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mandala
Junior Boarder
Posts:164
jerry junkie

something 2 consider b4 u sign that donor card...

#213205 1 year, 5 months ago
(from the BBC):


A Canadian man who was believed to have been in a vegetative state for more than a decade, has been able to tell scientists that he is not in any pain.

It's the first time an uncommunicative, severely brain-injured patient has been able to give answers clinically relevant to their care.

Scott Routley, 39, was asked questions while having his brain activity scanned in an fMRI machine.

His doctor says the discovery means medical textbooks will need rewriting.

Vegetative patients emerge from a coma into a condition where they have periods awake, with their eyes open, but have no perception of themselves or the outside world.

Mr Routley suffered a severe brain injury in a car accident 12 years ago.

None of his physical assessments since then have shown any sign of awareness, or ability to communicate.

But the British neuroscientist Prof Adrian Owen - who led the team at the Brain and Mind Institute, University of Western Ontario - said Mr Routley was clearly not vegetative.

"Scott has been able to show he has a conscious, thinking mind. We have scanned him several times and his pattern of brain activity shows he is clearly choosing to answer our questions. We believe he knows who and where he is."

Prof Owen said it was a groundbreaking moment.


Finding a voice for the brain injured

"Asking a patient something important to them has been our aim for many years. In future we could ask what we could do to improve their quality of life. It could be simple things like the entertainment we provide or the times of day they are washed and fed."

Scott Routley's parents say they always thought he was conscious and could communicate by lifting a thumb or moving his eyes. But this has never been accepted by medical staff.

Prof Bryan Young at University Hospital, London - Mr Routley's neurologist for a decade - said the scan results overturned all the behavioural assessments that had been made over the years.

FMRI SCANNING

Functional Magnetic Resonance Imaging measures the real-time activity of the brain by tracking the flow of oxygen-rich blood. The patients were repeatedly asked to imagine playing tennis or walking around their home
In healthy volunteers each produces a distinct pattern of activity, in the premotor cortex for the first task and the parahippocampal gyrus for the second. It allowed the researchers to put a series of yes or no questions to severely brain-injured patients. A minority were able to answer by using the power of thought. In 2010 Prof Owen published research showing that nearly one in five of the vegetative patients were able to communicate using brain activity. "I was impressed and amazed that he was able to show these cognitive responses. He had the clinical picture of a typical vegetative patient and showed no spontaneous movements that looked meaningful."

Observational assessments of Mr Routley since he responded in the scanner have continued to suggest he is vegetative. Prof Young said medical textbooks would need to be updated to include Prof Owen's techniques.

The BBC's Panorama programme followed several vegetative and minimally-conscious patients in Britain and Canada for more than a year.

Another Canadian patient, Steven Graham, was able to demonstrate that he had laid down new memories since his brain injury. Mr Graham answers yes when asked whether his sister has a daughter. His niece was born after his car accident five years ago.

The Panorama team also followed three patients at the Royal Hospital for Neuro-disability (RHN) in Putney, which specialises in the rehabilitation of brain-injured patients.

It collaborates with a team of Cambridge University neuroscientists at the Wolfson Brain Imaging Centre at Addenbrooke's hospital, Cambridge.

One of the patients is diagnosed as vegetative by the RHN, and he is also unable to show awareness in an fMRI machine.

A second patient, who was not able to be fully assessed by the RHN because of repeated sickness, is later shown to have some limited awareness in brain scans.

The Mind Reader: Unlocking My Voice - a Panorama Special - will be broadcast on Tuesday, 13 November, at 22:35 on BBC One. It wil be on BBC World News on Saturday, 17 November, at 09:10 GMT and on Sunday, 18 November at 02:10 & 15:10 GMT. Alternatively, catch up later on the BBC iPlayer using the link above.
life is what happens to you while you're busy making other plans - j. lennon
SunshineSue
Platinum Boarder
Posts:29208
Life is sweeter for this!

Re: something 2 consider b4 u sign that donor card...

#213264 1 year, 5 months ago
This article is completely inapplicable to organ donation, and I hope no one is confused or scared off because of it. As someone who worked directly with brain injured patients for years, let me clarify that no one in a "vegetative state" is ever a candidate for organ donation. Organ donation requires brain death in the donor, which is vastly different from a vegetative state, where the patient has brain stem activity and at times (as in the article) even higher level functioning. A patient with brain death (though the definition can vary slightly by state) has neither brain stem activity nor any kind of higher level brain activity. Zilch, zero, nada. There are very, very strict protocols involved in determining brain death, including the finding of brain death by at least two physicians in most places.

So please people, signing your organ donor card does NOT mean that you are at risk of being put to death when there is any chance of recovery at all, no matter how small. Organs for donation only come from patients with no brain activity at all and zero chance of recovery. So please, sign your donor card. Let's hope none of us is ever in that position, but if a tragedy happens, organ donation is one way to help others even at the end of your own life. It's a very good thing!!

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Last Edit: 1 year, 5 months ago by SunshineSue.
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