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    Vegetative Patients Talk With Brain

    A Few Patients in Vegetative State Signal Awareness by Changing Brain Activity at Will

    Talking With the Brain continued...

    Only five of the 54 patients were able to do at least one of these tasks; four were able to do both. Extensive tests showed that three of these five patients were indeed able to make some physical motion when tested at their bedside; two were able to signal researchers only via fMRI.

    Importantly, only patients who suffered physical head injuries responded via MRI. Those whose brains were damaged by lack of oxygen (via stroke or drowning, for example) remained unresponsive.

    One patient, who was tested five years after lapsing into a vegetative state, actually was able to communicate via MRI. He was asked to imagine playing tennis for a "yes" answer, and to imagine navigating to say "no."

    When asked six autobiographical questions (e.g., "Do you have any brothers?" or "Is your father's name Thomas?") he was able to signal the correct answer to all but the final question. He didn't get the final question wrong, he just stopped responding by the time it was asked.

    Vegetative State: Is Anybody in There?

    The question families most want answered by a loved one in a vegetative or minimally responsive state is, "Are you there?"

    The study does not provide an answer, notes an editorial by Allan H. Ropper, MD, executive vice chair of neurology at Brigham and Women's Hospital and professor of neurology at Harvard University.

    "Is there someone in there? There's no way to know," Ropper tells WebMD. "There may have to be a new way of thinking of consciousness. Not whether someone is in or not in, but maybe whether they are in some of the time -- or maybe in there but not able to take their own mental temperature and so not suffering. We just don't know who we are talking to. The current studies do not answer that question."

    The ability to respond to questions via brain activity doesn't necessarily imply that a person is aware, says Mark A. Brooks, PhD, consulting neuropsychologist at Glancy Rehabilitation Center in Duluth, Ga.

    "Awareness is the functional totality of all cognitive skills - the sum of arousal, orientation, attention, perception, memory, and reasoning," Brooks tells WebMD. "The Monti paper leaves me feeling like there are complete, thoughtful people trapped in these bodies, pining for a means of communication. This is clearly not the case."

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