'Vegetative' patient speaks to scientists using his brainwaves

http://news.scotsman.com/science/I39m-alive-39Vegetative39-patient-speaks.6041415.jp

by prat • 16 years ago

49 33 16 years ago

news.scotsman.com

Reported earlier: http://news.ycombinator.com/item?id=1099274

That sank without a trace - no comments, no upvotes - perhaps this report will get a better response. I think it's interesting, so I hope it does.

It's a fascinating idea, getting yes/no answers from brain scans. The potential is there for using text output devices similar to those that Hawking uses, except driven by the patient imagining playing tennis.

jacquesm• 16 years ago

> That sank without a trace - no comments, no upvotes -

That's because it didn't mention the Ipad.

RiderOfGiraffes2• 16 years ago

Now it's appeared via a New Scientist link as well:

http://news.ycombinator.com/item?id=1100899

pwhelan• 16 years ago

Well, I would hope the first application is to determine if the patient is in physical pain and where that pain is. Reducing suffering should be priority one. The next part I would hope would be to see if the patients can recognize voices of loved ones. I would imagine these two milestones could help patients learn to "write" to such a device, which could be automated to flag down a nurse or turn on a radio for a while or something.

The real question from this though is about the patient's rights to choose. IANAL but if I understand it correctly this could cause difficult questions in consent, especially where minors are concerned.

aarongough3• 16 years ago

If that patient is actually aware of his surroundings, then he has been trapped in a body with almost no sensory input for almost 6 years. Personally, that sounds like the worst hell imaginable.

I've told everyone close to me that if I am injured badly they are to ask for 'no extreme measures' for this exact reason...

aaronblohowiak• 16 years ago

The "trapped in a body" thing has a name and is well-researched: http://en.wikipedia.org/wiki/Locked-in_syndrome

You should consider a living will if you are serious about avoiding this.

aarongough3• 16 years ago

Good point on the living will... Up until now I have just made every person close to me promise to pull the plug if it ever came to a situation like this. I'll look into that some more...

tel• 16 years ago

It's just the opposite actually, and worse. If he's aware of his surroundings, he's been trapped for 6 years without any output instead. Able to observe and think, but unable to move, unable to speak, unable to interact with or affect his environment except as a comatose patient.

Being Locked-in is one of the worst things I can imagine and yet is very real.

aarongough3• 16 years ago

Yes, you are absolutely correct. I was kind of thinking in terms of interaction but got it backward.

What I was trying to convey was that no matter how dedicated your loved ones are they're not going to be with you every minute of every day if you're apparently comatose. That means this poor guy has probably spent most of the last six years lying in a bed by himself with nothing going on around him...

rms2• 16 years ago

I think within a few months you would descend into a self-hallucinatory dreamworld -- you'd be insane, but I don't think it would be the worst hell imaginable. Not even close.

metamemetics• 16 years ago

Hallucinations are caused by sensory-deprivation rather than motor parylization. For example, float tanks, also there are specially designed rooms that have as close to no background noise as possible, and people report hearing all kind of audio hallucinations such as bees, etc.

This test demonstrates he can at least hear sound. I'd imagine the effects would resemble senility from lack of engagement more.

Also, interesting side note, sleeping drugs such as Ambien in some cases allowed patients in coma to regain awareness and even hold CONVERSATION: http://www.guardian.co.uk/science/2006/sep/12/health.healtha...

Over stimulation by excitatory neurotransmitters is the primary cause of neuron death during stroke, the idea is that many neurons thought to be dead might have just shutdown to prevent from being overstimulated. And if baseline stimulation is reduced enough through what is normally sleeping medication, they might actually start to activate again.

yread• 16 years ago

Check out 'Johny got his gun' (the movie or novel) for such an experience

llimllib• 16 years ago

This is a much more informative link, with actual science! http://www.theness.com/neurologicablog/?p=1550

ajuc2• 16 years ago

Great news, comminucation is the most important thing.

Here is the story boy that was unable to speak or contact with world and was considered "vegetable" by doctors, till he picked up a language BLISS from a teacher that was teaching some other child in his hospital room.

http://www.youtube.com/watch?v=cvpGLxU6fVY

He is a poet now.

DanielBMarkham• 16 years ago

I can't even to begin to imagine the loneliness you have to feel trapped inside your own mind like that.

pmichaud• 16 years ago

This story gave me goosebumps--imagine the depth of joy he felt when he was finally able to get through to someone. Blows my mind.

mckilljoy4• 16 years ago

This whole story is really very fascinating, although a few details seem a bit odd.

