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Vegetative State Man 'Talks' By Brain Scan 202

c0lo writes "'Severely brain-injured Scott Routley hasn't spoken in 12 years. None of his physical assessments since then have shown any sign of awareness, or ability to communicate, thus being diagnosed as vegetative (vegetative patients emerge from a coma into a condition where they have periods awake, with their eyes open, but have no perception of themselves or the outside world).' Scott Routley was asked questions while having his brain activity scanned in an fMRI machine. British neuroscientist Prof Adrian Owen said Mr Routley was clearly not vegetative. 'Scott has been able to show he has a conscious, thinking mind. We have scanned him several times and his pattern of brain activity shows he is clearly choosing to answer our questions. We believe he knows who and where he is.' As a consequence, medical textbooks would need to be updated to include Prof Owen's techniques, because only observational assessments (as opposed to using mind-readers) of Mr. Routley have continued to suggest he is vegetative. Functional MRI machines are expensive (up to $2 million), but it's quite possible that a portable high-end EEG machine, costing about $75,000, can be used at a patient's bedside. Phillip K. Dick's world is one step closer."
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Vegetative State Man 'Talks' By Brain Scan

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  • I'm loath to ask: (Score:5, Interesting)

    by newcastlejon ( 1483695 ) on Wednesday November 14, 2012 @06:58PM (#41985849)
    Will they ask him if he wants to die?
  • Sounds like a match. (Score:4, Interesting)

    by olsmeister ( 1488789 ) on Wednesday November 14, 2012 @06:58PM (#41985853)
    Sounds like a great use for something like this. [slashdot.org] But, have fun getting insurance to cover it...
  • by Freshly Exhumed ( 105597 ) on Wednesday November 14, 2012 @07:00PM (#41985877) Homepage

    If even a small percentage of people suffering with "Locked-in" Syndrome [wikipedia.org] are reachable it will be a major win. Think "Johnny Got His Gun" or "The Diving Bell And The Butterfly" for cinematic examples of "Locked-in" Syndrome.

  • Re:I'm loath to ask: (Score:5, Interesting)

    by geekoid ( 135745 ) <`dadinportland' `at' `yahoo.com'> on Wednesday November 14, 2012 @07:52PM (#41986385) Homepage Journal

    Not me. Keep me going. I would rather be bored then dead. They might be able to cure me someday.

    In the mean time please leave the TV on. maybe get an EKG machine that lets me interface with a computer.

    You sir, are a quitter.

  • Re:Must be boring. (Score:4, Interesting)

    by meta-monkey ( 321000 ) on Wednesday November 14, 2012 @08:14PM (#41986611) Journal

    http://pub.psi.cc/ihnmaims.txt [pub.psi.cc]

    Maybe if you're considering Mr. Routely, the man in the article, to be similar to the AM computer from the story. The human protagonist has that thought ("I Have No Mouth and I Must Scream") at the end of the story, but I think what makes that story great was that it really describes the computer. It becomes intelligent, butit's just a world-spanning computer. It has consciousness, but no real purpose, drive or desires, and that's what drives it mad. I find that whole concept really intriguing, because we see a lot of "machines taking over the world" stories in which humans are eliminated because they're considered "inefficient" or simply because the cold, calculating machine sees no value in human life as the machines have no emotions (skynet), but in IHNMAIMS, the computer very much has emotions, it's just that it's hateful. So, instead of humans being eliminated by a machine of cold, cruel logic, they're eliminated and/or tortured by a sadistic machine driven by hatred. Really interesting.

  • Re:I'm loath to ask: (Score:5, Interesting)

    by pwizard2 ( 920421 ) on Wednesday November 14, 2012 @08:16PM (#41986629)
    You're assuming quite a bit. What if the parts of your brain that process visual/audio data are damaged and don't work anymore? Just how useful would TV be in that situation? Think about it... you would be trapped in a dark abyss entirely inside your head, unable to see or hear any stimulus. Even if people come to visit you, you would never know because you couldn't see or hear them. Yes, death would be preferable.
  • fMRI has problems (Score:5, Interesting)

    by capedgirardeau ( 531367 ) on Wednesday November 14, 2012 @08:23PM (#41986713)

    fMRI has problems and is very subject to interpretation, misuse and manipulation.

