By Dave Andrusko
For those follow NRL News Today, the name Adrian Owen will probably ring a bell. He has done some of the most spectacular work, demonstrating that some patients supposedly in a “persistent vegetative state’ (PVS) are actually aware.
Scott Routley had been diagnosed to be in a “vegetative state” for more than a decade. But according to Fergus Walsh, Medical correspondent for the BBC, Scott “has been able to tell scientists that he is not in any pain. It’s the first time an uncommunicative, severely brain-injured patient has been able to give answers clinically relevant to their care.”
But the latest is even more incredible. While the study participants watched the film, researchers monitored their brain activity by functional magnetic resonance imaging (fMRI). Under the headline “Hitchcock thriller reveals busy mind in ‘vegetative’ man,” here’s how Nature.com described the experiment, the results of which were published in this week’s “Proceedings of the National Academy of Science.”
“A dozen volunteers watched Alfred Hitchcock for science while lying motionless in a magnetic-resonance scanner. Another participant, a man who has lived in a vegetative state for 16 years, showed brain activity remarkably similar to that of the healthy volunteers — suggesting that plot structure had an impact on him.“
“It was actually indistinguishable from a healthy participant watching the movie,” said Owen, a neuroscientist at the University of Western Ontario in London, Canada. Nature reported that the study “provides the best evidence to date that fMRI [functional magnetic resonance imaging] can be used to identify consciousness in vegetative patients,” says Russell Poldrack, a cognitive neuroscientist at Stanford University in California who was not involved in the research.
As our readers will recall, in 2006 Owen reported conscious brain activity in a 23-year-old woman in a vegetative state [http://nrlc.cc/1sijcUN]. His team eventually would conclude that as many as one in five patients thought to be “vegetative” had detected patterns of conscious brain activity.
“But we suspect that number might be even higher,” says neuroscientist Lorina Naci, a postdoctoral researcher in Owen’s lab who co-led the new study. In previous efforts to detect brain activity in behaviourally nonresponsive persons, participants have received very specific instructions about what to think about, when. But their attention may wander while they’re lying in the scanner. Naci and her colleagues thought that showing them movies would make the test simpler. “It is a stimulus that engages attention naturally, and it’s impossible not to follow — especially when you have an engaging movie from a masterful director like Hitchcock,” she says.
The story ends with an almost Hitchcockian twist:
Owen says that the team has scanned many other people as they watched films, including many in vegetative states, and he hopes that other clinicians can adopt the method. Moreover, he says, his discovery could help to improve the lives of patients who are unable to express their wishes.
Ever since the 34-year-old man lost consciousness at age 18 after being assaulted, his father has taken him to the cinema every Wednesday. “The fact that we can say he is enjoying these movies he can understand these movies says something about his quality of life,” Owen says. “There are a lot of Wednesdays in 16 years.”
Take a few minutes of your time to go to www.nature.com/news/hitchcock-thriller-reveals-busy-mind-in-vegetative-man-1.15918