Man in vegetative state communicates

For more than a decade, Scott Routley has been living in a vegetative state.

He can't talk. He can't move. And although his eyes are open, no one is sure whether he can see.

But now, for the first time, doctors caring for the 39-year-old London, Ont., man say they know he's not in pain.

And they learned it from Routley himself, after finding a new way to analyze his brain waves.

"This was a landmark moment for us because for the first time, a patient can actually tell us information, important information about how they're feeling and their current situation," said lead researcher Dr. Adrian Owen on Tuesday.

The medical breakthrough, believed to be the only time a severely-brain injured patient has been able to relay clinically relevant information to their doctors, is being touted as a new way to communicate with vegetative patients and improve the quality of their care.

Owen, who is the head of the Brain and Mind Institute at the University of Western Ontario, says research into brain activity in vegetative patients shows that one in five are conscious, but unable to communicate verbally or physically.

Owen and his team had been working with Routley for the past year, in an effort to determine his "residual brain activity" and how much he was able to understand them.

Last June, the doctors used a functional magnetic resonance imaging machine (fMRI) to analyze his brain patterns.

They told Routley, who became vegetative following a car crash 12 years ago, that they wanted him to imagine that he was playing tennis if he wasn't in pain or imagine that he was walking around his house if he was in pain.

The thought process involved in playing a complex sport like tennis triggers the part of the brain that controls motor skills, while thinking about walking around your house triggers visual associations, contained in a separate area of the brain.

With the fMRI, doctors were able to measure the activity in Routley's brain and conclude he was trying to tell them he was free of pain.

Owen says this technology can be used to determine responses to simple yes or no questions, and may eventually pave the way for vegetative patients to communicate on a regular basis with the outside world using a computer-assisted interface.

"We can use this type of technology to ask them what sort of entertainment they want to be exposed to? Do they want to watch TV or do they want to listen to music? What type of music? What time would they like to be fed... activities of daily living which are entirely under the control of these people around them, the people caring for them," he said.

Routley is among several vegetative patients in Canada and the U.K. profiled for a year-long documentary that was slated to air Tuesday on the BBC.

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