In my first year of university, we were gifted the book “Into the Grey zone” by Dr Adrian Owen as part of our induction session. I forgetfully let the book sit on my shelf for a couple of months collecting dust, until I suddenly remembered I had it. If you have been unfortunate enough to enter the conversation of neuro-based research with me (either unwillingly or willingly), this book will have undoubtedly come up. As someone who is hoping to do research on traumatic injuries in comatose patients, I finished the book in about 2 days- luckily in first year I could afford getting lost in books for days. By the end of the final chapter my entire perspective on coma patients, consciousness and DNR’s had changed.
Although I am going to outline/mansplain some of the main studies conducted in the book, I still recommend you read it if this is a topic that interests you even in the slightest. Dr Adrian Owen is a British neuroscientist, who has had what I think a lot of us would deem an unfair share of heartbreak. His mother was diagnosed with an oligoastrocytoma and slipped into a coma state shortly after. A while later his ex-wife Maureen got into a tragic road accident and suffered a subarachnoid haemorrhage (bleeding between the arachnoid and pia mater layers of the brain). His personal experiences with seeing loved ones slip into the “grey zone” fuelled his research into the incredibly complex subject.
Dr Owen’s first patient was Kate, who had unfortunately developed acute disseminated encephalomyelitis. Her compromised white matter had impaired her brain’s communication network and she slipped into a vegetative state. Dr Owen’s research team used PET scans to establish command following in Kate. In a clinical setting, determining consciousness can be reduced into the patient being able to follow commands. Doctors may ask their patients to move their arms up and down to establish their awareness. Although patients in vegetative states are more animate than those in coma states, they still do not respond to external stimuli. They are sometimes referred to as being wakeful but unresponsive. His team showed Kate pictures of strangers (as the control) and pictures of her family and friends. Amazingly, her brain lit up when she recognised the faces and the results were relayed in her brain scans. Incredibly, Kate recovered years later and despite being physically disabled her brain is cognitively restored.
With new technology comes new information. fMRI scans map metabolic activity within the brain, which makes it possible to track the flow of blood in the brain. As the basic rule of metabolism goes, the areas in which more blood is flowing are areas that are being activated more. Dr Owen began to adopt fMRI scans as a new way to get vegetative patients to follow commands. He asked patients to imagine playing tennis, this mental image activates the pre-motor cortex in everyone. As you think of playing tennis, you are imagining yourself waving your arms, bouncing and throwing a lime green ball, these thoughts alone activate your pre-motor cortex and therefore it lights up on the scan. This was his way of establishing command following in vegetative patients. When they were told to relax, their pre-motor cortex became inactive. He found that 70% of “vegetative” patients he studied, were able to follow commands. Surely this meant that they were conscious?
Spatial navigation became his second golden ticket into the world of comas. He began to ask patients to imagine moving through their house, from the instant they put the key into the front door all the way until they were in their bedroom. He found that this activity involves an entirely different network of the parietal lobe, which is located deep in the brain within the parahippocampal gyrus. This part of the brain now lit up. So now he has two different activities to implement, with each one activating two different parts of the brain. He fused these principles together and devised a system that would allow him to ask comatose patients "yes or no" questions and for them to respond. In very few words, his experiment went something like: “if your answer is yes: think of playing tennis” and “if your answer is no: think of moving around your house”. I will add a brain scan from a patient of Dr Adrian Owen which beautifully show how the brain lights up.
He applied his theory and asked questions that they already knew the answer to, such as “Is your husband’s name Terry?” and more insightful questions such as “are you in pain?”. I will also include the link for the documentary of the imaging process and the implications these imaging techniques had on the family of patient's. Through this genius method, Dr Adrian Owen managed to do the unthinkable- speaking to those in the grey zone of consciousness. I think about this experiment a lot, but Kate’s email to Dr Owen has stayed with me also. “It found me. It was like magic.”
“We are our brains, but we’re also the memories, attitudes, opinions, and emotions that we imbue in others. Even in death we often continue to inspire, mould and affect the lives of the people we leave behind.” Research like this has changed thousands of lives, and I am beyond excited to see where it will take us in the future. The research team noticed that when the patient’s family were informed that their loved ones were conscious and could hear them, their attitudes changed and sometimes even helped with recovery. As Aristotle says “Hope is a waking dream”
- sham x
my poem of the week (a short one because I got carried away with this post):
Thank you, my dear
You came, and you did
well to come: I needed
you. You have made
love blaze up in
my breast- bless you! Bless you as often
as the hours have
been endless to me
while you were gone
- Sappho 46
http://intothegrayzone.com/mindreader/
Comentarios