Persistent Vegetative State After Brain Injury

New Research Suggests Possibility of Consciousness.

A study from a scientific team at Cambridge University has raised the possibility that some patients diagnosed as being in a Permanent Vegetative State (PVS) may in fact have a level of consciousness even to the point of understanding a command and following it.  PVS can occur after serious brain injury, and presents with patients who appear to be awake, who can open their eyes and look around, but in fact have no real awareness or consciousness of themselves or their environment.  Patients cannot react to commands, interact with others nor make any purposeful movement.  The diagnosis is only made after long and careful assessment by experienced medics following exact protocols.

However, the research from Cambridge University has provided some interesting results.  The numbers involved are small, and as such the evidence must be treated with caution, but this new study alongside a small number of other pieces of recent research has provided a suggestion that some patients diagnosed as being in PVS may have some awareness but are unable to communicate, perhaps more closely linked to “locked in syndrome”.

The research involved assessing electrical activity in the brain through electrodes and then comparing the results of patients apparently in PVS with a “healthy” control group.  For four of the thirteen PVS patients assessed, their electrical signature was similar to the control group.  Those four patients were then scanned by MRI whilst the research team asked them to imagine they were playing tennis.  The team looked at results from previous brain mapping tests which show the areas of the brain which become active when movement is planned, and three patients showed similar brain activity on their scan.  If this does demonstrate a causal link, it may be that these patients were able to understand the command to imagine playing tennis and potentially to follow it.

Philip Edwards, a Partner in the Birmingham office of Clarke Willmott who specialises in brain injury claims said:-

“I have acted for many clients diagnosed with PVS, and the trauma and emotional impact, particularly for families and loved ones, is something which is difficult to put into words. Although this research is new and limited in scope, anything that gives hope that more patients will eventually be able to communicate and  interact with their families again is a good thing. This study may only be a small step forward, but hopefully will lead to more research in this area. One interesting anecdotal point made by the team was that there seems to be a change in professional carer behaviour to patients where there is some evidence of awareness. As the goal has to be the provision of the highest quality of care to all brain injury survivors, again if this research leads directly or indirectly to improvements in such care, then it is to be applauded”.

The research can be found at the PLOS Computational Biology