Late last year, a Belgian man in his mid-forties created a media stir when doctors announced that he had been misdiagnosed as being in a coma for 23 years. Rom Houben, the victim of a horrific car-crash in the eighties, was incorrectly diagnosed as being in a “persistently vegetative state.” But by using new diagnostic tests and brain scans that were unavailable in the eighties, scientists revealed that Houben was actually conscious.
Reports then breathlessly announced that Houben could also finally “communicate,” expressing his thoughts by having his hand supported by his therapist who reportedly helped him tap out his messages on a touch-screen computer. “I shall never forget the day when they discovered what was truly wrong with me,” Houben apparently tapped. “It was my second birth. I want to read, talk with my friends via the computer and enjoy my life now that people know I am not dead” [The Guardian].
But now one of Houben’s doctors, neuroscientist Steven Laureys, has declared the Belgian hasn’t been communicating after all.
When the story first broke, DISCOVER and other discerning publications noted that this type of communication, called “facilitated communication,” is very controversial, and has repeatedly failed under conditions of rigorous testing. [Psychology Today]. Skeptics argued that the facilitated communication therapist brought in by Houben’s family was really guiding the man’s hand and choosing which letters to press herself. Skeptics who read Houben’s messages were also amazed that someone who was in a minimally-conscious state for more than two decades was so lucid, articulate, and forgiving of the medical staff. Laureys wanted to study the case further to determine if Houben could indeed communicate.
A few months ago, Belgian man Rom Houben hit the headlines for a misdiagnosis that lasted 23 years. Houben was thought to have lost all brain function in a horrific car accident, and was believed to be in a persistent vegetative state. New evaluations helped determine that Houben actually had normal brain activity, and was yearning to communicate–although the “facilitated communication” his family used to allow Houben to tell his story quickly kicked up a kerfuffle over the validity of the whole tale.
Now, a new study published in The New England Journal of Medicine gives credence to the notion that some patients who have been classified as vegetative are actually conscious, and a rare few may be able to communicate.
The researchers used functional magnetic resonance imaging (fMRI) to scan patients’ brains, and to record any activity generated in the patients’ brains following verbal prompts and questions from the doctors. They found signs of awareness in four patients, one of whom was able to answer basic yes or no questions by activating different parts of his brain. Experts said Wednesday that the finding could alter the way some severe head injuries were diagnosed — and could raise troubling ethical questions about whether to consult severely disabled patients on their care [The New York Times].
From 1983 to 2006, the Belgian man Rom Houben was misdiagnosed as a coma patient. In fact, doctors say, he was conscious for all those years, but incapable of communicating with doctors or family members who leaned over his bedside. But neuroscientist Steven Laureys finally caught the 23-year mistake. Laureys just published a paper on the case in BMC Neurology, spurring wonder at the remarkable case—and skepticism that Houben is truly “communicating” now.
Houben was paralyzed in 1983 after a vicious car crash, and doctors incorrectly diagnosed him as being in a persistent vegetative state until 2006. An expert using a specialized type of brain scan that was not available in the 1980s finally realized it, and unlocked Houben’s mind again [AP]. Houben indeed had an almost normal brain, his PET scan showed, and doctors say they clinched his consciousness by having him move his foot and then spell words on a touchscreen.
Some coma patients who appear to be completely unresponsive to the outside world are still capable of the most basic kind of learning, according to a small new study. Researchers found that both vegetative and “minimally conscious” patients were capable of a Pavlovian response, learning to associate a noise with a slightly unpleasant stimulus.
The researchers built on the work of 19th-century Russian psychologist Ivan Pavlov, who famously conditioned his dogs to salivate at the ring of a bell by associating the sound with the presentation of food. In this case, they sounded a tone, which was followed about 500 milliseconds later with a light puff of air to the eye [Scientific American]. At first the patients only responded after the puff of air by blinking or twitching or flinching. But after repeated trials, 15 of the 22 patients began to blink or flinch immediately after the tone sounded, before the puff of air. Electrodes by their eyes picked up the subtle muscle movements.