How Some Patients in a Vegetative State Can Retain Awareness, Despite Appearing Unresponsive
New insight into a vital cerebral pathway has explained how some patients in a vegetative state are aware despite appearing to be unconscious and being behaviourally unresponsive.
The findings, published in JAMA Neurology, identify structural damage between the thalamus and primary motor cortex as the obstacle between covert awareness and intentional movement.
The team of researchers hope that their study, the first to understand the phenomenon, will pave the way for the development of restorative therapies for thousands of patients.
Dr. Davinia Fernández-Espejo, from the University of Birmingham, explained, “A number of patients who appear to be in a vegetative state are actually aware of themselves and their surroundings, able to comprehend the world around them, create memories and imagine events as with any other person.”
“However, before we take the crucial step of developing targeted therapies to help these patients, we needed to identify the reason for the dissociation between their retained awareness and their inability to respond with intentional movement.”
“A Thalamocortical Mechanism for the Absence of Overt Motor Behavior in Covertly Aware Patients” by Davinia Fernández-Espejo, PhD; Stephanie Rossit, PhD; and Adrian M. Owen, PhD in JAMA Neurology. Published online October 19 2015 doi:10.1001/jamaneurol.2015.2614
Image of brain showing the location of the thalamus (green) and primary motor cortex (blue). Credit: University of Birmingham/Dr. Davinia Fernández-Espejo.
