
Brain zap rouses people from years of vegetative state - tjaerv
http://www.newscientist.com/article/mg22129582.700-brain-zap-rouses-people-from-years-of-vegetative-state.html?full=true
======
pessimizer
That 'facilitated communication' isn't mentioned in this article is worrying.
_How_ were the vegetative people communicating, how was it observed and
recorded, and how conscious were the experimenters of (possibly subconscious)
mistakes in the past related to the interpretation of slight movements from
the disabled or vegetative as communication?

edit:

[http://theness.com/neurologicablog/index.php/man-in-
coma-23-...](http://theness.com/neurologicablog/index.php/man-in-
coma-23-years-is-he-really-conscious/)

[http://www.skepdic.com/cleverlinda.html](http://www.skepdic.com/cleverlinda.html)

~~~
Luc
Yup, this is the same researcher from a few years back:

[https://www.google.com/search?q=facilitated+communication+St...](https://www.google.com/search?q=facilitated+communication+Steven+Laureys)

It's shameful, really.

See also this article (about the 2010 'revelation'):
[http://www.csicop.org/si/show/fabricating_communication/](http://www.csicop.org/si/show/fabricating_communication/)

"At the beginning and at the end of our trials, we tried to make normal
conversation with Houben, and the FC seemed to work perfectly fine, producing
intelligible and sometimes even elaborate sentences. In one test, we asked the
facilitator to leave the room while we showed Houben a large printed word,
which we read aloud to him several times. The facilitator was then allowed to
return and assist Mr. Houben in giving the word back to us. Although a well-
formed word, the resulting answer was completely wrong. We tried the same test
with a large and simple drawing, which yielded identical results. In another
test, we shielded the keyboard from the facilitator’s view in the midst of an
answer. Immediately, the typing changed into gibberish and soon halted
completely"

~~~
pessimizer
Awful. I didn't even catch that. As a journalist, writing up this story
without reference to Houben must be some sort of malpractice.

[http://scienceblogs.com/insolence/2009/11/28/coma-man-dr-
ste...](http://scienceblogs.com/insolence/2009/11/28/coma-man-dr-steven-
laureys-just-doesnt-g/)

[http://www.psychologytoday.com/blog/adventures-in-old-
age/20...](http://www.psychologytoday.com/blog/adventures-in-old-
age/201002/gullible-science-where-is-clever-hans-when-we-need-him)

------
rcthompson
Bizarre. What if we can fully rouse patients with this treatment, but only
temporarily? Imagine being dependent on a daily morning tCDS treatment to wake
up every day. Maybe this will be incorporated into an implantable device, like
a pacemaker for the brain (not in the sense of providing periodic pulses, but
rather in the sense of being required for normal functionality).

~~~
Jtsummers
There's actually precedent for that. [1] Uses there include epilepsy,
Parkinson's and depression treatment. But extending beyond that, my search
also found this [2], for Alzheimer's treatment.

[1]
[http://en.wikipedia.org/wiki/Brain_pacemaker](http://en.wikipedia.org/wiki/Brain_pacemaker)

[2]
[http://medicalcenter.osu.edu/mediaroom/releases/Pages/Ohio-S...](http://medicalcenter.osu.edu/mediaroom/releases/Pages/Ohio-
State-Implants-First-Brain-Pacemaker-To-Treat-Alzheimer's.aspx)

~~~
caycep
The Alzheimer's bit - well, it's an interesting story. It's always a brave
cowboy surgeon that even thinks about operating on an Alzheimer's brain for a
number of reasons - safety, brain-wide neurodegeneration (thus not immediately
obvious how something focused like surgery can help), poor cognitive baseline,
etc.

The group that's probably the furthest along is the Toronto group - they tend
to be pretty liberal about where to implant electrodes, and are always looking
for new indications to implant stimulators (i.e. generate new IP, etc). They
were initially looking to stick the thing into the hypothalamus to control
weight gain, since everyone in north america is overweight and there's a huge
market.

Well, turns out when they turn the thing on, the guy suddenly remembers every
sexual encounter he's had since puberty in vivid detail.

Hence the pivot to Alzheimer's, with at least 2 pilot studies done w/ ~40
subjects using the currently available Medtronic Inc devices, and a new
biotech startup.

The effects so far are modest - essentially the subjects deteriorated but more
slowly than expected. No one suddenly started remembering things like they
could when they were younger...

------
timdiggerm
This is a great argument against "pulling the plug" on folks in vegetative
states.

~~~
jtheory
It's certainly a great reminder that I should (as should everyone) make a
living will.

If you ever end up in a persistent vegetative state, it's grueling for your
family & loved ones. We now have the tech to keep you sort-of alive for many
years, but it's not cheap, of course.

There have been ridiculous controversies in the US (see
[http://en.wikipedia.org/wiki/Terri_Schiavo_case](http://en.wikipedia.org/wiki/Terri_Schiavo_case)
for a good example) about families that have decided (with the support of
medical professionals) to pull the plug after years of suffering... and there
may be protests from the devout (because to some people, any action or
explicit inaction that causes a life to end is murder), political interference
all the way up to high levels, etc..

It's also somewhat sad that if it's time to give up on restoring a person to
working order, the _ways_ of doing that may be limited to somewhat slow &
cruel methods (like removing a feeding tube) rather than more humane methods,
due to the legal terrain.

There's a certain level of brain damage from which it's not possible to
recover a functional person; it's hard to draw that line (see OP for emphasis
on that), but it's a line that people in real life are obligated to draw on a
regular basis.

If you make a living will that specifies that you do not wish to be kept on
life support if your brain activity is below X for Y time (a bit of research
required here), you can save the people you leave behind a great deal of
heartache by not foisting the decision on them.

