New hope for 'vegetative' patients

by Nic Rigby
BBC Inside Out East

Colin Simpson cares for his wife Christine at a private specialist centre

Mother-of-two Christine Simpson is in a coma. Her family was told she could not understand anything going on around her and would die within a few weeks.

But her husband Colin, who lives in Harlow, Essex, was convinced she was aware and was not in a vegetative state.

Thanks to Colin's campaign, Christine now gets specialist care at a centre in Hertfordshire and can communicate "yes" or "no" answers by moving her eyes up or down.

He believes there are hundreds or even thousands of such patients who have been wrongly diagnosed but claims he has met resistance from the medical community.

"It's now become an inconvenient truth that people in Christine's condition are aware and understand," he says.

His views are being backed by pioneering research from a team in Cambridge.

The team, led by Dr Adrian Owen and Dr Martin Coleman, have made breakthroughs in finding ways to communicate with people misdiagnosed as being in a vegetative condition using MRI scans.

Neuroscientist Dr Owen was one of the first in the UK to suspect that some people diagnosed as being in a vegetative state could be aware of their surroundings.

Scientist Dr Adrian Owen showed BBC's Colleen Harris scans of her brain

He recalls an early breakthrough case.

"I scanned a patient from Addenbrooke's Hospital who was apparently vegetative," he says.

"We showed her pictures of her family and friends and we saw activation in the area of the brain that we know responds to faces.

"When we first saw that this patient was actually consciously aware I was absolutely gobsmacked."

What he had discovered was that while some patients described as vegetative were unable to express themselves through movement, their brain patterns showed awareness of their surroundings.

Since then the team has come up with a way to communicate with patients by asking them to imagine playing tennis using their upper arm movements which activates one part of the brain.

Or they will be asked to imagine walking around a house which can activate another part.

The team hope this technique will prevent misdiagnosis of patients as vegetative and also allow rudimentary communication with people who are not even able to move their eyes to indicate a "yes" or a "no".

"It shows us that brain imaging can provide something in addition to clinical or bedside evaluation.

"In this case it told us that a patient that looked vegetative clinically was in fact entirely aware," says Dr Owen.

"It's important to stress that this will be a minority of patients, it doesn't mean that all vegetative patients are aware but it does mean that we are now able to detect those that are."

Parts of the brain activate when people think of playing tennis

He adds: "One obvious application of this research is that in future we may be able to adapt the brain imaging techniques to provide a rather rudimentary form of communication in patients that aren't able to communicate in any other way."

Mr Simpson, who looks after his wife every day, says: "People such as Christine need to be able to communicate their wishes, their understandings and their feelings.

"What they need above all is stimulation, and time of course.

"The team at Cambridge have proved beyond doubt that they have far more awareness than they are generally given credit for by the medical community."

The Inside Out documentary on communication with misdiagnosed vegetative patients will be shown on BBC1 in the East at 1930 BST on Friday and then will be available on BBC iPlayer for seven days.