For example, the patient didn't answer the last question because.. he fell asleep? I would imagine if I was trapped inside my body and suddenly given a mechanism to communicate, I would be too excited to fall asleep.

Did they observe any signs of excitement that I would expect a person to feel in this situation? Increased heart rate or other brain activity? Did the man try to convey his own message using the new-found communication mechanism?

It almost sounds like they are communicating with some small ghost of the man's subconscious, something that can respond to basic queries and recall memories, but lacks what we would really consider a consciousness.

pohl• 16 years ago

Did the man try to convey his own message using the new-found communication mechanism?

If I understand correctly, he was given the means to convey "yes" by imagining himself playing tennis. The concept of "no" was encoded by the absence of "yes".

If he had wanted to send some message, like "tell my children I love them", or "I feel pain in my abdomen", how would he encode it?

mckilljoy4• 16 years ago

He certainly can't send messages as complicated as that, but if I only had one bit to flip, I would be flipping it as much as possible to get someone's attention.

That said, he probably did the correct thing by simply answering their questions. That shows that "someone is home" better than flipping his bit randomly.

bitwize• 16 years ago

"No" was encoded by imagining himself walking from room to room.

The absence of anything was recorded as "no answer".

RK• 16 years ago

They probably made that assumption because people fall asleep inside MRI's all of the time, especially during extremely long fMRI tests, when they try to isolate the senses (i.e. it's very dark, you wear earplugs and ear phones). Also, the brain damage might predispose someone to have a short attention span/wakeful periods.

Sforlips• 16 years ago

Actually, detecting brain activity in an MRI requires long aquisition times. Around 30 seconds per answer at least (which is the duration used in this study AFAIK). That means that a single "yes" (imagining you're playing tennis) or "no" (imagining you're walking in your house) requires 30 seconds of sustained attention.

This patient is obviously severely brain damaged.

If you've ever seen a person recovering from brain trauma, you'll know that their ability to focus is usually minimal. Answering questions for this patient may very well have been exhausting. This means that out of the other 22 patients in the study, some may be conscious but unable to cooperate long enough for the mnesic trace to be recorded.

Regarding other signs of activity, you can't detect random activity using fMRI. I haven't read this paper so I don't know the details (I'm only familiar with previous studies done by this team), but regarding heart rate, blod presure, etc, the brain damage may prevent it from occurring too.

Since he was only able to produce yes and no ansers using a contrieved process, he was of course unable to produce any other message.

He's definitely conscious.

kentosi• 16 years ago

The idea that the patient was exhausted came to my mind as well.

Imagine being locked-in for so many years, and then suddenly being asked to imagine things. It's not as easy as it sounds: Imagining something in such a strict order over such a long period of time is actually quite exhausting.

S_A_P• 16 years ago

I could imagine this becoming part of a regimen for "physical" therapy. Also makes me wonder about others who have had the plug pulled...

ghotli• 16 years ago

There was a book written by a man with locked-in syndrome after a stroke. It made me want to write a living will.

"The entire book was written by Bauby blinking his left eyelid, which took ten months (four hours a day). A transcriber repeatedly recited a French language frequency-ordered alphabet (E, S, A, R, I, N, T, U, L, etc.), until Bauby blinked to choose the next letter. The book took about 200,000 blinks to write and an average word took approximately two minutes. The book also chronicles everyday events for a person with locked-in syndrome."

http://en.wikipedia.org/wiki/The_Diving_Bell_and_the_Butterf...

mckilljoy4• 16 years ago

So she went linearly through the whole alphabet until he found the letter he wanted? Sounds like somebody should have used a binary search! Hey-oooo!

albertni• 16 years ago

I wonder which would actually faster - binary search on the standard ordered alphabet or going linearly in order of letter frequency.

Even better - some hybrid algorithm that goes through the most common letters then goes into binary search for the remaining letters (many of which appear at approximately equal frequency)

jey• 16 years ago

Frequency order is analogous to Huffman coding while still being easy enough for a human to use, so it's probably better than binary search.

loaristys• 16 years ago

This is an interesting new development in what was a couple of years ago an already observed phenomenon by half of the same team:

http://www.sciencemag.org/cgi/content/abstract/313/5792/1402

However, I think their publishing the idea that these patients were "conscious" is morally questionable. The reasons for this are expressed far more elegantly that I could manage by Parashkev Nachev in the following response:

http://www.sciencemag.org/cgi/reprint/sci;315/5816/1221a.pdf

'Vegetative' patient speaks to scientists using his brainwaves

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