Is there Anybody in There? and Holy Surgical Side Effect

[Antoine]

Those two topics blew my mind:

1-Is there Anybody in There?, by Greg Miller, ScienceNOW, on February 3, 2010:

news.sciencemag.org/sciencenow/2010/02/03-02.html

When a brain injury leaves a person unresponsive and unable to communicate, doctors and nurses must provide care without input from their patient, and families agonize over whether their loved one might still have--or someday recover--a flicker of consciousness. A new study provides hope that technology might open a line of communication with some such patients. Researchers report that a man with a severe brain injury can, by controlling his thoughts, influence scans of his brain activity and thereby answer simple questions.
The work builds on a 2006 Science paper by Adrian Owen, a neuroscientist at the Medical Research Council Cognition and Brain Sciences Unit in Cambridge, U.K., and colleagues. Using functional magnetic resonance imaging (fMRI), they tested a young woman diagnosed as being in a vegetative state following a car accident. Although she was unresponsive and apparently unaware of her surroundings, she exhibited distinct patterns of brain activity when asked to imagine herself playing tennis or walking through the rooms of her house. As in healthy volunteers, imagining tennis activated motor planning regions in the woman's brain, whereas picturing her house activated a brain region involved in recognizing familiar scenes.
In the new study, published today in the New England Journal of Medicine, Owen and several colleagues used similar methods to examine 53 additional people who were in a vegetative state or in the slightly less severe minimally conscious state, in which patients show occasional flashes of responsiveness. In four of these patients, the researchers found distinct patterns of brain activity during the tennis versus house imagination task, hinting at some level of awareness that could not be detected by observing their behavior, says co-author Steven Laureys, a neurologist at the University of Liège in Belgium.
In one patient, a 22-year-old man who'd been in a vegetative state for 5 years, the researchers took an additional step, asking him to answer six questions by imagining tennis to indicate "yes" or picturing his house to indicate "no." The questions all involved basic autobiographical details, such as the name of his father or whether he had any brothers or sisters. In a group of 16 healthy volunteers, this method worked 100% of the time, the researchers report. The vegetative state patient answered the first five questions correctly. The final question elicited virtually no activity in the brain regions of interest, and the researchers speculate that the man may have fallen asleep or simply decided not to answer.
"This is a major step forward," says Nicholas Schiff, a neurologist at Weill Cornell Medical College in New York City. The paper is important because it shows that the Science report was not an isolated case and that technology can be used to establish communication with some patients who show no outward signs of consciousness, Schiff says.
Laureys cautions, however, that the fMRI method is not ready for widespread use in hospitals. He and collaborators are now trying to adapt the imagination task to work with electroencephalography, a relatively low-tech alternative to fMRI that's less expensive and easier to operate. "Our mission now is to translate this to clinical reality," Laureys says.
If such methods do become more widely available, they are sure to raise a host of sticky clinical and ethical questions, says James Bernat, a neurologist at Dartmouth Medical School in Hanover, New Hampshire. For example, doctors would want to involve patients in decisions about their care. But, Bernat asks, would a system that allows only yes or no answers make a physician "confident that all the nuances have been dealt with ... that they're dealing with a rational wish of the person that has been thoughtfully considered?"

2-Holy Surgical Side Effect, by Greg Miller, ScienceNOW, on February 10, 2010:

news.sciencemag.org/sciencenow/2010/02/10-02.html

People of many religious faiths share the belief that there is a reality that transcends their personal experience. Now, a study with brain cancer patients hints at brain regions that may regulate this aspect of spiritual thinking. The researchers found that some patients who had surgery to remove part of the parietal cortex became more prone to "self transcendence."
Scientists have grown increasingly interested in the origins and neural underpinnings of religious faith. Yet, contrary to some overenthusiastic media reports, brain scans of people of various faiths asked to ponder their relationship with God have so far failed to turn up a "God spot," suggesting instead that many regions of the brain are involved.
In the new study, psychologist Cosimo Urgesi of the University of Udine in Italy and colleagues took a different approach, asking 88 brain cancer patients to fill out a widely used personality questionnaire before and after surgery to remove their tumors. One section of the test measures "self transcendence." It asks respondents, for example, about their tendency to become so absorbed in an activity that they lose track of time and place and whether they feel a strong spiritual connection with other people or with nature.
Patients with malignant tumors in posterior brain regions, including the temporal and parietal cortex, scored higher on the self-transcendence scale on average than did those with tumors in the frontal cortex, Urgesi and colleagues reporttoday in Neuron. Moreover, these posterior tumor patients exhibited even higher self-transcendence scores after surgery. Additional analysis suggested that patients who had lost certain areas of the posterior parietal cortex were the most likely to show increases in self-transcendence. The researchers conclude that these regions normally inhibit transcendent thinking and that the damage caused by the tumor and the surgery weakens this inhibition. The researchers saw no postsurgical change in self-transcendence in the patients with frontal lobe tumors or in a group of meningioma patients, whose tumors in the membranes enveloping the brain could be removed without damaging the organ itself.
These posterior parietal brain regions have been implicated in providing awareness of the body's position and location in space, notes Richard Davidson, a neuroscientist at the University of Wisconsin, Madison. Damage to this area may disrupt that sense and make it easier to transcend the reality of the here and now, Davidson suggests.
Uffe Schjødt, a psychologist at Aarhus University in Denmark adds that he and others have found that some of the same regions become active during prayer and meditation. But he says the authors missed a golden opportunity by not conducting more detailed interviews with the patients after their surgeries. "The study does not tell us anything about religiosity, religious practices, or mystical experiences post-surgery, which is a shame."
The study does leave many questions unanswered, but it's an encouraging step nonetheless, says Anjan Chatterjee, a neurologist at the University of Pennsylvania. "Sometimes people are quite skeptical about combining spirituality and religion with neuroscience," he says. "This is one of the few things I've read that gives the hope that some of these questions might be tractable."