[16] Andrews et al., «Misdiagnosis of the
Vegetative State: Retrospective Study in a Rehabilitation Unit,» British Medical Journal, 313 (6 July 1996): 13 - 16, report on a study of forty PVS
patients at Britain's Royal Hospital for Neurodisability.
It is not only medicine that urges the continued treatment of
patients like Jones or those in a persistent
vegetative state.
At the beginning of the video we saw a mute, almost
vegetative - state female
patient being spoon - fed her meals.
It also suggests that some
patients diagnosed as being in a
vegetative state (VS) are in fact minimally conscious (MCS).
Although severely disabled she has become an advocate for improved efforts to detect consciousness in
patients who have been labeled «
vegetative.»
neuroscientist Adrian Owen of Western University in Ontario describes how his 1997 encounter with a
patient named Kate led him to explore new ways to detect consciousness in
patients who appear to be in a
vegetative state.
In one 1996 study published in the British Medical Journal, 17 of 40
patients originally diagnosed as
vegetative turned out to be locked - in instead.
In another study, the brain of a
patient who appeared to be in a
vegetative state responded just like a healthy person's when asked to imagine playing a game of tennis.
If the thalamus really is the door to consciousness, why don't physicians try stimulating it to bring back thousands of
vegetative and minimally conscious
patients?
Patients who lose consciousness for more than a year are considered extremely unlikely to regain it, but a 35 - year - old Frenchman who had been in a
vegetative state for 15 years has shown hints of awareness after having key brain regions electrically stimulated, scientists reported on Monday.
The
patient was able to follow an object with his eyes, turn his head when asked to, and widened his eyes in surprise when a researcher's head came close to his face — none of which he did in a
vegetative state.
Patients in a permanent
vegetative state (like Terri Schiavo) can never be involved.
The randomized, placebo - controlled study, Familiar Auditory Sensory Training (FAST), enrolled 15
patients with traumatic closed head injuries who were in a
vegetative or minimally conscious state.
Between these two extremes,
patients may be said to be in a
vegetative state or exhibit unresponsive wakefulness, characterized by open eyes and basic reflexes, but no signs of awareness.
Patients usually progress from a coma to either a minimally conscious or
vegetative state, and these states can last a few weeks, months or years.
If the technology helps other people recovering from coma, Monti said, it could eventually be used to build a portable device — perhaps incorporated into a helmet — as a low - cost way to help «wake up»
patients, perhaps even those who are in a
vegetative or minimally conscious state.
Brain scans of a 23 - year - old woman who, in a traffic accident, sustained head injuries so severe she met the clinical criteria for a
vegetative state are forcing many doctors to reconsider what they know about such
patients» awareness.
Patient N, who had been in a
vegetative state for three years following a motor vehicle accident, showed no signs of language comprehension and was constantly screaming.
The effects of the drug seemed to last for approximately 4 hours, after which
Patient L would relapse into the
vegetative state.
Only 13 % of the
patients remained
vegetative, the study reported.
We used functional magnetic resonance imaging to demonstrate preserved conscious awareness in a
patient fulfilling the criteria for a diagnosis of
vegetative state.
But experts caution that the
patients may not have been in a permanent
vegetative state (PVS), and that the men may simply have shown signs of natural recovery.
It may be that «there is a firm line» between
vegetative and minimally conscious
patients, «but our tools are too crude to tell us who is on which side of the line,» he says.
The new detection of learning also opens up questions about when
patients should be classified as being in a persistent
vegetative state — in which emergence isn't predicted to be likely — as Terri Schiavo was determined to be at the time.
Testing treatments The revelation that some
vegetative or minimally conscious
patients can learn does not come as a surprise to all.
Around the same time, Schiff heard about a female
patient who had been in a
vegetative state for nearly 20 years but sometimes blurted out a word, usually obscene.
In 2005, just as the deep brain stimulation
patient was making his first forays into awareness, the fate of Terri Schiavo, a Florida woman who had been in a
vegetative state since 1990, sparked an ideological war.
(In the United States, these are estimated at 280,000 cases versus 35,000
patients in the
vegetative state.)
«We're asked early on, when the
patient is still in the intensive care unit, what the prognosis is for meaningful recovery for a
patient who seems
vegetative,» he said.
For their next act, the two researchers turned to another mystery, the much larger number of semiconscious brain - injured
patients who are severely disabled but not truly
vegetative.
Owen predicts that within five years at least one
patient who appears fully
vegetative will, with the aid of some kind of brain — computer interface, be able to communicate routinely with the world.
With the support of Joseph Fins, chief of the department of medical ethics at Weill Cornell, who articulated the ethical arguments for why these
patients must be studied and treated, they used PET to look at four more people in
vegetative states.
At the time of admission for functional MRI scanning (5 years after the ictus), the
patient was assumed to remain in a
vegetative state, although extensive behavioral testing after the functional MRI revealed reproducible, but inconsistent, responses indicative of a minimally conscious state.
Thus, in a minority of cases,
patients who meet the behavioral criteria for a
vegetative state have residual cognitive function and even conscious awareness.14, 15
These results show that a small proportion of
patients in a
vegetative or minimally conscious state have brain activation reflecting some awareness and cognition.
Once validated, the tasks were given to one
patient (Patient 23 in Table 1 and Figure 1), who had received a diagnosis of being in a permanent vegetative state 17 months after a traffic accident; this diagnosis was confirmed by a month - long specialized assessment 3.5 years after the
patient (
Patient 23 in Table 1 and Figure 1), who had received a diagnosis of being in a permanent vegetative state 17 months after a traffic accident; this diagnosis was confirmed by a month - long specialized assessment 3.5 years after the
Patient 23 in Table 1 and Figure 1), who had received a diagnosis of being in a permanent
vegetative state 17 months after a traffic accident; this diagnosis was confirmed by a month - long specialized assessment 3.5 years after the injury.
Four of the five
patients who were able to generate these responses were admitted to the hospital with a diagnosis of being in a
vegetative state.
There are two main goals in the clinical assessment of
patients in a
vegetative or minimally conscious state.
If repeated examinations yield no evidence of a sustained, reproducible, purposeful, or voluntary behavioral response to visual, auditory, tactile, or noxious stimuli, a diagnosis of a
vegetative state — or «wakefulness without awareness» — is made.1 - 5 Some
patients remain in a
vegetative state permanently.
Before the scanning was performed, the
patient had undergone repeated evaluations indicating that he was in a
vegetative state, including a month - long specialized assessment by a highly trained clinical team.