Researchers of BBC’s Panorama program have followed several vegetative and minimally conscious patients in Britain and Canada for more than a year, searching for hidden awareness in otherwise unresponsive patients. By scanning brain activity with an fMRI machine, a Canadian man who was believed to be in a vegetative state for more than a decade communicated that he was not in any pain.
British neuroscience professor Adrian Owen conducted brain scans of Scott Routley, who suffered a severe brain injury 12 years ago. Routley was classified to be in a vegetative state where he has periods of being awake but has no perception of himself or the outside world. Previous physical assessments showed that Routley didn’t have the ability to communicate, but the brain scans overturned these assessments, according to Routley’s neurologist.
In 2010, Professor Owen published research showing that nearly one in five of vegetative patients were able to communicate using brain activity. Following several patients with severe brain injuries, Owen continues a study that he’s been conducting for almost a year. Patients like Routley were asked to imagine playing tennis or walking around their house. Healthy patients could produce two distinct patterns of brain activity. When someone is thinking, blood flow increases to certain parts of the brain, which can be measured by the fMRI.
Another patient that the study is following, Alex Seaman, is showing signs of response. When he was shown photographs of his family and his girlfriend, the scan results suggest he may be able to recognize them, and he successfully performed the tennis and house imagining tasks.
Routley’s ability to communicate that he is not in any pain marks a place in medical history; it’s the first time any brain–injured patient has been asked to answer something clinically relevant to their care. This breakthrough raises questions about whether the technology could help patients decide their fate. In Britain, over the past two decades, more than 40 vegetative patients have died after the removal of their feeding tubes. Regardless, Owen doesn’t believe that his study is the pathway to allow patients to decide their fate.
Over the years, Routley’s parents have thought he was communicating by lifting a thumb or moving his eyes, although medical staff didn’t accept that he was conscious. But the research is creating groundbreaking moments that are challenging current medical textbooks. Routley’s neurologist, Professor Bryan Young, explains how he was impressed and amazed with his patient’s cognitive responses: “He had the clinical picture of a typical vegetative patient and showed no spontaneous movements that looked meaningful.”