Question 1

Question 2

How long can you survive in a vegetative state?

Adrian Owen · Accepted Answer

You can survive for many years. Several of the patients described in my book have been in a vegetative state for almost 20 years, but it can certainly be longer than that. As long as patients are fed and hydrated (and medicated when needed) there is no direct reason why they would not live long lives. But typically they succumb to infections (like pneumonia) or die from complications stemming from their original brain injury.

Question 3

What is it like to be in a coma? Do you dream?

Adrian Owen · Accepted Answer

Comatose patients appear to be unconscious. In many ways, they look like someone who has been deeply sedated using an anaesthetic agent like propofol. They do not respond to touch, sound or pain, and nothing can be done to awaken them. Because of this, it is very hard to say "what it is like" to be in a coma. My best guess would be that it is similar to being under a general anaesthetic; that is, there 
is nothing.....nothing to experience, nothing to understand and nothing to remember. That is what a profound state on unconsciousness must be like. The brains of comatose patients often show no signs of the normal sleep-wakefulness cycle, which means they are unlikely to be dreaming.

Question 4

Question 5

Is there a way to develop communication techniques for those who are vegetative and aware?

Adrian Owen · Accepted Answer

Yes there is. In 2010 my team and I published a paper in The New England Journal of Medicine, showing how it is possible to communicate with some patients who appear to be vegetative using a technique called functional magnetic resonance imaging (fMRI). While in the scanner, we asked a patient (who had appeared to be vegetative for five years) a series of simple questions that had “yes” and “no” answers. We asked him to imagine playing tennis if the answer to the question was “yes“ and to imagine walking from room to room in his house if the answer to the question was “no“. Because we are able to detect with fMRI whether someone is imagining playing tennis or imagining moving from room to room in their house, we were able to decode the patient’s “yes” and “no” answers. Despite appearing to be completely vegetative and unaware, he was perfectly able to correctly answer the questions, simply by changing his pattern brain activity. This was the first time anyone communicated with a  patient who appeared to be vegetative, but was aware, although we have done it with quite a few patients since. We now commonly ask patients to tell us whether they are in pain, for example, and what their preferences are for watching TV, listening to music etc. I am attaching the paper for your interest.

Question 6

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Question 8

Does your work give any clues about what is consciousness?

Adrian Owen · Accepted Answer

Consciousness is, perhaps, the most intimate of human mental experiences, and yet the hardest to explain. It is the faculty that allows us to read this sentence, to remember yesterday’s events, to derive pleasure from music and art, and to daydream about plans for tomorrow. It provides our experience of the world and yet is mysteriously altered, or absent altogether, when we fall asleep at night. Although consciousness is an essential property of being human, until recently, we have had almost no understanding of what it is and how it is created. Some of the work that we and others are doing, using modern advances in cognitive neuroscience has provided us with tools and concepts that are helping us to understand how consciousness emerges from the neural machinery of the brain. More specifically, some of our studies have provided important new clues about how best to measure consciousness. Until recently, the only way we could know that another human being was conscious was to ask them; no specific neuroimaging technique could tell you unequivocally that someone was conscious. However, some of the tools that we have developed recently allow you to do exactly that; simply by looking at the pattern of activity coming from someone's brain when they, say, watch a movie, we can now tell whether they are conscious  of that experience or not.

Question 9

Question 10

When is the brain really dead?

Adrian Owen · Accepted Answer

A brain is really dead when it shows no activity at all and has no potential for becoming active ever again. This is what happens in a condition that is known as “brain death”. Patients who are brain dead are in a quite different situation to patients who are in a vegetative state, or in a minimally conscious state. Vegetative and minimally conscious patients do show brain activity – it is often not entirely normal and sometimes resembles the brain activity seen in somebody who is either asleep or deeply sedated with an anaesthetic agent. However, brain activity is clearly present. Patients who are brain dead never recover. On the other hand, patients who are vegetative or minimally conscious do, occasionally, recover, although it is rather rare.￼￼￼

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