A Penny for Your Thoughts

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You can’t move. You can’t speak. You can’t eat or drink. But yet you can still think. This may describe some patients in so-called “vegetative states." The New York Times has reported a study in the New England Journal of Medicine that might allow some of these patients a very narrow window to the outside world.

Four years ago, the team of researchers surveyed a number of patients in vegetative states using MRI. They found that the motor areas of one patient's brain lit up when she was asked to think of tennis, and her brain’s spatial processing area fired when asked to think of her house.

The authors of the first study then analyzed a different set of patients and found 3 more that showed response patterns similar to the first patient. They then taught one of the patients to associate tennis with yes and his house with no (or vice versa) and asked him a set of simple yes-no questions as he lay in the MRI. Incredibly, when the researchers matched his brain activity to the proper yes-no responses, they found he was largely correct.

This technology shows conscious thought in some people in vegetative states and provided them with an extremely limited means of communication. While the authors note that their techniques are still in their infancy and that they probably can’t be applied to the majority of patients, it seems to me that this technology opens many serious questions both about our knowledge of human consciousness and our approaches to  treating patients in vegetative states.

While there are serious limitations, both technological and otherwise, to this form of communicating, it seems highly promising. It merits further research to see if the technique can be expanded to more patients and refined to allow them more means of communication. However, as the article discusses, having a window into the minds of patients into vegetative states leads to many difficult questions. What should we ask them? And are we prepared for their answers?

- blog authored by John Froberg

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