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Waking the Dead – One Day, 'Deep Coma' Victims Will be Able to Talk and Move Around

Patients thought to be in a "persistent vegetative" state after suffering devastating brain damage could soon be able to "talk" and even steer a wheelchair, one of Britain's top neuroscientists has predicted.

Dr Adrian Owen at Cambridge University has already proved for the first time that some victims who show no outward signs of awareness, cannot only comprehend what people are saying, but also answer simple questions.

Now he believes a new breakthrough will mean that it will not be long before they can communicate using a voice synthesizer almost in "real time" and even move around using a motorised wheelchair.

Dr Owen has already shown that using a functional magnetic resonance imaging (fMRI) brain scanner one patient was able to give "yes" or "no" responses to queries.

He and his team have gone a step further and shown that a similar response can be achieved using a much cheaper and smaller Electroencephalography (EEG) machine which measures electrical activity in the brain.

That means that for as little as £30,000 they will have access to the outside world in much the same way as the scientist Stephen Hawking.
However instead of using their cheek or eyelid to communicate, they will activate different parts of the brain.

Dr Owen, whose team is moving from Cambridge to the University of Western Ontario, Canada, believes the new devices could be available within 10 years.

"I would never have believed that within a few years we would be actually communicating with a patient who was in a persistent vegetative state," he said.

"We have seen something that is quite extraordinary. We now have a moral and ethical obligation to find ways for them to communicate properly.

"We cannot be putting them in a fMRI scanner every time they want to communicate. It is very expensive and they are not portable and not available everywhere.

"EEG could work as well and it is cheaper and portable. I feel it will be possible for people to steer wheelchairs and be able to communicate."

Dr Owen's findings suggest that around one in five PVS patients may be able to communicate and will raise questions about when doctors should switch off life-support systems.

Up to 1,000 PVS patients in Britain are kept alive by doctors in the hope they may one day regain consciousness.

Dr Owen laid the foundation for his prediction after studying a 29-year-old man brain-damaged in a car crash in 2003.

The man was in a coma for two years before slipping into a persistent vegetative state.

He was seemingly awake, occasionally blinked, but showed no other sign of being aware of the outside world.

But Dr Owen's team, whose work was funded by the Medical Research Council, and Steven Laureys, of the University of Liege, discovered it was possible to talk to him by tapping into his brain activity.

They used a fMRI scanner to measure brain response while the patient was asked questions. The scan uses magnetic fields and radio waves to detect electrical pulses.

Because the brain signals associated with "yes" and "no" are complex and too similar to distinguish, they came up with a code they could understand.

The team asked the patient to think of playing tennis for "yes" and moving around his home for "no". While the movement in tennis sparks "spatial" areas at the top of the brain, the "navigational task" of moving around your own home sparks "motion" areas at the base of the brain.

An EEG, which looks like a swimming cap studded with electrodes, records electrical activity produced by the firing of neurons within the brain. A Portable version of EEG costs between £20,000 and £30,000 and is already available.

"That would be relatively affordable," said Dr Owen who is to receive a £15 million grant from Canada to continue his work.

"It would only be yes and no questions but you can get a long way with just yes and no questions," he said.
[20 Sep 2010, Richard Alleyne, Science Correspondent, ]