new tools peek into brain consciousness; may help doctors determine if patients are truly brain dead - one way car alarm
Picture: thinkstock source: when people have such a severe brain injury that they can't squeeze their lover's hand or make other responses, if they have any lingering awareness or are in a plant State, there are few good ways to judge them.
Now researchers have created a tool to look inside the brain and measure awareness to varying degrees.
The work reported at night is highly experimental and is not ready for bedside use
If it succeeds, a big problem is how to use it without causing false hope.
No one knows that the level of consciousness at some point after the injury really predicts recovery.
But, it gives hope that one day doctors can track awareness as easily as checking blood pressure.
Dr. Marcello mini, a neuroscientist at the University of Milan in Italy, said: "consciousness will grow and shrink . " He led the study to quantify what happened in different situations.
It looks obvious.
During deep sleep, consciousness disappears and doctors slip under anesthesia.
However, scientists do not have a good way to measure consciousness, especially when the patient appears unconscious.
It is important to try to distinguish whether the patient is at least a minimum consciousness, not a plant state, because the earlier signs of consciousness, the greater the chance of recovery.
Today, doctors check whether these patients can blink or move their limbs under orders, or respond to touch or pain.
If not, a scan of brain electrical activity may provide clues.
Scientists even put patients who looked unconscious in an MRI scanner and let them imagine throwing a ball.
The brain's response can show if they are aware of it, but they can't show it. this is called locking. in syndrome.
But there are shortcomings in these tests.
The new work, reported in the journal Science Translational Medicine, aims to find an easier and more objective measure.
This is based on the theory that consciousness depends on the complexity of brain activity, the degree of connection and processing of information in different regions.
For example, a neighbor's car alarm may not wake you up when you are asleep, but your brain will still process the sound you hear.
When you are fully awake, it also handles how annoying the alarm clock is and how long it will sound.
Dr. Massimini's team will have two wells.
Known medical devices
First, the coil emits a powerful magnetic pulse that stimulates the brain through the skull and basically knocks on it and says "wake up ".
"Then, the EEG measures the brain waves by the electrodes attached to the scalp, recording the activity patterns of the response of the neurons.
The last trick: the researchers created a formula to compare the complexity of these brain patterns by "compressing" them, such as compressing digital files for email delivery.
The numerical measurements they get are called PCI, which is the computational complexity index.
The team compared the tests of 32 awake, asleep, dreaming or narcotic health people and 20 people with various severe brain injuries.
Two locked patients.
They reported that in the syndrome, they clearly realized that the score was almost as high as that of a sober and healthy person.
Patients diagnosed with plant status scored lower than those who lost consciousness through the most powerful anesthesia.
The lowest consciousness is-between.
This strategy may miss awareness, so it will not give the doctor enough information to endof-
The researchers warned that life was decided.
But the groundbreaking study provides very promising clues, says Dr. Nicholas Shiff, professor of neurology and neuroscience at wilcornell Medical School in New York, who is not part of the project.
Dr. Lori Shutter added that if it is ultimately proven to be effective, the greater impact may be to help doctors study whether patients have improved when they receive different treatments, A brain intensive care unit expert at the University of Pittsburgh was also not involved in the work.
But she warns that finding a trace of consciousness can mislead families who want to see miracles long after the possibility of improvement ends.
"This may provide a lot of insight," Dr. Shutter said . ".
"The downside is how will a family react once you prove any awareness?