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Brain-wave Test Challenges Vegetative-State Diagnosis

Tests using an EEG have shown unexpected cortical functioning in vegetative patients

3 min read

6 August 2008— Eluana Englaro has been lying motionless in a hospital bed in Italy for 16 years. In 1992, Englaro survived a serious car crash that left her brain damaged, completely unresponsive, and unable to eat, drink, or breathe on her own. She is now in a class of patients diagnosed as ”persistently vegetative.” Her father, convinced that Eluana would have opposed the medical intervention she received, has fought in court for the past nine years for the right to remove her feeding tubes and turn off her respirator. In early July, he finally won, but Italian state prosecutors have 60 days to appeal.

End-of-life decisions in nonresponsive patients like Englaro and American Terri Schiavo pose a deep challenge to the science of consciousness. When these types of cases go to trial, courts spend much of their time hearing opinions on whether the patient is truly in a vegetative state and whether he or she has any chance of improving. The controversy surrounding these disputes is due in part to the primitive methods we rely on when assessing consciousness. But some scientists are working on technical ways to measure consciousness in patients with brain injuries.

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This Implant Turns Brain Waves Into Words

A brain-computer interface deciphers commands intended for the vocal tract

10 min read
A man using an interface, looking at a screen with words on it.

A paralyzed man who hasn’t spoken in 15 years uses a brain-computer interface that decodes his intended speech, one word at a time.

University of California, San Francisco

A computer screen shows the question “Would you like some water?” Underneath, three dots blink, followed by words that appear, one at a time: “No I am not thirsty.”

It was brain activity that made those words materialize—the brain of a man who has not spoken for more than 15 years, ever since a stroke damaged the connection between his brain and the rest of his body, leaving him mostly paralyzed. He has used many other technologies to communicate; most recently, he used a pointer attached to his baseball cap to tap out words on a touchscreen, a method that was effective but slow. He volunteered for my research group’s clinical trial at the University of California, San Francisco in hopes of pioneering a faster method. So far, he has used the brain-to-text system only during research sessions, but he wants to help develop the technology into something that people like himself could use in their everyday lives.

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