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Dr.s communicate with coma patient thru MRI

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Vegetative patient Scott Routley says 'I'm not in pain'

By Fergus Walsh Medical correspondent

http://www.bbc.co.uk/news/health-20268044

A Canadian man who was believed to have been in a vegetative state for more than a decade, has been able to tell scientists that he is not in any pain.

It's the first time an uncommunicative, severely brain-injured patient has been able to give answers clinically relevant to their care.

Scott Routley, 39, was asked questions while having his brain activity scanned in an fMRI machine.

His doctor says the discovery means medical textbooks will need rewriting.

Vegetative patients emerge from a coma into a condition where they have periods awake, with their eyes open, but have no perception of themselves or the outside world.

Mr Routley suffered a severe brain injury in a car accident 12 years ago.

None of his physical assessments since then have shown any sign of awareness, or ability to communicate.

But the British neuroscientist Prof Adrian Owen - who led the team at the Brain and Mind Institute, University of Western Ontario - said Mr Routley was clearly not vegetative.

"Scott has been able to show he has a conscious, thinking mind. We have scanned him several times and his pattern of brain activity shows he is clearly choosing to answer our questions. We believe he knows who and where he is."

Prof Owen said it was a groundbreaking moment.

http://www.bbc.co.uk/news/health-20268044

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I can not imagine how horrible it would be, to be completely unable to react or respond to anyone or anything, and yet still be 'awake', aware and mentally active...

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fMRI uses a form of "contrast" in the images that shows where the brain is being activated based on oxygen levels. A typical early demonstration that was done was having a patient tap one of their fingers for a period of time, rest and then repeat. The pictures of the brain would "light up" in that part of the brain that controlled those movements. I'm sure that modern protocols have been designed to gain much more info from a scan but the process is essentially the same. I have to wonder just how effective these protocols would be and how much is subjective for the physician doing the evaluation. Very interesting story.

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Utterly fascinating! The human brain is such an amazing organ.

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