New test for vegetative coma patients

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Brain researchers develop illogical test for vegetative coma patients

Some vegetative coma patients show conspicuous brain activity when illogical sentences are read to them. This is what Bielefeld neuropsychologists found out. Her investigation showed that most of these patients woke up from a coma after three to five years. The researchers may have found an important indicator of waking up later. 14 of the 15 vegetative coma patients whose brains responded to sentences like "Paul drinks his coffee with sugar and socks" woke up later.

Test with illogical sentences triggers brain reaction in some vegetative coma patients "The patient with this measurement curve woke up later," Inga Steppacher told the news agency "dpa-infocom" while showing a curve diagram. "We call it 'the mental hae'." The diagram shows a clear rash that shows the patient's brain reaction to an illogical sentence. The changed brain waves are triggered by nonsense sentences such as "Klaus eats pasta today with tomatoes and pants". The neuropsychologist evaluated more than 100 such diagrams in order to be able to make statements about the chances of recovery of patients with the so-called apallic syndrome. Brain activity is based on a mechanism in the human brain that causes excitement when sentences end illogically. Because the brain is always looking for a logical meaning. If it doesn't find one, it responds with measurable rashes. As the Steppacher results show, the "search for meaning" also works for some vegetative coma patients. Even though they don't seem to notice their surroundings, their brains react to illogical sentences.

For ten years, doctors in the Schmieder rehabilitation clinic in Allensbach on Lake Constance had played out various noises, texts and nonsense phrases to vachoma patients, and at the same time recorded the brain activity of women and men. "A huge amount of data, which had not yet been evaluated with regard to whether certain reactions of the brain waves can be linked to the probability of re-awakening," reported the neuropsychologist. In the next step, Steppacher examined which patients regained consciousness after being released from the clinic. Then she analyzed how they reacted to noises like clapping hands or knocking, the texts, and finally the illogical sentences. Only from the data of the nonsense sentences could indications of possible chances of recovery be derived. More than 80 percent of vegetative coma patients whose brains responded to the illogical sentences later regained consciousness.

Does brain reaction to illogical sentences increase the chances of cure for vegetative coma patients? Steppacher evaluated the medical history of 87 patients, 30 of whom regained at least a minimum level of communication ability. 15 of the 87 vegetative coma patients had shown a reaction to the illogical sentences. 14 of them woke up later. Some of the other 72 patients who had not responded to the nonsense sentences regained consciousness, but with only 16 cases significantly less than in the group with a brain reaction.

“We found a good indicator of the likelihood of waking up here. This is a milestone in the field of vegetative coma research, ”Professor Johanna Kißler, who supervised the study, told the news agency. However, the brain reaction does not mean that the patients understood the sentences. However, despite the coma of the awakening, their brains are very likely capable of processing the language that the other patients did not have, Steppacher reported. “For this reaction, several brain structures have to work together. We suspect that this is also the key to re-awakening: that the brain is currently severely damaged by a traffic accident or stroke, but that certain areas continue to work correctly. "

Longer rehab phase for vegetative coma patients
Armin Nentwig, Chairman of the German Wachkoma Society "Traumatic Brain Patients in Need" has been working for those affected and improving their situation for more than 20 years. “We have always said that: look closely at how the patients react. But it has to be measurable and scientifically verifiable before it gets attention, ”Nentwig commented on the result of the study to the news agency. It is a "step in the right direction".

“But much more research needs to be done. We know far too little about this clinical picture, which is becoming increasingly important, ”explained Nentwig. His son fell into a coma after a skiing accident in 1988. He died after six months. In his view, it was "important that such results lead to the active rehabilitation phase being extended". Often, the patients would be released too quickly and "deported" to nursing care.

But as the study by the Bielefeld brain researchers shows, there is still a chance to come back to life after a few years. "We saw that almost half of the patients who had recovered only woke up after three to five years," said Steppacher. Further investigations are planned. The aim is to test how vegetative coma patients react when the illogical sentences are spoken, for example, by their own mother and thus add feelings.

Why do people fall into a coma? Every year about 3,000 people fall in vegetative state. Triggers are brain injuries from car accidents, bleeding from a broken vessel or a cardiac arrest with prolonged lack of oxygen in the brain.

The damage can affect different areas. While the outer cerebral cortex, which is responsible for processing stimuli and perception, is injured in some cases, the midbrain may be the damaged area in other patients. The midbrain is located below the cerebrum and has important areas for the transmission of stimuli. Damage to the brain stem, the oldest area of ​​the brain, can also cause patients to fall into a coma. Using special behavioral tests, doctors and brain researchers can find out whether the person affected still perceives something or whether there is any reaction to the environment. Vagoma patients who regain consciousness often need help for a lifetime. (ag)

Image: Michael Bührke /

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