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Vegetative patient able to "tell" doctors he's not in pain

A man in a permanent vegetative state reportedly has been able to communicate that he is not in pain, leading doctors to believe that the previously-held notion that people like him have no perception of the outside world is untrue.

Scott Routlney suffered severe brain trauma 12 years ago when he was involved in a car accident, the BBC reported. Since then, doctors have said he has no signs of awareness or ability to communicate.

But when lead researcher Dr. Adrian Owen, a neuroscience professor at the University of Western Ontario, asked Routley questions while he was inside a functional magnetic resonance imaging (fMRI) machine, his brain activity showed clear responses to what he was asked.

"Scott has been able to show he has a conscious, thinking mind," he told the BBC. "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."

Researchers asked Routley simple questions or instructed him to do small tasks while he was in the fMRI. For example they asked him to move his arms, and the command corresponded with brain activity showing that Routley was thinking about moving his arms, even if they were not physically moving. When researchers told him to stop imagining it, the activity would disappear on the scan.

Owen and his team then developed a method for interpreting which brain responses meant yes or no by asking factual questions. Using the technique on Routley, the injured man was able to "tell" them he was not in any pain.

"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," Owen said.

Another patient, Steven Graham was able to show that he had made new memories after his accident by responding yes to whether or not his sister had had a child. His sister had a baby five years after he entered a vegetative state, the BBC reported.

Owen hopes that in the future, the fMRI method can help with the care of people in vegetative states, Nature reported. Caregivers can ask if their patients if are in any pain or what music they wanted to hear. However, the ethical question -- whether doctors should ask patients if they want to end their lives -- is something Owen still won't touch.

One problem is that fMRI machines are still rather expensive. The Toronto Star reports that it can cost almost $2 million, and moving vegetative patients to the machine may harm them. However, there are high-end portable EEG machines that cost a little less than $75,000 each that can also measure brain responses which may be a possibility some day.

The BBC's Panorama television program detailed more about the Routley's story and Owen's research on a special called "The Mind Reader: Unlocking My Voice".

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