Sophisticated brain-imaging techniques suggest that a young woman in a vegetative state five months after a traffic accident had some mental functioning, even though she was unable to physically respond to her environment, British researchers report today.
The woman's brain showed mental activity virtually identical to that of healthy people when she was addressed in complex sentences and when told to imagine activities such as playing tennis, the physicians reported in the journal Science.
The findings challenge the standard diagnosis of a vegetative state, implying that some patients may have what Dr. Lionel Naccache of the French National Institute of Health and Medical Research called "a rich mental life" in an accompanying editorial.
"I was absolutely stunned" by the results, said Dr. Adrian M. Owen of the Medical Research Council Cognition and Brain Sciences Unit in Cambridge, who led the study. "This showed that she is aware."
That conclusion will inevitably bring new hope to people with loved ones in comas or vegetative states, along with demands for further testing -- a difficult proposition because most hospitals do not possess the expensive equipment required.
And Dr. Joseph J. Fins of Cornell University's Weill Medical College in New York cautioned that because so little is known now, such brain scans might raise more questions than answers.
"This one picture may require a thousand words," he said. "The technology is going to answer some questions, but it will create some difficult choices for families."
Owen and his colleagues cautioned against drawing generalizations based on their report. "This is just one patient," Owen said. "The result in one patient does not tell us whether any other patient will show similar results, or whether this result will have any bearing on her."
Other experts were more critical.
"You don't really know whether the patient is imagining a tennis game or simply responding to the word 'tennis' " in much the same way that she would respond to a pinprick, Dr. Paul Matthews of Imperial College London told the journal Nature. "There is a lot that's interesting about this research, but I think their result is overclaimed."
The report immediately stirred memories of Terri Schiavo, the persistently vegetative Florida woman who became the center of a national controversy when her husband received permission over her parents' objections to remove the feeding tube that was keeping her alive.
