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Brain-damaged, comatose—but conscious

Despite appearing completely comatose, some “vegetative” patients remain aware of their surroundings and may even be able to communicate their thoughts, new research shows. An international team of neurologists used a sophisticated brain-scanning tool called a functional MRI to peer inside the minds of 54 brain-damaged patients classified as either in a “persistent vegetative state” or “minimally conscious.” The patients were all asked to imagine that they were playing tennis, and then to imagine that they were exploring their homes, room by room. Most of the patients’ scans showed no activity. But five patients’ brains “lit up” in the right areas, clearly indicating that they were responding to the spoken directions and visualizing the two activities. “It was incredible,” neuroscientist and study leader Adrian Owen tells The Washington Post. “These are patients who are totally unable to perform functions with their bodies—even blink an eye or move an eyebrow—but yet are entirely conscious. It’s quite distressing, really, to realize this.” One of the patients, a 29-year-old Belgian man, was even able to respond to questions about his personal life—“Is your father’s name Alexander?” —by visualizing playing tennis for “yes” and walking through his home for “no.” Scientists and doctors must now consider the possibility that some “vegetative” patients could be asked to make decisions about their treatment—and even whether they want to go on living. “They can now have some involvement in their own destiny,” says Owen.

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