Caption: Prof. Timothy Joseph Lane indicated that research overseas has shown that through brain imaging technology like PET and fMRI, the changes in signal in vegetative patients can be seen, which can further be used to determine the degree of awareness and their response to conversation
In the past three years, the TMU Research Center of Brain and Consciousness (RCBC) has evaluated almost 150 patients in Taiwan, of which around 60 has been examined by the TMU team as part of the clinical experiment. TMU Prof. Timothy Joseph Lane, Dean of College of Humanities and Social Sciences, points out that currently it seems that 11 patients diagnosed as being in a vegetative state may have awareness, are consciously aware of their surroundings, and is able to respond to questions through blinking and other responses. The chance is quite high that these patients are able to communicate with their family through brain imaging, and express their thoughts.
Research showed that misdiagnoses of patients being in a vegetative state can be as high as 40%. Prof Lane says that past experience within and outside of Taiwan has also shown that the degree of awareness of over 20% of such patients is not much different with the average person, and is able to clearly hear and see their surroundings, as well as able to feel their body. But due to misdiagnosis, they are treated the same way as patients who have no awareness. Overseas research has trained patients to imagine specific scenery to express their likes or dislikes, and was also able to observe changes in the patient’s cerebral cortex through brain imaging technology.
The research mainly determined the patient’s response through the activity of the supplementary motor area and parahippocampal gyrus in the brain, as these two areas are related to motor action and spatial memory. Thus, the research first tried to get the patient to imagine specific scenarios for up to 30 seconds, such as playing tennis represent like, while imagining walking around at home represent dislike. So when the patient is thinking about playing tennis, the supplementary motor area will show activity, and thus represent a yes response.
Conversely, when imagining walking around at home, the parahippocampal gyrus will show activity, and thus represent the patient’s dislike, or no. The patient’s family members can understand the needs of the patient through these changes as well as understand the patient’s response to the comfort level of care. In reality, although the research team continued with the related clinical experiment, but the fact that the cost of PET and fMRI runs into the tens of thousands for each use is not sustainable for most families, thus the resuscitation project for vegetative patients faces significant obstacles, requiring more donations and funding in order to proceed.
Ms. Zheng （鄭）, who has taken care of her mother that is in a vegetative state for over two years, says that sometimes her mother will turn her head slightly or blink her eyes, so her family really hopes that they have the chance to interact with her mother. Not only Ms. Zheng, family members of other vegetative patients also want to know the feelings of these patients during the caretaking process, including whether they feel discomfort, if they like the music, or perhaps even if they want to continue with treatment. Prof. Lane says that autonomy of the patients is also a pragmatic issue. If research can validate the possibility of speaking with vegetative patients, it would be possible to communicate with them through such a method, thus returning autonomy back to the patients.
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