‘It’s Gigantic’: A New Way to Gauge the Chances for Unresponsive Patients


“This is very big for the field,” stated Dr. Nicholas Schiff, a professor of neurology and neuroscience at Weill Cornell Medical College in New York. “The understanding that, as the brain recovers, one in seven people could be conscious and aware, very much aware, of what’s being said about them, and that this applies every day, in every I.C.U. — it’s gigantic.” The discovering, he added, “should change practice requirements around the world.”

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Other docs stated it was nonetheless too early to predict the affect of the new method. “This approach is not ready to be incorporated into standard practice at this time, as we are just not able to reliably predict outcomes early after injury,” stated Dr. Flora Hammond, chair of bodily drugs and rehabilitation at Indiana University School of Medicine.

In the new evaluation, researchers at Columbia University and New York University tracked 104 unresponsive sufferers in Columbia’s neurological I.C.U., taking EEG recordings from every in the first few days after damage. The mind accidents had a wide range of causes, together with blows to the head, coronary heart assault and inner bleeding. During every EEG recording, the researchers gave the sufferers directions by headphones, together with, “Begin opening and closing your right hand,” and “Stop opening and closing your right hand.”

The researchers fed the EEG information right into a machine-learning algorithm, which in contrast the mind exercise following every command to resting-state exercise, wanting for distinct and constant variations — the chatter of motor indicators, filtered from the background noise. And in 16 sufferers, hidden exercise grew to become evident. Previous analysis, in sufferers who had been unresponsive for years, had discovered subset confirmed hidden mind operate. The new examine is the first to use this method to study numerous sufferers simply after the damage.

“Somewhat to our surprise, we found that about 15 percent of patients who were not responding at all had this brain activation in response to the commands,” stated Dr. Jan Claassen, medical director of the neurological I.C.U. at Columbia and the lead writer of the paper. “It suggests that there’s some remnant of consciousness there. However, we don’t know if the patients really understood what we were saying. We only know the brain reacted.”



Source link Nytimes.com

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