Healthsifter by mary desmond pinkowish, since 2003

Are You Really in a Coma, Or Did Your Doctor Make a Mistake?

Scary: New Scientist reports on a study out of Belgium that raises the possibility that some people whose doctors think they are in a persistent vegetative state (VS) are actually in a minimally conscious state (MCS)--a small distinction, perhaps, but a very important one. Here's a portion of that article:

For the patient and the family, the difference between MCS and VS can make a huge difference, though. Drug treatments, painkillers, physical therapies designed to stimulate the brain, as well as techniques for encouraging communication, are more likely to be given to someone in a MCS.

And more...

The clinics and units all used a "clinical consensus" agreed by a range of specialists to diagnose patients. Some of the specialists relied on qualitative, "bedside" observations to diagnose patients, others used older diagnostic tools, but none used the CRS-R – the only one designed specifically to distinguish between MCS and VS.

Of the 44 patients diagnosed as being in a vegetative state by the clinicians, the researchers diagnosed 18, or 41 per cent, as being in a MCS according to the CRS-R.

"We may have become much too comfortable about our ability to detect consciousness," concludes Giacino. "I think it's appropriate for there to be some level of alarm about this."

Read more here. The original study was posted yesterday in BMC Neurology.

A Blind Man Walking: An Obstacle Course is No Obstacle

Wow. What to make of this story about a man who became blind as a result of stroke damage to both hemispheres of his brain but who retains the ability to navigate an obstacle course? Here's a portion of the news article at ScienceDaily:

"This is absolutely the first study of this ability in humans," said Beatrice de Gelder of Tilburg University, The Netherlands and of the Martinos Center for Biomedical Imaging and Harvard Medical School. "We see what humans can do, even with no awareness of seeing or any intentional avoidance of obstacles. It shows us the importance of these evolutionarily ancient visual paths. They contribute more than we think they do for us to function in the real world."

TN was previously known to have what is called blindsight—the ability to detect things in the environment without being aware of seeing them. For instance, he responds to the facial expressions of others, as indicated by activity in brain regions consistent with emotional expressions of fear, anger, and joy. He is nevertheless totally blind. He walks like a blind person, using a stick to track obstacles and requiring guidance by another person when walking around buildings.

To test his navigational ability in the current study, the researchers constructed an obstacle course consisting of randomly arranged boxes and chairs and asked him to cross it without the help of his cane or another person. Astonishingly, they report, he negotiated the course perfectly, never once colliding with any obstacle. Several onlookers witnessed the feat and applauded spontaneously when he reached the end of the maze.

The demonstration shows that alternative visual paths available in the brain allow people to orient themselves and rapidly detect obstacles in the environment without any conscious attention or experience of seeing them. "It's a part of our vision that's for orienting and doing in the world rather than for understanding," she said. "All the time, we are using hidden resources of our brain and doing things we think we are unable to do."

The original article appears in the December 23rd issue of the journal Current Biology.

Performance-Enhancing Drugs for Your Normal Brain: Ritalin, Provigil, Others

Big story: A group of scientists writing in this week's Nature have endorsed the idea of studying the use of drugs like Ritalin and Provigil by healthy people as a way to improve mental focus and function. Read about it at Yahoo. The snippet:

While supporting the concept that healthy adults should be able to use brain-boosting drugs, the authors called for:

• More research into the use, benefits and risks of such drugs. Much is unknown about the current medications, such as the risk of dependency when used for this purpose, the commentary said. Also, according to the Food and Drug Administration, Adderall, for example, is an amphetamine that carries warnings about possible sudden death, heart attack and stroke, especially for people with heart problems.

• Policies to guard against people being coerced into taking them.

• Steps to keep the benefits from making socio-economic inequalities worse.

• Action by doctors, educators and others to develop policies on the use of such drugs by healthy people.

• Legislative action to allow drug companies to market the drugs to healthy people if they meet regulatory standards for safety and effectiveness.