    For example the now classic dead fish fMRI tests:
    http://www.wired.com/wiredscience/2009/09/fmrisalmon/ [wired.com]

    I am very skeptical of this until it has been repeated, tested and evaluated in other settings by different researchers.

    For some reason when reading the story, it really reminded me of "facilitated communication" which is a terrible, cruel scam non-communicative and vegetative or near vegetative state people are subject to. I realize this is different, but really not very different.

  • Re:fMRI has problems (Score:4, Interesting)

    by Chuckstar ( 799005 ) on Wednesday November 14, 2012 @08:47PM (#41986969)

    You also have to be careful when thinking about this due to the different conditions that could all be lumped into "vegetative states".

    Someone with localized damage could appear vegetative, but really just be "locked in". In other words, they could have a largely intact brain, except for key regions blocking movement/communication. They would appear vegetative, but actually be able to react in ways that would show up in fMRI. This research could prove to be valid in such cases.

    Someone like Teri Shiavo, though, is a whole different story. Her brain was so damaged that most of it was simply gone (damaged material is cleared out by the immune system). She mostly had a big empty cavity in her head filled with fluid. It's unlikely that fMRI would show any response in such a case. And even if it did, with that much damage it would be impossible to make any guess as to what that activity might mean.

  • False positive? (Score:5, Interesting)

    by xlsior ( 524145 ) on Wednesday November 14, 2012 @09:19PM (#41987227) Homepage
    Just because they got results, doesn't mean that there's any conscious thought going on.

    Case in point: http://www.wired.com/wiredscience/2009/09/fmrisalmon/ [wired.com]
    "So, as the fish sat in the scanner, they showed it “a series of photographs depicting human individuals in social situations.” To maintain the rigor of the protocol (and perhaps because it was hilarious), the salmon, just like a human test subject, “was asked to determine what emotion the individual in the photo must have been experiencing.”

    The salmon, as Bennett’s poster on the test dryly notes, “was not alive at the time of scanning.”

    If that were all that had occurred, the salmon scanning would simply live on in Dartmouth lore as a “crowning achievement in terms of ridiculous objects to scan.” But the fish had a surprise in store. When they got around to analyzing the voxel (think: 3-D or “volumetric” pixel) data, the voxels representing the area where the salmon’s tiny brain sat showed evidence of activity. In the fMRI scan, it looked like the dead salmon was actually thinking about the pictures it had been shown."
  • Re:Kill me, please (Score:2, Interesting)

    by Anonymous Coward on Wednesday November 14, 2012 @09:28PM (#41987299)

    I've had trauma surgeons tell me that advance directives/living wills are very frequently overridden by family.

    It makes sense, in a degenerate way: the docs and the hospital have better things to do than sue families to get them to follow their invalid family member's advance directive document. It would be a PR disaster, and it's just easier to leave a patient as a full code on a vent rather than fighting a family willing to attempt to get an injunction from a court.

    Basically, what I was told was that these help to absolve your power of attorney of any guilty feelings they might have about terminating care and letting you die. So, it's important that your PoA is on board with your wishes, otherwise they won't be happening while you're incapacitated (and if you're *not* incapacitated then you don't need a living will in order to execute your wishes). Don't get me wrong—I have a notarized living will for which I and my PoA carry a digital copy on our USB keychain drives. I'm just saying that the documents aren't a panacea.

    Also, it's tough to be a doctor. If a patient is resuscitated after their DNR is on file then performing CPR, etc, is legally considered assault (or battery). I've seen a department in damage control mode after a resident failed to let a patient die (ie. the resident successfully resuscitated a DNR patient and wasn't aware of the DNR order). Can end up charged with malpractice or worse...

  • Re:I'm loath to ask: (Score:3, Interesting)

    by mariox19 ( 632969 ) on Wednesday November 14, 2012 @09:42PM (#41987403)

    You mean like being a patient such as Mr. Routley and having your organs harvested? Generally, donors are not given pain medication, only tranquilizers to keep their bodies from flinching, since it's assumed that people in such a state are "gone." I brought this up to my brother, the anesthesiologist, when this story was in the news a few months back, and he insisted that there was no need for anesthesia. That's the consensus of the medical community.

    That puts us a step ahead of vivisection—but only barely.

Fear is the greatest salesman. -- Robert Klein