Working in Movement

The news media has been saturated with the Terri Schiavo case. Schiavo is the severely brain-damaged Florida women whose feeding tube was removed last week as a result of extensive court cases and appeals. Her husband contends that she expressed a desire to die under dire medical conditions like those of being in a persistent vegetative state; her family contends that she may not be in a vegetative state, shows signs of consciousness and might be rehabilitated somehow. Courts have ruled on the evidence of Schiavo being in the persistent vegetative state, with virtually zero chance of change from that condition.

Media reports on the case haven't usually gone into much depth on the condition. Right to die case highlights brain mysteries supplies a bit more useful information. It makes a distinction between a persistent vegetative state (PVS) and a minimally conscious one (MCS). In PVS, which evidence strongly places Schiavo in:

Some such patients may spontaneously move, cry or smile, but are unable to respond to commands. They are said to be in a persistent vegetative state (PVS). Their chances of recovery are very slim and decline with time. As in Schiavo, this type of profound damage often occurs after a heart attack robs the entire brain of oxygen.

But the MCS state is somewhat different:

Within the past 15 years, however, doctors have recognized a second category of patients, who occasionally respond to commands by, say, moving their eyes or reaching for a glass of water. These people are said to be in a minimally conscious state (MCS). They have generally suffered traumatic injuries that have left parts of their brain intact, and are thought to stand a slightly better chance of some recovery.

One of the interesting things in MCS is brain scans that researchers did as they played audio of loved one's voices.

The patients' brain areas for processing language lit up, the researchers showed, in a very similar way to those in healthy volunteers. By contrast, studies looking at PVS patients suggest that only isolated fragments of brain networks survive

While this sounds interesting and perhaps hopeful, no one knows if the sort of brain activity translates into any kind of feeling or experience for MCS patients.

It's sad that we don't know more about these sorts of conditions. Perhaps if there is at least one bit of optimism in this tragic case, it might be support for more investigation into what's going on in those brains.