updated 9/7/2006 3:59:06 PM ET 2006-09-07T19:59:06

A car crash severely injured the woman’s brain, leaving her in a vegetative state. But British scientists found startling signs of awareness when they peered deeper into her brain: She seemed to hear and follow — mentally — certain commands.

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This novel brain-scanning experiment, reported Thursday, is sure to elicit pleas from families desperate to know if loved ones deemed beyond medical help have brain activity that doctors didn’t suspect.

It’s far too soon to raise those hopes, the British researchers and U.S. doctors stress. There’s no way to know if this woman ever will recover, and therefore if her brain activity means anything medically. Nor can many hospitals perform this type of brain imaging.

But the study does raise calls for more research into one of medicine’s ethical minefields — because it raises the tantalizing prospect of one day being able to predict whose brain is most likely to recover and maybe even tailoring rehabilitation.

'Heartwrenching' requests from families
“What an unmet need is out there,” said neuroscientist Joy Hirsch of New York’s Columbia University Medical Center, who is conducting similar research and receives “just heartwrenching” requests to scan patients.

“Making medical decisions based on this information at this point in time we say is not appropriate,” she warned.

Added lead researcher Adrian Owen of Britain’s Medical Research Council: “I want to be extremely cautious about this. This is just one patient. The result in one patient does not tell us whether any other patient will show similar results.”

A car crash last year injured the 23-year-old woman. By the time Owen scanned her brain five months later, she had been pronounced in a vegetative state — physically unresponsive to a battery of tests. Some people do make at least some recovery after being in a vegetative state for a short period.

Those who don’t improve eventually are diagnosed with a “persistent vegetative state,” such as the late Terry Schiavo. Schiavo became a lightning rod of political controversy over the question of taking such patients off life support, but an autopsy showed she had irreversible brain damage.

The brainDoctors use MRI machines and other scanners to examine brain injuries. To see how the brain actually fires — what areas are activated during different physical or mental processes — they use more advanced imaging called functional MRI, or fMRI.

In the journal Science, Owen and colleagues write that fMRI testing showed the 23-year-old car-crash victim had preserved conscious awareness despite her vegetative state.

How could they tell? First, they checked that she could process speech. Told a sentence such as “there was milk and sugar in the coffee,” the woman’s brain regions that recognize speech reacted just the way healthy volunteers’ brains reacted.

Using her imagination
Then came the big test. They told the woman to perform a mental task — to imagine herself playing tennis.

The motor-control regions of her brain lit up, again just like they did in the healthy people Owen compared.

“There is no other explanation for this than that she has intentionally decided to involve herself in the study and do what we asked when we asked,” he said in an interview.

Other scientists say the result isn’t that clear-cut.

The results are “not totally convincing of consciousness,” neuroscientist Lionel Naccache of INSERM, France’s national science institute, wrote in a review in Science. He cautioned that the woman’s injuries weren’t as massive as most vegetative-state patients.

Columbia’s Hirsch said the woman is not conscious. But, “it tells me that this patient’s brain is operating the essential elements for consciousness. The machinery is there and operating,” she explained.

This kind of research is difficult — there’s little funding for it, among other barriers — but Thursday’s report demands that more be done, Hirsch added.

“It raises the tension about how we treat these patients,” she said. “In some sense, one could interpret this as saying it’s ethically unconscionable not to address.”

© 2012 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.


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