The fMRI study that changed how we think about vegetative state

25:19they can't answer. >> Yeah. That's very good. Yeah, exactly. How do you How can you tell? Right? This is a Yeah, that's subtle. That's very subtle and for the longest time wasn't really considered until science paper 2006 by Adrian Owen. It's a landmark paper. It's quite incredible. This was a wake-up call, so to speak. Okay? He used functional MRI to ask a patient that was diagnosed in a vegetative state to imagine playing tennis. And imagine walking around her home. I love scientists so much. >> Okay? And the brain activity from that fMRI study was identical to someone who was fully aware. So, she like she's she's there in this

25:59vegetative state. There's no way that she can express Mhm. her awareness. Mhm. But if we look into the brain MRI, it's the same as someone who's aware. The idea being they may not be able to move their hands to touch a button or verbalize Or even move their eyes. Or move their eyes, which is techniques that have been used yeah, have been used before to communicate. Now we're just saying it's because the awareness is in the brain. And so you shouldn't actually need any of these secondary uh meth avenues to communicate. And the only way to make the differentiation between the uh is someone home versus is someone not

26:41home reference point, you have to go directly to the source if all of their physical capacities are are are not available to them, which does not necessarily mean Yeah, no one is home. >> Exactly. It's like no one's answering the door, but here it's kind of like we did an x-ray of the home and the person is moving around in the house. >> We have the thermal and you can see. Exactly, you know? It's I thought that was a very cool paper. >> very clever. It's very clever and now now it's it's a real crisis, right? Because now there's a third. It's called minimally conscious state, okay? And it turns out that 15 to 20% of patients that are classified as vegetative actually might have covert conscious awareness. That's a lot.

27:21>> That's got to be terrifying. >> got to be so terrifying. You know what I mean? Cuz you can hear and see everything happening around you and you cannot engage in that environment. That's just unbelievable. >> was only 20 years ago, 2006, right? >> After this 4 500 year cycle we've just talked about. >> Yeah, so I mean this field is just one of those where you can really sit back and be like, "Wow, we really don't know much about the brain." Right. Like Right, because this is like kind of, you know, people's this goes to the materialist uh Yes. non-materialist debate. >> Mhm. You know, is it that consciousness arises out of matter Mhm. uh uh or is consciousness primary? Which gets a little that's Again, that was above our paygrade and not the focus

28:01of this podcast. >> Yeah. But it is it is one of those it's the first question. >> Yes. Because once you You know what I mean? Like you have you can't everything else downstream is really impacted by which of the two Which of those two, right? What are we talking about? >> Right. Who am I? Who are you? And what the hell is going on? That's that's that's how I like to say it. You know? And so with with these kinds of studies it's it's really like underscoring how much we don't know about this, right? And now 15 to 20% of patients we're saying are classified um incorrectly. Which is fascinating cuz I mean I'm sure after that study a variety of cuz fMRIs are

28:44not hugely uh a negative for a patient. So, at least as a way of especially for families or anybody to try,