The common wisdom that people in a "vegetative state" cannot be reached may need to be rethought after researchers in London, Ont., have shown otherwise in the case of Canadian Scott Routley.
He suffered a severe brain injury in a car accident 12 years ago. Traditional assessments suggested he had no sign of awareness, or ability to communicate.
But Routley, 39, was able to provide answers to simple questions while having his brain activity scanned in a functional MRI scanner, researchers say.
Dr. Adrian Owen of the Centre for Brain and Mind at Western University in London, Ont., said they are dealing with patients who are classified as being in a vegetative state who are awake but seem unaware of who they are or what's around them.
"These are patients who look vegetative," Owen said. "Even when they're examined clinically, they show no responses. But in the scanner, they can respond with their brains and in that way they can tell us that they're actually aware."
In Routley's case, they asked a question that is relevant to his care: Was he in pain? His brain response suggested no, which was a relief to his family, Owen said.
Functional MRI measures the real-time activity of the brain by tracking the flow of oxygen-rich blood. Owen's team uses MRI to look for certain patterns in brain activity when patients are prompted.
Owen moved from Cambridge, U.K., to London, Ont., where he was offered a Canada Excellence Research Chair, which brought $10 million in federal funding over seven years, the university said.
Dr. Don Weaver is Canada Research Chair in neuroscience at Dalhousie University, where he helped develop the Halifax Consciousness Scanner. Unlike MRI technology, it's a portable EEG device that measures electrical activity in the brain using a head cap with electrodes.
The whole field of consciousness is a huge evolving field now with many contributions occurring, Weaver said.
"This represents another step in the improved management of people who have head injury so that we're better able to identify people who are indeed 'in there,'" Weaver said.
BBC's Panorama documentary followed several vegetative and minimally-conscious patients in Britain and Canada for more than a year.
In the documentary, another Canadian patient, Steven Graham, showed he has formed new memories since his injury, such as answering yes when asked whether his sister has a daughter. His niece was born after his injury five years ago.
So far, Owen said his MRI technique reveals that there is some awareness in about one in five patients in a vegetative state. But potential therapies are a long way off, both Owen and Weaver cautioned.