Lorina Naci, a postdoctoral fellow from Western’s Brain and Mind Institute and her colleague Adrian Owen, the Canada Excellence Research Chair in Cognitive Neuroscience and Imaging, reported their findings today in The Journal of American Medical Association for Neurology in a study titled “Making every word count for non-responsive patients.”
While inside the functional magnetic resonance imaging (fMRI) scanner, the patient answered several questions, such as “Are you in a hospital?,” by concentrating on the specific words, “yes” or “no.” In this way, he reported that he knew what his name was and that he was in the hospital at the time of communication.
“For the first time, we showed that a patient clinically diagnosed as ‘vegetative’ can use his attention to show that he is conscious, and to communicate with the outside world,” says Lorina Naci, lead researcher on the new study. “Frequently, after a severe injury to the brain, patients lose their ability to make any physical responses. When we look at or talk to any such patient, we don’t know whether they are conscious, can understand what is happening around them, or have any thoughts about their condition.”
In two different hospital visits, five months apart, not only were Naci and Owen able to communicate with the patient but found that he was also aware of his environment, meaning he could maintain coherent thoughts and lead a rich mental life.
“This new technique takes communication with some patients who are assumed to be in a vegetative state to the next level,” says Owen. “It will make detecting who is conscious and who is not much faster and more reliable and for those who are conscious, communicating their wishes will be that much easier.”
Naci and Owen continue to utilize this novel method of communicating with behaviorally nonresponsive patients, who, similarly, may have been misdiagnosed as being in a vegetative state.
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