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Study reveals 25% of coma patients may actually be aware and conscious
An alarmingly high percentage of people in comas, in a vegetative state or having only minimal consciousness still experience cognitive motor dissociation, aka covert awareness, according to a recent study. One academic has described the findings as incredible& but also kind of scary.
The researchers gave the patients verbal commands, such as telling them to imagine themselves swimming or to open and close their hands. For 60 out of 241 of them, brain scans produced evidence the patients were still performing those tasks in their heads.
Covert awareness is more common than we thought
Until this study, estimates ran at around 10% to 20%. In other words, one or two out of every 10 unresponsive patients were thought to have been able to perform tasks in their heads, when prompted verbally.
This research suggests that number might be as high as 25%, or one in four.�
Researchers identified 241 patients who had been diagnosed as comatose, in a vegetative state, or having minimal consciousness.
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And yet, 60 of them and the studys lead author, Dr Nicholas Schiff, says this is a conservative estimate could evidently hear, in some way, the verbal commands delivered to them. Brain wave tests and functional MRIs showed they were performing the relevant tasks in their heads. The more we know about the brain, the more we realize we don’t know!
When conscious people are told to do something, parts of their brains become more active. Blood flow to these areas increases, and this is detectable evidence that something is going on in response to the command.
We know we missed people, Dr Schiff said, as quoted by NBC News. This means the number could be even higher. The study itself was published by the New England Journal of Medicine, but its only readable for subscribers.
We also know that patients who have severe brain injury have what are called fluctuations in arousal. They have good and bad times of the day.
Its both an incredible finding, but also kind of scary
Caroline Schnakers, assistant director of the Casa Colina Research Institute, as saying: Its both an incredible finding, but also kind of scary.
The notion that so many ostensibly unresponsive patients could be able to at least respond to their environment, but are not given the right tools for doing so& thats very alarming for clinicians, she said.
However, assuming off the back of this research that anyone in a coma, or in a vegetative state, is in there and going to make a full recovery would be the wrong course of action, warns Dr David Greer, chair of Boston University School of Medicines neurology department.
I think that would be very misleading for families to have that kind of false hope because many if not most of these patients will still have a severe disability.
As is often the way, the conclusion drawn by the study authors themselves is specific and austere. Where people’s health is concerned, it’s important not to color outside the lines. One in four participants without an observable response to commands, they write, nevertheless performed a cognitive task.
Make of it what you will.
