Patients in comas could be conscious, but are left ignored T | TomBen’s Web Excursions

Patients in comas could be conscious, but are left ignored

The vegetative state is often described as ‘wakefulness without awareness’. These patients open their eyes and will often have sleeping and waking cycles, although they remain non-responsive to any form of external prompting or stimulation. They are both ‘there’ and ‘not there’, lingering in the indeterminate space between life and death. For decades, it was assumed that such patients lack any awareness, including who they are, where they are, and the predicament they are in.

Several months after her accident, we put Carol into a fMRI scanner at Addenbrooke’s Hospital, Cambridge, and asked her to imagine waving her arms in the air, as if she was playing a vigorous game of tennis. Amazingly, a part of her brain known as the premotor cortex ‘lit up’ in exactly the same way as it does in healthy people, when asked to imagine the same series of actions in the scanner.

This startling result told us that Carol must have understood the instructions and, furthermore, she had been able to turn them into a response; not a physical response, like squeezing a hand or blinking an eye, but a conscious brain response that confirmed beyond doubt that Carol was not vegetative at all, but conscious and aware, even though she had been physically non-responsive for more than five months.