How far we came to communicate with coma patients.

How far we came to communicate with coma patients. 

Imagine being able hear, feel and think. Clinically, a coma can be defined as the inability to consistently follow a one-step command.  For a patient to maintain consciousness, the components of wakefulness and awareness must be maintained.  For decades’ people have spoken to people in vegetative states, hoping their voices will be heard. 

FMRI

Recent researchers has shown that coma patients have more ability to understand than that was previously thought. Researchers are going much further than that: in controversial experiments, a group of scientists are working out how to communicate with people in comas. Nature has a wonderful feature piece which centers around Adrian Owen, a maverick in the field of neuroscience. The article describes one of Owen's early successful experiments:

"The patient was only 24 years old when his life was devastated by a car accident. Alive but unresponsive, he had been languishing in what neurologists refer to as a vegetative state for five years, when Owen, a neuro-scientist then at the University of Cambridge, UK, and his colleagues at the University of Liège in Belgium, put him into a functional magnetic resonance imaging (fMRI) machine and started asking him questions.

"Incredibly, he provided answers. A change in blood flow to certain parts of the man's injured brain convinced Owen that patient 23 was conscious and able to communicate. It was the first time that anyone had exchanged information with someone in a vegetative state."

One goal is to identify other brain systems, such as smell or taste, that might be intact and usable for communication. Imagining sucking a lemon, for example, can produce a pH-level change in the mouth and a recognizable brain signal. Owen has shown that registering jokes provokes a characteristic response in healthy people and plans to try it on patients in a vegetative state. He hopes that he can use these tests to find some level of responsiveness in patients who cannot produce the tennis and navigation patterns of activity because of their level of brain damage.

"The studies will also explore whether these patients have the capacity for greater intellectual depth. Owen thinks that some people in a vegetative state will eventually be able to express hopes and desires, perhaps like French magazine editor Jean-Dominique Bauby, who dictated his memoirs by repeatedly winking one eye. "I don't see a reason why they could not have a similar richness of thought, although undoubtedly some will not," Owen says."

Perhaps unsurprisingly, many scientists are skeptical of Owen's work. Were his early successes just fluke? Are his hopes for the future wildly optimistic? Maybe. But while his experiments continue to point in the right direction, we'd be fools not embrace his work Coma patients, who were for long thought unable to receive stimuli from their environment, could answer simple questions with yes/no and activate some zones of the brain like imagination as a response to certain stimuli.

 SME Instrument

The project was developed by Guger Technologies, a growing company with two branches in Austria (Graz and Schiedlberg), one branch in Spain (Barcelona), one branch in the US (Albany) and distribution partners all over the world. All hardware and software developments are done in-house by a team of researchers, engineers and developers. G.tec is also an active member in a number of national and international research projects and is active in scientific publishing. The technologies developed by the company have earned multiple awards for innovation and are sold in 70 different countries worldwide.

The company received an SME Instrument Phase 2 grant in October 2015 to build a new headset the mindBEAGLE. In addition to providing assessment and communication, the new mindBEAGLE prototype will also be able to provide prediction and rehabilitation.

With this technology, patients will once again be able to convey their needs and desires to carers, influence decisions about therapy and communicate with their family and friends.