United States: A new study found that some patients in a coma, which means they are unconscious and not moving, might still be paying attention to what’s happening around them.
Scientists discovered that about 1 in 4 of these patients could respond to instructions using only their brains, even though their bodies didn’t move. For example, when they were asked to imagine opening and closing their hand, their brains showed that they were doing it, according to special scans like MRI and EEG.
Insights from the Research:
This shows that some of the patients who are suffering from the brain injury are paying attention to the things happening around them said the lead researcher Yelena Bodien who is the investigator for Massachusetts General Hospital’s Center for Neurotechnology and Neurorecovery.
Ethical and Clinical Implications:
“These results bring up critical ethical, clinical and scientific questions — such as how can we harness that unseen cognitive capacity to establish a system of communication and promote further recovery?” Bodien said in a hospital news release.
As reported by HealthDay, for the study researchers scanned almost 241 people with brain injury who showed no signs of the consciousness such as being able to respond to the very simple instructions.
The study included the data from participants in six different sites in the United States, and the U.K. and Europe collected over about 15 years.
The patients all had sustained severe brain injuries often form either a stroke and the cardiac arrest or a traumatic event like a car crash.
MRI and EEG brain responses showed that 60 of the people (25%) were indeed trying to respond to these instructions but had no control over their bodies.
This phenomenon is called cognitive motor dissociation, researchers said. Patients understand language, remember instructions and can sustain attention, but the link between their thinking and motor abilities is broken.
Call to Action:
Knowing that the person is already aware about this and even if they can’t show it can also alter the care they’re receiving, Bodien said.
“Families have told us that once a positive test result revealing cognitive motor dissociation is shared with the patients’ clinical team, it can change the way that the team interacts with their loved one,” Bodien said. “Suddenly, the team is paying more attention to subtle behavioural signs that could be under volitional control or speaking to the patient or playing music in the room.”
“On the other hand, failing to detect cognitive motor dissociation can have serious consequences, including premature withdrawal of life support, missed signs of awareness and lack of access to intensive rehabilitation,” Bodien added.
Now the doctors know that some of the patients are aware but can’t respond and I think we now have an ethical and obligation to engage with these patients and try to help them connect with the world said the senior researcher Dr. Nicholas Schiff who is a professor of neurology and the neuroscience in the Feil Family Brain and the Mind Research Institute at Weill Cornell Medicine in the New York City.