People who suffer extreme brain trauma sometimes fall into what is known as a "persistent vegetative state." Unlike a coma, where the patient is completely immobile and unconscious, people in a vegetative state will sleep, wake, and open their eyes — without showing any sign of awareness or consciousness. They don't speak, move on their own, or respond to questions. Also unlike a coma, which is rarely longer than a couple weeks, a vegetative state can last indefinitely.
Because patients in this state cannot respond to commands (like "squeeze my hand if you can hear me"), there has always been uncertainty about whether they are really "there." On the one hand, they don't show any typical signs of being present and conscious. But the possibility of being trapped inside your mind — aware of your surroundings, but unable to move or respond while your loved ones are right there — is a frightening thought.
Most people thought that, in principle, it would never be possible to know. But neuroscientist Adrian Owen, author of Into the Gray Zone, thought there might be a way to rout around damage to the nervous system, allowing patients to respond using only their thoughts.
Using fMRIs, neuroscientists discovered that there are distinct patterns in brain activity when healthy, conscious people think about doing different things — say, playing tennis vs. walking through their house. Owen put vegetative patients inside an fMRI and asked them to respond to yes or no questions by imagining one activity or the other. He found, amazingly, that around 20% of the patients he scanned were actually aware of their surroundings — and thanks to his technique, able to communicate for the first time.
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