Brain Scans Show Some Unresponsive Patients May Be Aware

A recent study has unveiled that a significant number of patients with severe brain injuries may possess a form of awareness despite appearing unresponsive. Researchers conducted tests on 241 patients, discovering that approximately 25% exhibited signs of “cognitive motor dissociation,” meaning they could mentally perform tasks like responding to their name or following commands, even if they did not physically react. This phenomenon, also referred to as “covert awareness,” raises critical questions about the assessment methods used for unresponsive patients. Dr. Nicholas Schiff, a neurologist at Weill Cornell Medicine and co-author of the study, emphasized the implications of these findings, noting that the mental tasks were challenging enough that even some patients who had regained physical responses struggled with them. The study suggests that covert awareness may be more prevalent than previously estimated, with earlier research indicating only 10%-20% of unresponsive patients might experience it. This revelation is concerning for clinicians, as many patients may be capable of responding to their environment but lack the appropriate means to do so. Dr. David Greer, chair of the neurology department at Boston University, acknowledged a limitation in the study due to the varied nature of the patients' injuries. He cautioned that while some patients may be conscious, it does not guarantee a return to normalcy, which could mislead families into harboring false hopes. The study highlights the urgent need for improved assessment techniques and a reevaluation of how care is provided to these patients, as many may still face severe disabilities despite their hidden awareness.