After 15 years, patient leaves vegetative state

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The patient was 20 years old when he suffered a car accident that left him in a persistent vegetative state (PVD). Now, 15 years later, the man recovered, for the first time, “signs of conscience”. This revelation was published in the journal Current Biology, by the person responsible for the application of vagal nerve stimulation therapy, Angela Sirigu, director of the Marc Jeannerod Institute of Cognitive Sciences in Lyon, France.

“He’s still paralyzed and unable to speak, but he can respond. Now he’s conscious”, the investigator, an expert on neuropsychology, told The Guardian. The patient, whose identity is anonymous, underwent a small surgery of 20 minutes last year of 2016, during which he was placed in the neck area, a small implant, able to stimulate by electric discharges the vagus nerve, which connects the brain to virtually every vital organ.

After two weeks of stimulation, the patient was kept under permanent observation and was filmed with an infrared camera, the scientists finally obtained results: upon hearing his favorite music, the man, in a vegetative state for 15 years, let out a tear. “When we saw a tear trickling down her cheek was… Exciting. It was just…”, returned to emotion Sirigu, interviewed by Wired.

Among the signs, the man began to follow objects with his eyes, then he stayed awake while they read him stories, once even opened his eyes in surprise, when the investigator brought his face close to his. As the months went by, he was able to respond to simple requests, such as turning his head to one side or the other, always slowly, often taking more than a minute. The whole register of brain activity also revealed some substantial improvements, namely, increased electrical communication between zones of the brain and increased activity in areas related to movement, sensation and consciousness.

But this patient was not chosen at random, explained Angela Sirigu. “If you show him the brain of this patient, you will see that the left hemisphere is completely damaged. He cannot speak or move because the part of his brain responsible for movement is injured. He was the most seriously ill patient we had. We knew that if we could observe anything in it, it would not be by chance or coincidence. We have chosen this strange situation for ourselves. But in our case, it was liberating. Because before the stimulation he did not respond to a single external stimulus, and then he responded”.

That is, the patient was so severe (as a rule, the medical protocol establishes that after 12 months in persistent vegetative state patients are not expected to improve), that if the stimulation was successful, it could be in any other with a less reserved prognosis.

This innovative method also brings some controversial issues to researchers and to families of patients in persistent vegetative state. One is that, will it be so advantageous for a patient who can never walk, talk, or interact with others recover consciousness? “I cannot answer that question. Personally, I think it is preferable to be aware, even in a bad condition, to have a sense of what is happening. So at least you can make a decision on whether you want to continue this way or if you want…”, Sirigu explained to The Guardian. The other question is exactly what the investigator did not use: euthanasia.

“Many of these patients may have been, and others have even been, neglected, and passive euthanasia often occurs in vegetative states. This article is a warning to everyone who believes that, after one year, this state is irreversible”.

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