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title: Brain Imaging Technique Can Predict If Vegetative Patients Can Recover
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# Study: New Technique Predicts Consciousness of Brain-Damaged Patients

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<!-- video src="https://cdn.jwplayer.com/manifests/qIFFbiCm.m3u8" -->
## Video: PET Scans Could Help Predict Brain Injury Recovery

[Watch (HLS stream): PET Scans Could Help Predict Brain Injury Recovery](https://cdn.jwplayer.com/manifests/qIFFbiCm.m3u8) (2:01)

![PET Scans Could Help Predict Brain Injury Recovery](https://cdn.jwplayer.com/v2/media/qIFFbiCm/poster.jpg?width=720)

_Published 2014-04-16. Researchers found that brain scans using PET technology were able to point out hidden levels of consciousness in one-third of patients who had been diagnosed as in a vegetative state for more than a year._


by 

[Alexandra Sifferlin](https://time.com/author/alexandra-sifferlin/)


## Alexandra Sifferlin


Apr 15, 2014 10:58 PM UTC

Researchers found that brain scans using PET technology were able to point out hidden levels of consciousness in one-third of patients who had been diagnosed as in a vegetative state for more than a year. 

by 

[Alexandra Sifferlin](https://time.com/author/alexandra-sifferlin/)


## Alexandra Sifferlin


Apr 15, 2014 10:58 PM UTC

End-of-life questions are complicated by the uncertainty of whether a patient in a deep vegetative state will ever regain consciousness or recover, and doctors have been baffled by patients who they thought were all but dead coming back to life after an extended period of unconsciousness.

For those cases where patients do seem to wake from the dead, it’s most likely that they were in a minimally conscious state, where there is some awareness or response to stimuli. Such patients have a better chance of recovery than those in a vegetative state, where there are no signs of awareness or response to stimuli.

Diagnosing consciousness is tricky; oftentimes brain activity can be observed, but that doesn’t necessarily translate into consciousness on the part of the patient. The most well-known and standard test for determining awareness is the Coma Recovery Scale-Revised (CSR-R), a behavioral test. Now researchers have discovered that a particular type of brain imaging, positron emission tomography, may be able to determine which vegetative patients will recover.

In a study out Tuesday, scientists looked at 126 patients who had experienced severe brain damage. Researchers from the University of Liége in Belgium tested whether using PET with the imaging agent fluorodeoxyglucose (FDG) or another imaging technique called functional MRI (fMRI) could distinguish between a vegetative and a minimally conscious state.

Overall, the FDG-PET combination was better than the fMRI method at distinguishing between the two states. FDG-PET was also 74% accurate at predicting recovery within the next year. Additionally, 12 of the patients in the study group who showed some brain activity on the FDG-PET scan were diagnosed by the CSR-R method as behaviorally unresponsive, but 9 of them later recovered some consciousness.


“We confirm that a small but substantial proportion of behaviourally unresponsive patients retain brain activity compatible with awareness,” says study leader Professor Steven Laureys from the University of Liége in Belgium.

But diagnosing consciousness through brain imaging is far from an exact science. It’s often unclear how to interpret brain activity. In 2011, researchers from the University of Western Ontario reported that they had successfully used an electroencephalogram (EEG) to record brain signals that suggested awareness in patients in a vegetative state. However, when a team of scientists from Weill Cornell Medical College [tried to replicate their data](http://healthland.time.com/2013/01/25/researchers-question-study-documenting-awareness-of-patients-in-vegetative-state/) a few years later, they discovered that the original researchers didn’t account for false-positives. When they went back over the data, accounting for interfering factors like muscle activity and EEG blips, they were unable to replicate the results.


What the study does indicate, though, is that PET may be needed for confirmation of consciousness. “Our findings suggest that PET imaging can reveal cognitive processes that aren’t visible through traditional bedside tests, and could substantially complement standard behavioural assessments to identify unresponsive or ‘vegetative’ patients who have the potential for long-term recovery,” Laureys said in a statement.


## Transcript

Family members with a loved one, coming out of a coma may soon have a much better shot at telling if the patient's aware, or has any shot at ever fully waking up. A new study says PET scans, could help doctors find answers to those difficult questions. Researchers found that brain scans using PET technology, were able to point out hidden levels of consciousness, in nearly one third of patients who had been diagnosed as in a vegetative state for over a year. During the 4 year long study, Doctors, examined 41 patients who had severe brain damage, and were classified as being in a persistent vegetative state.

Which, according to the American Brain Foundation, means an individual is unconscious and unaware of his or her surroundings, and stays in a vegetative state for more than a month. People who are in this state for more than a year, are typically thought to have little to no chance of recovering. But, the researchers found that of the 41 patients who were thought to be in a vegetative state, a PET scan found that 13 had some level of awareness. And, as The Guardian notes, out of those 13, nine regained consciousness within the year, three died of other causes, and one remained in a vegetative state.

If these scans are as accurate as they seem, the way doctors treat patients in a vegetative state, could change significantly. The study's lead author said in a news release, the research suggests that PET scans, can detect neurological processes, that aren't visible through traditional bedside tests. And an expert who wasn't involved in the study told the New York Times, this type of testing could help doctors unravel the more puzzling cases. They may be borderline, and this could be the tiebreaker, and help you discriminate who's who. The first thing we owe these people is a credible diagnosis.

Other scientists argue this kind of brain imaging, is expensive and difficult as of right now. But they say the price and the difficulty, will most likely go down in the future. The study was published in the journal The Lancet Tuesday. Thanks for watching. I'm Cliff Judy.

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