Superb: For vegetative patients, a brain scan may detect hope of recovery

In the netherworld that lies between death and full consciousness, some grievously injured or ill patients will remain suspended indefinitely. But others, given time, will eke their way out of the twilight and toward recovery. Accurately predicting which group an apparently vegetative patient falls into could bring comfort, solace and sometimes hope to their families--and also to the patients involved, who may wish to convey they are still "in there," or may feel pain that is not being addressed.

Superb: For vegetative patients, a brain scan may detect hope of recovery 600

Superb: For vegetative patients, a brain scan may detect hope of recovery 600

Developing a test that could foretell the long-term outcome of a stricken patient has proved elusive. But a new study finds that scans that look for signs of metabolic activity in certain regions of the brain can improve prediction.

The latest research, published Tuesday in the journal Lancet, tracked for at least a year 102 unconscious subjects, assessing them initially by brain scan, bedside examination and a complex diagnostic test to measure impairments of consciousness. All were diagnosed as either minimally conscious, locked in, or unresponsively wakeful (also called vegetative).

Imaging the subjects' brains with a positron emission tomography (PET) scan allowed researchers to predict accurately 74% of the time whether a patient would show evidence of consciousness a year later. It was a better prognosticator of a poor outcome (continued lack of consciousness), accurately predicting that a patient would continue to be vegetative or minimally conscious in 92% of cases. But in 67% of cases in which PET scan results suggested a patient would regain some level of lost consciousness, he or she did so.

As other research has suggested, the prognosis for recovery was generally better in patients whose consciousness disorder stemmed from traumatic brain injury than in those harmed by hypoxia--a prolonged interruption of the supply of oxygenated blood to the brain.

PET imaging of 39 healthy control subjects helped researchers sketch the activity profile of a fully functioning brain and of brains with distinct patterns of impairment: Even when no difference in two patients' awareness levels was evident, the metabolic patterns of a brain in a vegetative state looked very different from those of a brain with intermittent consciousness. And when the PET scanner detected those patterns in an apparently vegetative patient, the researchers suspected that the patient was more likely than one without them to recover some levels of conscious awareness.

More: http://www.latimes.com/science/sciencenow/la-sci-sn-vegetative-brain-scan-recovery-20140415,0,2704032.story

Superb: For vegetative patients, a brain scan may detect hope of recovery

Superb: For vegetative patients, a brain scan may detect hope of recovery

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