Detecting Awareness in the Vegetative State

[DrGachet]

There was a short article in Science back in 2006, entitled "Detecting Awareness in the Vegetative State" which interested me very much.

Here's the abstract:

"We used functional magnetic resonance imaging to demonstrate preserved conscious awareness in a patient fulfilling the criteria for a diagnosis of vegetative state. When asked to imagine playing tennis or moving around her home, the patient activated predicted cortical areas in a manner indistinguishable from that of healthy volunteers."

In 2007, Nachev commented, in response: "Owen et al. correctly state that the absence of brain activation in functional imaging is not proof that the associated behavior is not taking place. However, it is also the case that the presence of brain activation is not sufficient evidence for the associated behavior—here, supposedly consciously mediated behavior— unless one has also shown that the same activation cannot occur without it."

Any thoughts?

---

Members don't see this ad.

 

[myPsychAlt]

well, there's always "facilitated communication"

http://www.freep.com/apps/pbcs.dll/...&Lopenr=101120405&Ref=AR&template=fullarticle

 

[nitemagi]

There was a short article in Science back in 2006, entitled "Detecting Awareness in the Vegetative State" which interested me very much.

Here's the abstract:

"We used functional magnetic resonance imaging to demonstrate preserved conscious awareness in a patient fulfilling the criteria for a diagnosis of vegetative state. When asked to imagine playing tennis or moving around her home, the patient activated predicted cortical areas in a manner indistinguishable from that of healthy volunteers."

In 2007, Nachev commented, in response: "Owen et al. correctly state that the absence of brain activation in functional imaging is not proof that the associated behavior is not taking place. However, it is also the case that the presence of brain activation is not sufficient evidence for the associated behavior—here, supposedly consciously mediated behavior— unless one has also shown that the same activation cannot occur without it."

Any thoughts?

I remember this article. Very interesting. Makes you question many things, including our baseline presumptions about what the vegetative state really is. Controversial. More of a philosophical/ethical debate for psychiatrists than something we encounter in direct clinical practice. Unless you're on the ethics committee for your hospital.

 

[Ibid]

Our scanner, which art from Siemens,
Hallowed be thy coils.
Thy data come;
Thy scans be done;
In grey matter as it is in white matter.
Give us this day our daily blobs.
And forgive us our trespasses,
As we forgive them that trespass onto our scan slots.
And lead us not into the magnet room carrying a pair of scissors,
But deliver us from volunteers who can’t keep their heads still.
For thine is the magnet,
The gradients,
And the headcoil,
For ever and ever (at least until we can afford a 7T).
Amen.

 

[peppy]

Makes you question many things, including our baseline presumptions about what the vegetative state really is. Controversial.

All the unanswered questions about the human brain are what make our work so interesting.

 

[tortuga87]

There's been a follow-up paper from the same authors in 2010 in NEJM

http://www.nejm.org/doi/full/10.1056/NEJMoa0905370

It's a scary state to be in...

 

[DrGachet]

Thanks for the NEJM reference.

Yes, this indeed is a horrific situation to be in, paragon of helplessness, consciousness and sense of self entombed in a malfunctioning physical body that can not communicate our state to the outside world. What terror!

I wonder how much of this is "affective" consciousness as opposed to "cognitive" consciousness. And if I can divide this up further, how much of this is a general perception, let's say, of fear. In this situation, there is nothing, but fear. In another case, there is embodied fear, the sense that "I am afraid." Or more cognitively, there could be anxiety, existential anxiety, like, could somebody help me, and what is happening to me?