Medical textbooks will need rewriting- says Prof Bryan Young

[Pollux]

A Canadian man who was believed to have been in a vegetative state for more than a decade, has been able to tell scientists that he is not in any pain.

It's the first time an uncommunicative, severely brain-injured patient has been able to give answers clinically relevant to their care.

Scott Routley, 39, was asked questions while having his brain activity scanned in an fMRI machine.

His doctor says the discovery means medical textbooks will need rewriting.


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.

Mr Routley suffered a severe brain injury in a car accident 12 years ago.

None of his physical assessments since then have shown any sign of awareness, or ability to communicate.

But the British neuroscientist Prof Adrian Owen - who led the team at the Brain and Mind Institute, University of Western Ontario - 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."

Prof Owen said it was a groundbreaking moment.

"Asking a patient something important to them has been our aim for many years. In future we could ask what we could do to improve their quality of life. It could be simple things like the entertainment we provide or the times of day they are washed and fed."

Scott Routley's parents say they always thought he was conscious and could communicate by lifting a thumb or moving his eyes. But this has never been accepted by medical staff.

Prof Bryan Young at University Hospital, London - Mr Routley's neurologist for a decade - said the scan results overturned all the behavioural assessments that had been made over the years.

"I was impressed and amazed that he was able to show these cognitive responses. He had the clinical picture of a typical vegetative patient and showed no spontaneous movements that looked meaningful."

Observational assessments of Mr Routley since he responded in the scanner have continued to suggest he is vegetative. Prof Young said medical textbooks would need to be updated to include Prof Owen's techniques.

BBC News - Vegetative patient Scott Routley says 'I'm not in pain'

Where will this take the debate about consciousness?

[Arouet]

Thanks for posting this. I had meant to search for this to bring up in the other thread.

[Paul C. Anagnostopoulos]

Originally Posted by Pollux

Where will this take the debate about consciousness?

Prediction: We will learn that "cognitive responses" do not require consciousness.

~~ Paul

[JCearley]

I thought it was already known that in some coma patients who eventually remitted back to health, later acknowledged that they knew when their family was visiting them. I suppose this is better evidence that trend wasn't "just conflated" by having been told it happened afterwards.

[fls]

"Prof Young said medical textbooks would need to be updated to include Prof Owen's techniques."

So a more sensitive test of cognitive function has been developed. How does this mean that consciousness does not take place in the brain?

Linda

Originally Posted by Paul C. Anagnostopoulos

Prediction: We will learn that "cognitive responses" do not require consciousness.

~~ Paul

Why would you assume he doesn't have any consciousness?

Chuck

[Pollux]

Regardless were this put the philosophy on consciousness, I think it is a big step forward for a group that might suffer silently year in and year out psychologically in being under-stimulated. IOW being bored to death.
Just as that discovery a few years back that regular sleeping medicine coul bring people back from coma.
There is so much more that we've yet to learn.

One way of testing for a part of the NDE experience -without having people being near death- is the stress of pain and emotional pressure.
Not that it would be that ethical, but it could be serving as a study for peoples experience with OBE in these situations rather than those who had full-blown NDE's.
Like setting the perimeters for when and how this happen, and possibly have volunteers, (back to the ethical part again though). But even without a volunteer group they could work as a coordinators for these cases alongside with the usual NDE's. And soon enough we might get pretty solid evidence of OBE's.

[David Bailey]

Originally Posted by Pollux

Where will this take the debate about consciousness?

I guess if this is real, and if it became possible to increase the bandwidth of the communication, it would be very interesting to find out what someone 'does' in such a state. Do they enter states of consciousness akin to OBE's etc - perhaps because of the lack of normal stimulation (though presumably they must be able to hear).

David

[fls]

This supports Sam Harris' contention that the extent of Eben Alexander's ability to have conscious experiences is unknown given that Alexander is relying upon physical exam and CT findings while this case demonstrates that these can be at odds with a more sensitive measure of function - the fMRI.

Linda

[XXII]

Linda, let's not jump to conclusions, we are completely ignorant as to the phenomenology of the man's experiences. Let's keep in mind that such speculation cuts both ways, as one could easily point out that it also supports Bernardo's contention that the fact people retain conscious experiences even when the structures that are supposed to give rise to consciousness are damaged is akin to claiming that a car runs better when you take everything out but some wires.