Measuring Conscious Awareness in Vegetative Individuals

I remember the first time I saw my uncle after a drunk driver tragically hit him in 2007.  Honestly, it was a miracle he was still alive. However, was he still ‘alive’? Unfortunately, the trauma of the accident took a toll on his brain, rendering him in a permanent vegetative state.  Looking at him, I knew he essentially was trapped inside his own, once flourishing body. It was devastating how such a brilliant physician was now a prisoner sealed behind the bars of a one-time traumatic brain injury. Ever since that day in 2007 I have been interested in learning about the brain’s influence on vegetative individuals. I recently found a Scientific American article written by Katherine Harmon, Conditional Consciousness: Patients in Vegetative States Can Learn, Predicting Recovery, which discusses the question of whether or not brain-damaged patients can recover and/or create new memories amidst their loss of conscious awareness.

            It has proved to be a difficult process of measuring the actual level of conscious awareness in individuals who have suffered through a traumatic brain injury. However, recent research has discovered that some of these brain-injured patients actually are adept to simple learning processes.  These findings show that there might be a glimmer of consciousness in 'vegetative' state individuals who likely have failed regular cognitive exams. 

            In various forms of fMRI testing, individuals labeled as minimally conscious or as vegetative did not necessarily perform as they should have based upon their brain designation label. Thus, the labeling process of a patient’s state of brain damage should be revised, as most are incorrectly determined. Furthermore, findings have suggested that around 40 percent of brain injured diagnoses are actually diagnosed incorrectly as vegetative state. 

            With these new methods of detecting learning potential, it has been discovered that some of the brain-injured patients have the capacity to learn and potentially recover a bit. The learning tests were approximately 86 percent accurate in the ability to predict recovery in brain-injured individuals. Plasticity in the brain network can imply that there is the potential for some recovery. 

            This article strongly relates to chapter seven, Living on the Fragile Edge of Awareness, of Daniel Bor’s novel, The Ravenous Brain. This chapter discusses disorders of consciousness and profound brain damage.

Viewing consciousness from within proved to be the basis behind Bor’s advisor, Adrian Owen’s, research.  Owen’s primary research looks for direct ways of measuring the level of consciousness within brain damaged individuals. Owen established fMRI sound tests and determined that the patient’s score was a very strong indicator of if and how much the individual could recover six months in the future.  The information in this chapter of the novel strongly correlates to the article in the Scientific American.  Owen’s landmark study is a strong assessment of the level of consciousness in the individuals he tested.  

            Bor’s novel discussed one remarkable finding Owen had when testing a 23-year-old vegetative-labeled woman.  Under the scanner Owen would ask her to imagine various things, such as playing tennis. Upon looking at her brain activity results, Owen noticed that this 'vegetative' woman had brain responses remarkably similar to a normal individual. Thus, it is possible that her doctors misdiagnosed her as vegetative because Owen’s tests show her having signs of consciousness, something a vegetative patient would not be showing.

          

            These test have shown that some individuals incorrectly labeled as being unconscious are clearly in a conscious state of living and even capable of having communication via a brain scanner. 

           The article from Scientific American and the chapter from Bor’s novel are both strongly connected in the notion that they both discuss the various aspects of conscious communication. They both argue that a doctor’s diagnosis of a traumatically brain damaged individual may not be fully accurate. Those labeled as in a permanent vegetative state with no signs of consciousness may actually show signs of consciousness under an fMRI scanner, thus proving that they are indeed not fully vegetative and they may have the capacity to show some recovery over time. 

            I find both of these scientific articles absolutely fascinating since I have a personal connection to brain injury through my uncle. In conclusion, I think that the research behind determining the level of conscious communication is something that needs to continue being researched. These tests have shown the potential that some of the brain-injured still have consciousness within them and have the capacity to learn. Even a little bit of learning is a sign of hope for the traumatically brain damaged. Furthermore, any form of detected consciousness could help families determine the ethical question of whether or not to end a loved one’s life. Further research can potentially lead to a form of rehabilitation of forming memories. At this rate, the future may prove to show more groundbreaking ways of recovery for traumatic brain injuries.

Bor, D. (2012). The ravenous brain: How the new science of consciousness explains our insatiable

          search for meaning. New York: Basic Books. 

Harmon, K. (2009). Conditional consciousness: Patients in vegetative states can learn, predicting 

         recovery. Scientific American Global RSS. Retrieved from

         http://www.scientificamerican.com/article/learning-in-vegetative-state/