Ontario Researchers Find Signs of Consciousness in Unresponsive Brain-Injured Patient

Unresponsive patients with severe brain injury may still be conscious despite showing no signs of awareness at the bedside, a recent study suggests.
The findings could impact decisions on patient care, said the authors, which are typically based on subjective behavioural responses.
“These findings have important practical and ethical implications for the patient’s standard of care and quality of life,” reads the conclusion of the study, led by Canadians Karnig Kazazian and Androu Abdalmalak from Western University in London.
The patient in the vegetative state, tested on Day 7 of ICU stay, showed the most robust responses, wrote the authors. They observed that the patient could “willfully” control his brain activity when told to do so.
“A successful motor imagery response reflects intention and does not occur in the absence of conscious awareness, suggesting that this patient’s true condition was cognitive motor dissociation,” they wrote. Cognitive motor dissociation is when patients are aware but can’t react to commands.
Researchers also found the patient could slightly process speech.
The patient in a coma, who was tested on Day 2 of ICU stay, did not show any response to the tests.
“Our findings suggest that fNIRS is a viable tool for improving diagnosis and prognosis in patients with acute brain injuries in the ICU,” they wrote, adding that studies with larger sample sizes are needed to fully understand the prognostic potential of fNIRS.
They said their findings may open the door to the possibility of communicating with unresponsive patients in the future.