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A Canadian man believed to be in a vegetative state has been able to tell scientists he is not in pain.

He managed this not by speaking or even blinking an eye or raising a finger, but with his brain activity during a brain scan, a new BBC television special reveals. The special followed several vegetative or minimally conscious patients in Canada and Britain for more than a year.

Scientists working at the Brain and Mind Institute at University of Western Ontario found that 39-year-old Scott Routley – who suffered a brain injury during a car crash 12 years ago – was able to answer yes or no to questions by either thinking about playing tennis or walking around his home, the Telegraph reports.

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Because each of those thoughts activated different parts of the brain, British neuroscientist Adrian Owen, who led the team, says Routley was able to communicate clearly.

"Scott has been able to show he has a conscious, thinking mind. We have scanned him several times and his pattern of brain activity shows he is clearly choosing to answer our questions. We believe he knows who and where he is," he told the BBC.

The finding could revolutionize not only our understanding of people we think are in a vegetative state or with minimal brain activity, but Owen said it could also have an impact on everyday practicalities.

"Asking a patient something important to them has been our aim for many years. In future we could ask what we could do to improve their quality of life. It could be simple things like the entertainment we provide or the times of day they are washed and fed."

For their part, Routley's parents told the BBC they always thought he was conscious and "could communicate by lifting a thumb or moving his eyes."

But this has apparently never been accepted by medical staff. Indeed, Routley's neurologist, Bryan Young of University Hospital in London, Ont., told the BBC the results effectively overturn all the behavioural assessments in his patient's file.

"I was impressed and amazed that he was able to show these cognitive responses. He had the clinical picture of a typical vegetative patient and showed no spontaneous movements that looked meaningful," he said, adding that medical textbooks will need to be updated to include the brain scanning techniques.

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