~~~
carbocation
Removing a feeding tube, when consistent with the patient's wishes, is not
cruel; rather, when appropriate, it is one of the most humane ways to permit a
dead or dying brain's body to die.

~~~
Cass
It's not exactly cruel, but it's also not exactly the most pleasant way to
die. We recently pulled a patient's feeding tube (in accordance with her own
wishes - she had terminal cancer, and had been able to see the end coming for
a while), and it took her a full freaking eighteen days to die on no
sustenance but a single cup of water someone gave her on day six. We obviously
had the poor woman on a morphine pump the whole time, so she was too out of it
most of the time to suffer much, but it's not a perfect system - she kept
having moments where she'd become more awake and agitated, and I did feel like
she was experiencing some suffering in those moments during our best efforts.

Coincidentally at the same time, I had to have my cat put to sleep. The vet
came to my house, he received a single injection, and then he peacefully fell
asleep in my arms without so much as a twitch. The entire process took not
five minutes altogether. I know which way of dying _I 'd_ prefer, if it was my
terminally ill body at stake.

~~~
voidlogic
Ironic, isn't it, that humane treatment is reserved for non-humans.

------
tjaerv
Fascinating research suggesting how consciousness as an emergent phenomenon
needs to cross an activation threshold to boot up.

~~~
cristianpascu
IF consciousness is an emergent phenomenon. :)

~~~
pohl
What's a real, possible alternative? If consciousness is not something that
arises out of a multiplicity of relatively simple interactions, then is the
alternative that consciousness is unrelated to the multiplicity of relatively
simple interactions but by sheer coincidence vanishes when those interactions
are disrupted?

~~~
mgkimsal
maybe just the ability for the consciousness to express itself in a way humans
can understand vanishes. ??

~~~
pohl
I kind of like that idea. Sort of like how Tomb Raider's ability to express
itself vanishes when you turn off the Playstation. Laura continues to proceed
through the dungeon, but we just can't see her.

------
muraiki
I found it interesting that the article mentions amantadine. I suffered a mild
traumatic brain injury with post-concussion syndrome whose effects were
persisting for quite a long time. While vestibular therapy made a big
difference, once that treatment plateaued I started taking amantadine -- it
had been suggested by my doctor before, but I'm a stubborn person. The
difference that amantadine made in terms of my concussion was significant.

My migraines almost completely vanished, but more importantly I had the
cognitive energy to do things that had been impossible for many months, such
as programming and playing my musical instruments. I had to take it slow at
first, but the difference amantadine made was truly remarkable.

It's not fully understood how this drug works, especially considering that it
was originally used as an anti-flu medicine. Furthermore, my understanding is
that it was no longer used in treating Parkinsons. But it's one of the few
drugs that seems to have an effect in people suffering from post-concussion
syndrome. A cousin of mine who also suffered from pretty serious post-
concussion syndrome likewise had good results with amantadine.

It should be noted that the use of amantadine is controversial in concussion
treatment. From what I've heard, some patients don't get much benefit, and the
effects tend to wear off over time. Also, it caused me to have problems with
insomnia, which were mostly addressed through sleep hygiene and melatonin. But
I thought that I'd share my experience here, as this experience helped me to
understand just how physical our mind is, and how there are likely a variety
of avenues for helping the brain when it is damaged.

------
md224
Those of you fascinated by electrical manipulation of consciousness may find
this interesting:

[http://blogs.discovermagazine.com/neuroskeptic/2014/02/23/di...](http://blogs.discovermagazine.com/neuroskeptic/2014/02/23/disconnecting-
consciousness-external-environment/)

> Guillaume Herbet and colleagues describe the case of a 45 year old man in
> whom electrical stimulation of a particular spot in the brain “induced a
> dramatic alteration of conscious experience in a highly reproducible
> manner.”

Basically, when they zapped a certain point in his brain, it sent him into
some kind of dream state. Very interesting.

~~~
jhvh1134
And this is how Total Recall became a reality

------
grannyg00se
Interesting. I wonder what people typically describe after suddenly becoming
communicative after months or years of vegetative state.

------
caycep
The problem is the outcome measures for these sort of things are always kind
of murky. "Signs of Responsiveness Not Previously Seen Before Intervention"
might mean more eye twitching than average, etc. These aren't people who
suddenly wake up and start talking after tDCS

~~~
rcthompson
I guess the next step is to set up blind studies, where one doctor sets up the
apparatus for either a real or sham treatment, and then leaves the room, then
another doctor comes in with the family and runs the treatment without knowing
which treatment is being administered.

Alternatively, the treatment is administered (or not) by a second doctor in
another room who can't communicate with those in the room.

------
gagege
At first I thought some guy named Brian Zap was doing this.

~~~
aantix
Oh the irony, "Dr. Zap" applies mild electric stimulation to wake up his
vegetative patients. :)

------
whoopiecush
I hate to be a skeptic, but a sample size of 15 people is far from conclusive.
And just when I thought electric shock therapy was almost dead...

~~~
beejiu
The sample size was 55. 15 showed sign of response. I don't know the
probabilities, but that's probably greater than the probability of response
without treatment, with statistical significance. Obviously, you'd have to
know the exact details to gauge its significance -- I'm sure those will be in
the paper.

~~~
asfapifb
It depends on what the prior probability of them waking up without
intervention was as to its significance. Statistical significance is a
function of both frequency of effect and magnitude of effect.

------
LukeShu
mybbor: You appear to be shadow banned. All of your comments since December
2010 are "[dead]".

[https://news.ycombinator.com/item?id=7320083](https://news.ycombinator.com/item?id=7320083)

