- The Washington Times - Friday, September 8, 2006

A car crash severely injured a woman’s brain last year, leaving her in a vegetative state. But when British scientists peered deeper into her brain, they found startling signs of awareness: She seemed to hear and follow — mentally — certain commands.

This novel brain-scanning experiment, reported yesterday in the journal Science, is sure to elicit pleas from families desperate to know whether loved ones deemed beyond medical help have brain activity that doctors didn’t suspect.

It’s far too soon to raise those hopes, the British researchers and U.S. doctors say. There is no way to know whether this 23-year-old woman will ever recover and whether her brain activity means anything medically. Many hospitals cannot perform this type of brain imaging.

The study has raised calls for more research, because someday the technology could predict a patient’s ability to recover or help tailor rehabilitation.

Neuroscientist Joy Hirsch of New York’s Columbia University Medical Center, who is conducting similar research, said she receives “heart-wrenching” requests to scan patients, but warned, “Making medical decisions based on this information at this point in time we say is not appropriate.”

Lead researcher Adrian Owen of Britain’s Medical Research Council added, “I want to be extremely cautious about this. This is just one patient. The result in one patient does not tell us whether any other patient will show similar results.”

When Dr. Owen scanned the patient’s brain five months after the injury, she was pronounced in a vegetative state, or physically unresponsive to a battery of tests. Some people make at least some recovery after being in a vegetative state for a short period.

Those who don’t improve eventually are diagnosed as being in a “persistent vegetative state,” which was the case of Terry Schiavo. Mrs. Schiavo became a lightning rod for political debate over the question of taking such patients off life support.

To see what areas of the brain are activated during different physical or mental processes, doctors use a functional MRI, or fMRI.

In the journal Science, Dr. Owen and his colleagues wrote that fMRI testing showed the woman had preserved conscious awareness despite her vegetative state.

How could they tell? First, they checked that she could process speech. When told “there was milk and sugar in the coffee,” the woman’s brain regions that recognize speech reacted just the way healthy volunteers’ brains reacted.

Then they told the woman to perform a mental task: to imagine herself playing tennis.

The motor-control regions of her brain lighted up, again just like they did in the healthy people Dr. Owen used for comparison.

“There is no other explanation for this than that she has intentionally decided to involve herself in the study and do what we asked when we asked,” he said.

Other scientists say the result isn’t that clear-cut.

The results are “not totally convincing of consciousness,” neuroscientist Lionel Naccache of INSERM, France’s national science institute, wrote in a review in Science.



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