Research May Help People in Vegetative States Communicate

Patient lies in hospital bedMore than a decade ago, the story of Terri Schiavo brought vegetative states into the national consciousness. Schiavo suffered a brain injury after collapsing in her home, and she ended up in a persistent vegetative state. A fight between her husband and parents about whether to remove life support made its way to the Supreme Court, and doctors ultimately removed Schiavo’s feeding tube.

Vegetative states result in persistent diminished consciousness, including the inability to communicate or voluntarily move. However, people in vegetative states still have reflexive responses, and some spontaneously recover from the state—though recovery is uncommon.

Debate continues about the degree to which people in vegetative states are aware of their surroundings. Researchers speculate that some people who appear to be in vegetative states may be conscious, aware, and even interested in communicating—despite their inability to do so. Researchers from the University of Birmingham in the United Kingdom have uncovered structural abnormalities in some people trapped in a vegetative state. Eventually, this discovery could lead to new communication tools for people in a persistent vegetative state.

What Causes Persistent Vegetative States?

Researchers compared a patient who was in a vegetative state for more than 12 years to another patient. The second patient had similar health issues, but was capable of movement. The team also recruited 15 healthy volunteers as a control group. Each participant was monitored with the assistance of functional magnetic resonance imaging (fMRI) and fiber tractography.

The scientists asked participants to respond to commands, such as imagining moving their hand in response to the word “move.” Researchers also explored the structural pathways that connect the thalamus to the motor cortex. These pathways are thought to play a key role in voluntary motor activity. They found that damage to thalamocortical fibers—which connect the thalamus to the brain’s motor cortex—appears to be behind the movement difficulties inherent to a persistent vegetative state.

Can Someone in a Persistent Vegetative State Communicate?

The study did not explore treatment options, and none of the currently available treatments can reverse a vegetative state. Researchers say insights into the pathways that figure prominently in vegetative states could ultimately lead to a treatment. Moreover, the research suggests at least some patients in a vegetative state might be fully or partially conscious—able to think, feel, and develop relationships, even though they cannot express those thoughts to others.

References:

  1. Disorders of consciousness. (n.d.). Retrieved from http://www.nhs.uk/conditions/vegetative-state/Pages/Introduction.aspx
  2. People in vegetative state may be able to respond. (2015, October 19). Retrieved from http://www.medicalnewstoday.com/articles/301188.php
  3. Terri Schiavo: Ten years after her death, ‘end of life’ debate rages on. (2015, March 31). Retrieved from http://abcnews.go.com/Health/terri-schiavo-10-years-death-end-life-debate/story?id=30013571

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  • shelby

    shelby

    October 22nd, 2015 at 5:43 PM

    I have a hard time even thinking about this, that someone could know exactly what was happening all around them but they have no way to communicate with anyone.

  • Gregg

    Gregg

    October 23rd, 2015 at 3:08 PM

    But this would imply that there is still life within someone even if they are in this kind of state, so wouldn’t that then say maybe this is a person who should still deserve to live? I mean if there is an ability to communicate that still remains then for me that would mean that hope for recovery would remain as well.

  • Terrell

    Terrell

    October 24th, 2015 at 12:06 PM

    I am very torn when it comes to this issue. I think that if it were me being loike that then I would not want to live. I would want to be taken off of life support and just have my family let me go. But i know that for many there is such a need and a desire to believe that this person is going to heal and be whole again that it is difficult for them to even consider letting this be over. I don’t know what I would ever do if I truly found myself having to make a decision like this.

  • stover

    stover

    October 26th, 2015 at 9:07 AM

    I know that there is always hope in scientific research, but I also think that it is important that we stress to families that we are looking at treatments here, not cures. That for now there is only hope that improvements can be made, but not much hope for full recoveries.

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