A breakthrough that could lead to improvements in the treatment of brain-damaged patients who cannot move or speak. "A crash victim thought to have been in a vegetative state for more than a decade has used the power of thought to tell scientists he is not in pain."
Canadian Scott Routley, from London, Ontario, communicated with researchers via a brain scan, proving that he is conscious and aware. It is the first time such a severely brain-damaged patient has been able to provide clinically relevant information to doctors.
British neuroscientist Professor Adrian Owen, who leads the research team at the Brain and Mind Institute of Western Ontario, said: "Scott has been able to show he has a conscious, thinking mind. We have scanned him several times and his pattern of brain activity shows he is clearly choosing to answer our questions. We believe he knows who and where he is." By monitoring the activity on an fMRI scanner, the researchers can ask yes or no questions. One type of brain activity is taken as a "yes" and the other as a "no".
Routley suffered traumatic brain injuries when his car was in collision with a police vehicle. Until Prof Owen's intervention, he was assumed to have been in a vegetative state for more than 12 years.
Vegetative state patients are not aware of their surroundings or capable of conscious thought. Neurologist Professor Bryan Young, from University Hospital in London, Ontario, who has cared for Routley for 10 years, said the scan results overturned all previous assessments of the injured man's condition. "He had the clinical picture of a typical vegetative patient – no emotional response, no fixation or following with his eyes," said Prof Young. "He didn't have any spontaneous movements that looked meaningful and I was quite impressed and amazed that he was able to show these cognitive responses with fMRI."
Prof Owen has previously shown that nearly one in five vegetative patients may in fact be conscious.Another of his patients, road accident victim Steven Graham, was able to answer "yes" when asked if he knew about his two-year-old niece, Ceili. Since she was born after his car accident, this demonstrated that he was able to create and store memories. The Panorama team spent more than a year filming several vegetative and minimally conscious patients taking part in pioneering research at the Brain and Mind Institute and Addenbrooke's Hospital in Cambridge.