In The New Yorker, Jerome Groopman discusses the work of Adrian Owen, a researcher at Cambridge University’s Cognitive and Brain Sciences Unit who has been using functional imaging to assess patients in a vegetative state.
Neurologists face major problems in diagnosing the persistent vegetative state (PVS) and other “disorders of consciousness” such as the minimally conscious state (MCS), not least because there is no reliable means of assessing the level of consciousness in patients.
Large proportions of patients in such conditions are therefore misdiagnosed, and, until recently, most doctors assumed not only that such patients were incapable of higher cognitive functions, but also that there is no possibility of recovery. However, in the past year or so, there have been several cases of vast improvements in the brain function of patients with disorders of consciousness.
Earlier this year, for example, researchers from Weill Cornell Medical College in New York used deep brain stimulation to increase arousal levels and motor control in a patient who had been in a minimally conscious state for more than 6 years.
And one of Owen’s own studies, published in Science about a year ago, showed that a woman in her early 20s who had been in a vegetative state for 5 months after sustaing severe traumatic brain injury in a car accident was able to imagine playing tennis and to comprehend various spoken sentences, leaving no doubt that she was consciouosly aware of herself and of her surroundings.
This latter study, as well as Owen’s earlier work, and that of researchers at the J.F.K. Johnson Rehabilitation Institute in Edison, New Jersey (who were involved in the other study mentioned above) are discussed in detail in the New Yorker article. Groopman also discusses the ethical issues raised by the care of patients with consciousness disorders, and current medical thinking about these disorders.
Owen, A. M. et al. (2006). Detecting awareness in the vegetative state. Science 313: 1402. [PDF]