Study: Comatose patients may be more aware than it seems

Some comatose patients may still be able to understand conversations, new research has suggested.

A study on functional near-infrared spectroscopy (fNIRS), published in the Proceedings of the National Academy of Sciences, compared brain scans of 100 healthy participants with three intensive care patients in University Hospital, Ontario.

One patient, who had been in a vegetative state for a week, was found to “wilfully modulate brain activity when instructed to imagine playing a game of tennis”, among other cognitive responses.

Life support

The researchers concluded that fNIRS is a “viable tool for improving diagnosis and prognosis”, in light of evidence that 15 to 20 per cent of those clinically diagnosed as being in a vegetative state are actually aware.

Lead author Dr Karnig Kazazian stated: “The end game of the work is to use fNIRS with every patient who is unresponsive to see if they have more consciousness than what is apparent just from behaviour. Down the road, we hope that we can use fNIRS to predict which patients will wake up from a coma.”

He explained that those who “show awareness on fNIRS may be able to understand conversations around them, and perceive pain”. He emphasised that it is “is extremely important to try and identify if patients have hidden awareness to avoid inappropriate or premature withdrawal of life sustaining measures”.

The researcher added that the technology could be used “in the future to pass messages from patients to doctors or family”, by analysing the brain’s responses to questions.

Decades

In 2019, a woman from the United Arab Emirates spoke to her son after 28 years of limited awareness.

Munira Abdulla fell into a minimally responsive state after suffering a severe brain injury in a car crash in 1991, aged just 32.

For years, there were no signs she would ever recover, but she astounded doctors after regaining some consciousness following specialist treatment in 2017.