Slashdot Mirror
"Vegetative State" Patients Can Communicate
Kittenman writes "The BBC is carrying a story about researchers in the UK and Belgium who can detect the thinking processes within a patient previously thought to be in a vegetative state. The researchers ask the patient verbally to think in certain ways to indicate a 'yes', in other ways to indicate a 'no' — and have successfully communicated with 4 out of 23 patients previously thought to be in a coma."
As a life-long vegetarian, I'm horrified with the idea of being able to communicate with my... oh wait.
From TFA:
"Patients in a vegetative state are awake, not in a coma, but have no awareness because of severe brain damage. "
It's official. Most of you are morons.
A vegetative state is by definition where there is no detectable awareness. You could legitimately say that they were "previously thought to be in a vegetative state," but if you detect awareness then they are in a coma.
This is not really surprising if you are aware what a real coma is. There is a lot of states between fully consciousness and complete unconsciousness. In movies, and in soaps you switch between those states in a surprise wake-up. In reality this is much more complex.
Anyway, better diagnosis is needed to prevent accidents like Brain scan finds man was not in a coma--23 years later and other possible improvements in brain damage treatment.
"Eat me, I'm nutritious."
5 of 54 patients who underwent this procedure. Showed a possible response.
3 of those 5 it turned out showed awareness to normal stimuli and were either mislabeled by doctors, or their condition changed.
So basically that leaves 2 patients out of 51 seeming to "be able to modulate their brain activity". And only ONE of those was able to "correctly answer 5 of 6 yes/no questions"
This could be legit, but there is also PLENTY of room for statistical chance to have created this "result".
The bottom line is that too much of a big deal is being made out of a tiny kernel of good data in a mountain of null results.
Relative: "Oh, I just don't know what he would want! I can't make this decision for him..."
Doctor: "Well, thanks to recent breakthroughs we may be able to ask him directly. Lets just get him into this MRI..."
Doctor: "The results are clear, we were able to communicate with him and he was very adamant about stopping all treatment. He clearly does not want to live out his remaining days in this state, and I don't think anyone could blame him for that."
Relative: "If that's his wish then yes, lets stop all treatment."
Doctor: "I'm sorry m'aam, but that's no longer an option..."
It may have been funny if it weren't so sad...
Murphey's fighting Occam, and we're in the stands.
I don't think they addressed the "no answer" vs. "B", however, they did assess the patients' ability to answer a series of factual questions about the patient's life prior to whatever put them where they were - I think that pretty much shows that there is something non-spurious being measured here and it's not just the dead salmon fMRI effect as another reply suggested - the probability of random readings matching up with the correct answers to a series of such questions seems very minute.
And 4 out of 23 is not a success rate - it's a misdiagnosis rate! Nobody in their right mind is claiming that *all* patients in persistent vegetative states have meaningful cognition occurring (except the EXTREMELY inaccurate and misleading Slashdot article title). Rather, some patients who failed the standard tests to assess consciousness levels are perhaps more conscious than was previously detectable.
Fry: "BEEP!"
Zap: "'Yes.' Ok. And, are you guilty!?"
Fry: "BEEP! BEEP!"
Zap: "Double 'Yes'!"
Sorry -- too lazy to dig for the exact quote.
If you haven't check out this study publicized in Wired, where they detected human emotion activity in the brain of a salmon. A dead salmon.
Just because the fMRI shows some colors, that doesn't necessarily mean that there's really cognition going on. It could just be false detections from imperfect scanning, or it could be scientists seeing patterns in data that don't really exist, or it could be the result of our imperfect understanding of how the brain works, or a whole slew of other things.
This is made worse by things like the Houben case, which used Facilitated Communication to "prove" that Houben had an intact consciousness. FC hasn't passed any rigorous scientific study (i.e. blind tests to prevent the facilitator's motivations/desires from modifying the results), but stories like Houben cause those with loved ones with sever brain damage in PVS to start clamoring that there may still be hope. James Randi has written about FC, and the Houben case in particular.
Especially if a land mine has taken your sight, taken your speech, taken your hearing, taken your arms, taken your legs, taken your soul, and left you with life in hell.
Of the 54 patients examined in the study most had suffered either from traumatic brain injury or anoxic brain injury. Anoxic brain injury for the most part means your heart had stopped for a prolonged period of time (although other things such as severe prolonged hypoglycemia or carbon monoxide can do the same thing). Anoxic brain injury is a diffuse process and its course is highly predictable. Depending on the severity of the initial event with anoxia patients will either improve after a relatively short period of time or they never will. Of all of the 'miracle' re-awaking cases that have occurred (extremely rare cases of people waking up to a severely disabled state) none of them have been by someone who has suffered anoxia.
Traumatic brain injury has a less predictable course as some of the parts of the brain are destroyed while other parts can be relatively undamaged. Of the five patients in the study who were found with some brain activity all of them were traumatic brain injury cases.
Schiavo suffered anoxic brain injury due to cardiac arrest. These patients never need fancy brains scan as their external findings accurately reflect what has happened to their entire brain. The current New England Journal of Medicine article actually serves to support that anoxia patients have no cognition.