Some patients who appear unconscious know what’s going on

livemint.com:

As many 100,000 Americans with severe brain injuries are unresponsive, showing few or no signs that they are aware of themselves or their surroundings. But one in four people with this kind of injury can perform cognitive tasks on command, according to a study published Wednesday in the New England Journal of Medicine. The responses were detected with brain scans that show the patients are conscious but have no motor control.

The findings could influence decisions about whether to continue life support or how caregivers interact with patients who appear unconscious but might be aware of what’s happening around them. “Knowing someone has more capacity for thinking than they appear to have, the family might read to them more or play music," said Yelena G. Bodien, first author of the study and an investigator for the Spaulding-Harvard Traumatic Brain Injury Model Systems and Massachusetts General Hospital’s Center for Neurotechnology and Neurorecovery.

“Nurses might talk to them more or be more likely to turn on the TV to give them some stimulation. A clinician or therapist might be more likely to look for signs of behavior that might go undetected." The precise number of Americans with severe brain injuries who appear unresponsive is uncertain because until recently there was no diagnostic code for the conditions in the International Classification of Diseases system. An estimate based on available data suggests the number is around 100,000, according to Nicholas Schiff, a professor of neurology and neuroscience at Weill Cornell Medicine and the study’s senior corresponding author.