New research from Mass General Brigham found that brain scans can detect consciousness in some unresponsive brain injury patients. The study tested 241 patients using fMRI and EEG while giving them instructions like “imagine opening and closing your hand.”
Results showed that 25% of participants followed these instructions in their brains, even if they didn’t show outward signs of awareness. This condition, called cognitive motor dissociation, means these patients can think and remember, even if their motor skills seem absent.
Dr. Yelena Bodien explained that while some brain injury patients seem unresponsive, advanced brain scans like fMRI and EEG can reveal they are still aware. This discovery raises important questions about using this hidden awareness to improve communication and recovery.
The study found that cognitive motor dissociation, where patients can think but not move, affects about 25% of unresponsive patients. This suggests an urgent need for more testing to accurately detect this condition, which could significantly impact patient care and outcomes.
The study collected data from six US, UK, and European sites over 15 years. Researchers tested methods to detect cognitive motor dissociation in new and long-term brain injury patients.
Researchers studied 241 patients who didn’t respond to instructions and 112 who did. Surprisingly, 62% of the responsive group didn’t show brain activity, suggesting they followed instructions and highlighting the complexity of these tests.
Knowing that patients are more aware than they seem can significantly impact their care. Positive test results for cognitive motor dissociation can lead to better interaction and care from medical teams, like paying more attention to subtle signs or engaging with the patient.
Without detecting this condition, people might lose out on essential support and gain. The study highlights the need for standardized testing and improved clinical practices to help patients with disorders of consciousness.
“To keep improving in this area, we need to make testing for unresponsive patients more accessible and standardized”, said Bodien. While the Emerging Consciousness Program at Mass General Hospital provides these tests, other places may only offer them through research studies.
The findings could lead to new ways to help patients communicate, like using brain-computer interfaces. Another study in the same issue of the New England Journal of Medicine showed a BCI assisting a man with ALS to turn his speech attempts into text.
Journal reference :
- Yelena G. Bodien, Judith Allanson, et al. “Cognitive Motor Dissociation in Disorders of Consciousness.” New England Journal of Medicine. DOI:10.1056/NEJMoa2400645.
