‘Into the Gray Zone’ details journey to tap into consciousness of vegetative patients
Imagine being fully conscious, fully aware, but trapped inside your body with no ability to move at will or communicate with loved ones or health care providers — with no way to say “I’m in here.’’
For the last 20 years, neuroscientist Adrian Owen has dedicated himself to trying to “make contact” with such patients, diagnosed as being in a persistent vegetative state or minimally conscious following a devastating brain injury that has robbed them of their autonomy.
The case of U.S. student Otto Warmbier, who was returned home to his family in a state of “unresponsive wakefulness’’ from a severe neurological injury of unknown cause following imprisonment in North Korea, is a timely example. Doctors said the 22-year-old had opened and blinked his eyes, but seemed unaware of his surroundings and did not respond to verbal commands. He died last week.
In his new book, “Into the Gray Zone’’ (Scribner), Owen traces how he and his research team began harnessing the power of progressively sophisticated brain scanners to tap into the essential being of such patients caught in what’s described as a twilight existence between life and death.
It was the notion of brain-damaged but consciously aware patients imprisoned within their bodies that has driven Owen — first at Cambridge in the U.K. and for the last seven years at Western University in London, Ont. — to search for ways to give these people a voice and bring them back to their families.
“If a patient was lying, sometimes for decades, fully aware of everything going on around them, witnessing every conversation, hearing every decision being made about their health — and we didn’t know it — that’s a pretty horrific idea,’’ he says.
Using what’s known as functional magnetic resonance imaging, or fMRI, Owen and his team have scanned hundreds of such patients over the years, and in almost one in five cases, they were able to make a connection and prove the person was consciously aware.
An fMRI measures brain activity by detecting changes in oxygen levels in neural blood flow. Different mental activities will “light up’’ various parts of the brain, allowing the neuroscientists to pose yes-or-no questions to a patient by targeting a specific region.
In groundbreaking research, Owen and his colleagues discovered that asking a vegetative patient lying in the scanner to imagine playing tennis would activate one part of the brain, while having the person mentally move from room to room in their home would fire up another.