It involves hooking electrodes to the patient’s head with a tight cap and gel, showing the patient random images of letters and then tracking the involuntary pulses the brain emits when the patient identifies the letter needed to spell a word.
One of the barriers to the technology is that it can be slow, frustrating and cumbersome, says Leslie Collins, one of the engineers. Her lab is trying to make the equipment easier to use in the home.
But so far, the technology that links the human brain and the machine is in its infancy. Dr. Owen’s body of work shows how far it has already come, and how surprising its promise is.
When Dr. Owen speaks about his research, he becomes so excited that he leans forward in his chair with infectious enthusiasm. He came to Canada two years ago from Cambridge University in England, a kinetic, ginger-haired man and a bit of a wag – his Twitter name is @Comadork.
He began his pioneering work in 1997, driven mainly by the scientific challenge of trying to figure out some practical applications for the emerging field of three-dimensional brain imaging and by the thrill of doing something no one had ever dreamed of.
“I’m really interested in solving problems that seem to be completely unsolvable,” he says.
That year, he popped a 26-year-old woman who was thought to be in a vegetative state following a fever into a scanner “on a whim,” he says.
He showed her pictures of people she knew and other images. The parts of her brain that are linked to facial recognition lit up when she saw people she knew. Eight months after her illness, the landmark paper on her case was accepted by the medical journal The Lancet. Today, she is able to communicate fluently using an alphabet board. http://adrianowen.org/site/Publications_files/Menon-1998-Lancet.pdf
A whole new world of brain research on those in the seemingly vegetative state opened up for Dr. Owen. What if more patients were being misdiagnosed, he thought, and he could help?
“It’s important to get the diagnosis correct,” he says simply.
Back then, and in many hospitals still today, brain-injured patients were diagnosed based on whether they were capable of consistently moving a bit of their body in response to a command.
It’s the classic movie scenario of the medic at the car crash at the side of the road asking a patient for a squeeze of the hand or a flick of the eyelid if the patient can hear. Cue soaring music.
In turn, that physical movement determined whether doctors considered the patient either “vegetative,” meaning no awareness, or “minimally conscious,” meaning some awareness.
In some parts of the world, the two different states are the dividing line between pulling the plug and leaving it in. But what if the mind was aware and responsive, just unable to show that by moving the body?
Dr. Owen reckoned that an active mind might light up by verbal command in the scanner, rather than just by seeing images. So he began developing experiments with both patients and healthy volunteers to see whether he could read minds.
When he started, there was no standardized three-dimensional map of the healthy brain, much less one of a brain that had suffered catastrophic injury. As recently as 2002, he published a paper explaining to colleagues that figuring out which parts of the brain are being activated is “both conceptually and technically more difficult than has been generally assumed.” http://adrianowen.org/site/Publications_files/Brett-2002-NatRevNeurosci.pdf
In 2006, he had his sensational breakthrough paper. http://adrianowen.org/site/Publications_files/Owen_Science_Brevia_2006.pdf It presented the findings of a scan of a 23-year-old woman who had been in a traffic accident and was deemed vegetative. While she was in the scan, he asked her to imagine first one and then a second complex task: playing a game of tennis and then visiting all the rooms in her house.
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