Neurologists Jan Claassen e Brian Edlow, respectively of Columbia University and Harvard, introduce us to "hidden consciousness", a condition experienced by 15-20% of people in a coma. And they do it with a real example.
Maria Murkevich, a XNUMX-year-old from New York City, fell into a coma after a blood vessel ruptured in her brain. All conventional tests to detect her state of consciousness (moving her eyes or head, wiggling her toes, etc.) produced no response, but her loved ones still believed she was "in there." ". And they didn't want to give up.
They were right. But it would take a high-tech method to prove it.
The medical team gave her an EEG (placing sensors on her head to monitor the electrical activity of hers brain) as they asked her to "continue to open and close the right hand". Then they asked her to "stop opening and closing the right hand". Her hands did not move, but her brain activity patterns differed between the two commands. These brain reactions clearly indicated that she was aware of her requests and that those requests were different.Jan Claassen, Brian L. Edlow, "Some comatose people may actually be conscious", Scientific American print edition November 1, 2022, open access document.
In a year Maria Murkevich slowly recovered, and now she is back to work in the pharmacy, as before her problem.
The "hidden consciousness" shown by Maria, the authors say, is changing our understanding of consciousness disorders. There are still some questions (for example, Murkevich doesn't remember anything about those tests) but a very important road has opened up.
A hook to return to life
According to the study by the two neurologists, patients who show hidden consciousness (if detected early) are more likely to return to normal consciousness and "functional recovery".
Some neurologists are now focusing on identifying patients with hidden consciousness to direct needed help.
Building on the momentum of these studies, the scientists came together to launch the Curing Coma Campaign, an international collaboration to direct medical resources and public attention to the condition, with the aim of developing new therapies that promote the recovery of consciousness.Jan Claassen, Brian L. Edlow, "Some comatose people may actually be conscious", Scientific American print edition November 1, 2022, open access document.
Detecting the hidden conscience, an ethical imperative
I'm not going around it: in the immediate future, as soon as possible, we need protocols and tools to detect hidden consciousness to identify patients who are conscious but cannot physically prove it.
The progress made on the subject of the conscience of people in a state of coma are many. There are many questions to answer, but also many answers. Three in particular also emerge from these studies.
Can people suddenly wake up from a coma?
Klaassen and Edlow dispel the myth that people suddenly "wake up", as we sometimes see in books or movies. It takes weeks or months of rehabilitation before regaining more independence before an awakening.
Can our comatose loved ones hear us?
Adrian Owen showed, using MRI, that a patient in a deep coma could hear and understand. And her research has been repeated by numerous other labs on many, many patients with persistent vegetative states.
About 40% of people in a persistent vegetative state show high levels of intellectual functioning even in a deep coma.
Can brain death be reversed?
It could, even among people diagnosed with brain death. Most experts in this field recognize that even in these patients there are indeed residual "nests" of neuronal activity and residual blood flow. It makes sense that recovery is theoretically possible with the right neuroregeneration and remodeling tools.
On the other hand, it is widely recognized that brain dead individuals can continue to maintain circulation, digestion, metabolism, hormonal balance, growth, sexual maturation, fetal gestation, wound healing, and other manifestations. It is difficult to be definitive about such complex things as consciousness and the human brain.