PopTech : Blog : Adrian Owen’s quest for consciousness

Adrian Owen’s quest for consciousness

Kiley Lambert ( Bio / Posts ) | Saturday, October 23, 2010 UTC

Imagine you were entirely conscious but unable to move — your eyes could be open, you might twitch, but the movements would be completely involuntary. In short, you would be just as conscious as you are right now but totally incapable of communication. What would you give for someone to figure out that you were, indeed, fully awake?

Neuroscientist Adrian Owen has dedicated his career to determining consciousness in vegetative patients. Since 1997, he has used brain-scanning techniques and, most recently, functional magnetic resonance imaging, to measure brain activity.

“We have a logical problem here,” he told the PopTech audience Saturday evening. “If a patient was conscious but incapable of generating responses, which is the hallmark of vegetative state, we would logically have no way of knowing if that person was conscious.”

Since command following is the most effective means of determining consciousness, Owen devised a rather simple experiment – he would have patients imagine performing physical activities upon command. “When you imagine things, the same areas of brain will activate as if you were actually doing that thing,” he said. “The point is to get this person to think about…initiating movement. When you ask someone to relax, the brain activity disappears.”

In 2006, Owen and his team had a rather improbable breakthrough. Using functional magnetic resonance imaging, they were going to measure brain activity in a vegetative patient. “We had a young woman who had been in a road traffic accident and was entirely vegetative for five months,” he said. “She was the very first patient we tried this technique on. We asked her to imagine playing tennis. And she activated the same area of her brain as a healthy volunteer despite outwardly showing no signs of being conscious. When we asked her to relax, the activity disappeared.”

Owen’s team then had her imagine moving from room to room in her house. “She activated all three regions of the brain we would expect in a healthy person. On this basis, we determined she wasn’t vegetative at all. She was command following.”

They went on to follow other patients. Over the course of the next few years, they tested 23 patients. 17% of them were determined to be entirely conscious.

“The question now is can we hone this tech to actually communicate with these individuals?” he said. “Can we turn this into a rudimentary language?”

Owen’s work has really just begun and he shared a story that exemplifies why he does what he does. In 1997, Owen and his team were studying a young woman who for all appearances had been vegetative for months.

“We put her in the scanner and we really had no idea what we were doing. We showed her photographs of her family and her brain lit up like a Christmas tree. We didn’t know if we could interpret that as consciousness or not but we knew something was happening," he said. “She eventually came out of it and even though she’s severely disabled she still emails us regularly.

”Not too long ago, there was a question of whether to continue using yes/no questions with patients. She sent us an email saying that one time a physiotherapist had been asking her why she was making so much noise. She wanted to explain to him that she was screaming in severe pain and if it had been possible to ask her a yes/no question, she could have told him.”

(Photos: Kris Krüg)

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