Monday, May 04, 2009

All in the Mind - Beyond Coma

Due to copyright issues, we don't get to hear the podcast for this week (on the killing of "spirit children" in Ghana), but the archive edition is interesting, too - on comas.
Beyond coma: the plight of the persistent vegetative state

A woman thought to be in a persistent vegetative state, unresponsive and unconscious to herself and the world, is asked to play a game of 'mental' tennis. Extraordinarily, brain scans reveal she can. In Australia, new ethical guidelines govern the care of people in this devastating situation. Besides new technologies and terminologies -- what prospects for those living frozen lives?

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Guests

Dr Adrian Owen
Senior Scientist/Assistant Director - Cambridge Neuroscience
Medical Research Council Cognition and Brain Sciences Unit
Cambridge, England.
http://www.mrc-cbu.cam.ac.uk/~adrian/Site/Homepage.html

Dr Martin M Monti
Post-doctoral researcher
Medical Research Council Cognition & Brain Sciences Unit
Cambridge, England.
http://www.mrc-cbu.cam.ac.uk/~mm03/index.htm

Professor Cameron Stewart
Professor and Dean of Law (acting)
Macquarie University
Australia
http://www.law.mq.edu.au/html/staff/stewartc/stew.htm

Further Information

All in the Mind blog with Natasha Mitchell
Comment, read, participate! Just click on "comments" under the blog posts and follow the prompts.

The blog post for this edition on persistent vegetative state can be found here

Technology Unlocks the Silent Mind
ABC Science Online, news in Science.

Brain Reading with Real-Time fMRI: Communication via detection of brain states in the absence of motor response
Paper presented at the 14th Annual Meeting of the Organisation for Human Brain Mapping, Melbourne, Australia.

Abstract: It is increasingly accepted that a sub-group of patients meeting the behavioral criteria defining the vegetative state (VS) retain aspects of cognitive function. In a recent report, a patient fulfilling the criteria for VS demonstrated the ability to willfully produce sustained mental states, as detected by fMRI, in response to brief cues (Owen et al., 2006). Adopting this paradigm we propose a novel method employing real-time fMRI to communicate via sustained production of an appropriate mental state in response to a question.

Coma and impaired consciousness after brain injury: a guide for carers
Written by Martin Coleman, Impaired Consciousness Research Group, University of Cambridge

Read more about Dr Adrian Owen's team's work

Mind Reading (Part 2 of 2): The rise of mental surveillance
Broadcast on All in the Mind, ABC Radio National, 2007.

The Catastrophe of Coma
Broadcast on All in the Mind, ABC Radio National, 2004.

Life Beyond Coma and Brain Injury
Broadcast on All in the Mind, ABC Radio National, 2002.

Publications

Title: Ethical Guidelines for the Care of People in Post-Coma Unresponsiveness (Vegetative State) or a Minimally Responsive State
Author: National Health and Medical Research Council (NHMRC)
Publisher: Australian Government, 2008
URL: http://www.nhmrc.gov.au/publications/synopses/e81_82syn.htm

Title: A Guide for Families and Carers of People with Profound Brain Damage.
Author: National Health and Medical Research Council
Publisher: Australian Government, 2008
URL: http://www.nhmrc.gov.au/publications/synopses/e81_82syn.htm

Title: Post-coma Unresponsiveness (Vegetative State): A Clinical Framework for Diagnosis
Author: National Health and Medical Research Council
Publisher: Australian Government, 2004
URL: http://www.nhmrc.gov.au/publications/synopses/hpr23syn.htm

Title: The Australian Medico-legal Handbook
Author: Cameron Stewart, Ian H. Kerridge, Malcolm Parker
Publisher: Elsevier Australia, 2007
URL: http://books.google.com.au/books?id=mvgzfWkL-68C&printsec=frontcover&dq=Handbook+for+Medical+Law+Cameron+Stewart&source=gbs_summary_r&cad=0
ISBN 0729537609

Title: The Messiha and Schiavo cases: third-party ethical and legal interventions in futile care disputes
Author: Thomas A Faunce, and Cameron Stewart
Publisher: Medical Journal of Australia, 2005; 183 (5): 261-263
URL: http://www.mja.com.au/public/issues/183_05_050905/fau10214_fm.html

Title: Functional Imaging Patients with Altered Consciousness
Author: Adrian M Owen, Martin R Coleman, John D Pickard
Publisher: BRAIN 2006, Brescia Anesthesia Intensive Care Neuroscience
URL: http://www.brain.bs.it/image/brain06engl.pdf
The link is to a PDF file.

Title: Functional MRI in disorders of consciousness: advantages and limitations
Author: Adrian M. Owen and Martin R. Coleman
Publisher: Current Opinion in Neurology 2007, 20:632-637
URL: http://www.mrc-cbu.cam.ac.uk/~adrian/Site/Publications_files/currentopinion2007.pdf
The above links is to a PDF file.

Title: Dissociating speech perception and comprehension at reduced levels of awareness
Author: Matthew H Davis, Martin R. Coleman, Anthony R. Absalom, Jennifer M. Rodd, Ingrid S. Johnsrude, Basil F. Matta, Adrian M. Owen, David K. Menon.
Publisher: Proceedings of the National Academy of Sciences 104(41): 16032-16037, 2007
URL: http://www.mrc-cbu.cam.ac.uk/~adrian/Site/Publications_files/proof.pdf

Title: Detecting awareness in the vegetative state
Author: Adrian M. Owen, Martin R. Coleman, Melanie Boly, Matthew H. Davis, Steven Laureys, John D. Pickard.
Publisher: Science, Vol 313, 8 September 2006.
URL: http://www.mrc-cbu.cam.ac.uk/~adrian/Site/Publications_files/Owen_Science_Brevia_2006.pdf

Title: Response to Comments on "Detecting awareness in the vegetative state
Author: Adrian M. Owen, Martin R. Coleman, Melanie Boly, Matthew H. Davis, Steven Laureys, Dietsje Jolles, John D. Pickard.
Publisher: Science, 315, 1221c, 2007.
URL: http://www.mrc-cbu.cam.ac.uk/~adrian/Site/Publications_files/owentechcomment.pdf

Presenter

Natasha Mitchell


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