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"She can understand us"

Jülich researchers demonstrate emotional life in comatose patients

[10. Dezember 2008]

Jülich, 9 December 2008 – Do people in a persistent vegetative state (PVS) experience their surroundings? Scientists at Forschungszentrum Jülich have now been able to demonstrate that these patients do indeed react if addressed directly. In a recently published study, researchers from the Institute of Neurosciences and Biophysics showed that in future functional imaging could be able to give new insights into what is experienced by comatose patients.

In cooperation with neurologists from Düsseldorf University Hospital, Jülich researchers headed by Dr. Simon Eickhoff have used functional magnetic tomography to show that after sensory stimulus activity of the corresponding areas of the cerebral cortex was still present in a patient who had been in a coma for years. Furthermore, they were able to demonstrate that an understanding of speech was still present and that there was a person- and situation-specific activity in the so-called amygdala which is known to occur in the case of emotional reactions. However, this could only be demonstrated for the patient\\\'s children and close friends and above all when she was addressed directly. This provided objective evidence for the view held by the patient’s family and friends that she recognized familiar voices and “reacted” when spoken to.

The results published in the December issue of the high-impact journal “Experimental Neurology” thus show that even after severe traumatic brain injury and after many years of deep unconsciousness a processing of sensory stimuli and emotions takes place similar to that of the healthy brain.

Every year, 270 000 people suffer traumatic brain injury in Germany – in a road accident, at work or at home. The longer patients remain unconscious after such an injury the smaller is their chance of recovery. Almost 20 per cent of PVS patients remain in a permanently unconscious state and thus require continuous nursing.

The question of the state of awareness of PVS patients and how to deal with this situation, which is extremely distressing for all involved, has frequently been asked even before the case of the American PVS patient Terry Schiavo. In particular, the clinical diagnosis of deep unconsciousness is frequently countered by the view put forward by family and friends that he or she “can understand us". Jülich researchers have now found an answer to this question.

Original publication:

Eickhoff, S.B., Dafotakis, M., Grefkes, C., Stöcker, T., Shah, N.J., Schnitzler, A., Zilles, K., Siebler, M.: fMRI reveals cognitive and emotional processing in a long-term comatose patient. Exp. Neurol. 214(2):240-246 (2008)

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