Reports this morning about Rep. Gabrielle Giffords' (D-Ariz.) condition are, so far, positive. The bullet that entered her skull did so from the back-left section of the brain and exited through the front-left section. In doing so, it missed critical brain structures and major blood vessels. During surgery, the doctors at Arizona's University Medical Center removed a large portion of Giffords' skull to allow the brain to swell without being damaged. They also used drugs to induce a coma, which slows the metabolism and blood flow in the brain, decreasing pressure.
A medically induced coma is different from one that's the result of an overdose, a disease or trauma. With a medically induced coma, the doctors can generally change the drug dosage to bring the patient back into consciousness. But not so with comas, which can leave a person unconscious for hours, weeks — even years.
Thinking about this condition reminded me of a talk I heard at the PopTech conference last fall given by Adrian Owen, senior scientist and assistant director of the Medical Research Council's Cognition and Brain Sciences Unit at the University of Cambridge, U.K. Owen and his team are using brain-imaging techniques to determine the levels of consciousness in patients who are in a vegetative state.
Some of these patients seem wakeful; they open their eyes, make noises and appear to look around. But, they're not awake. They do not ever look directly at objects or people, nor do they respond to people or commands. According to Owen, wakefulness and awareness are two different components of consciousness. Wakefulness can be observed and measured using an EKG machine that picks up brain wave activity.
But until his team's research, awareness remained elusive. The only way to know if a human being is fully aware is to engage them in an activity known as command following. In this activity, a person requests an action and the test subject follows up with the requested action.
In the case of Gabrielle Giffords — who at the moment is unable to speak — the doctors have asked her to squeeze their fingers or hold up a certain number of fingers. She has responded to the commands wonderfully, even showing a thumbs up.
But what about patients who are not awake and in a vegetative state? How can doctors determine if those people are conscious and aware?
Owen's research group used functional MRI scanning, which images the brain. It turns out that if you imagine doing an activity, the same area of the brain will light up as if you are actually performing the activity. So if you imagine playing tennis, the same area of the brain lights up as if you're actually playing tennis. A completely different area of the brain lights up if you imagine moving from room to room in your house.
The researchers used this information to get patients in a vegetative state to answer yes and no questions, proving that these people were conscious, but for some reason unable to come out of their vegetative state.
The video above, of Owen's talk at PopTech, is truly remarkable and filled with hope. Please watch the video above and let us know what you think.
