Brain Scan May Foster Communication With Vegetative Patients

Feb. 3, 2010— -- For the brother of Terri Schiavo, Wednesday's news that a team of researchers in England were able to use a novel scanning technology to establish limited communication with a man in a persistent vegetative state was bittersweet.

Bobby Schindler said that while the test using functional magnetic resonance imaging (fMRI) likely holds promise for the families of minimally conscious and persistently vegetative patients, he wishes his sister had been afforded this technology before a court ruling allowed her husband Michael Schiavo to remove her feeding tube in 2005 leading to her death.

"It's upsetting to me when I see this type of research," Schindler said. "We were looking to afford these kinds of tests for Terri, but the court did not allow us to perform these kinds of tests."

Schiavo's case ignited a firestorm of publicity in between 1998 and 2005. Ultimately, the courts sided with doctors who testified that Schiavo was in a persistent, vegetative state with no hope of recovery -- though doctors that the Schindlers brought to court said there was a chance of recovery.

The case eventually went to the U.S. Supreme Court, which refused to intervene.

The new study released Wednesday that could spell hope for many families likely will arouse a measure of controversy as well.

"I think it shows that if you just use the conventional bedside-type of exam [to determine consciousness], you can get it wrong," Schindler said.

In the new study, researchers found that a 34-year-old man was able to answer simple yes or no questions by imagining different types of activity, which caused changes in brain activity that could be seen in the machine, according to Martin Monti of the Medical Research Council Cognition and Brain Sciences Unit in Cambridge, England, and colleagues.

The finding showed that at least some patients who are otherwise unresponsive may have some residual awareness, the researchers reported online in the New England Journal of Medicine.

"The incredible thing is that we could never do something like that at the bedside," Monti told MedPage Today. Outside of the fMRI machine, he said, the patient remained unresponsive to standard tests.