New research suggests that a third of patients diagnosed as vegetative may be conscious with a chance for recovery

Imagine being confined to a bed, diagnosed as “vegetative“—the doctors think you’re completely unresponsive and unaware, but they’re wrong. As many as one-third of vegetative patients are misdiagnosed, according to a new study in The Lancet. Using brain imaging techniques, researchers found signs of minimal consciousness in 13 of 42 patients who were considered vegetative. “The consequences are huge,” lead author Dr. Steven Laureys, of the Coma Science Group at the Université de Liège, tells Maclean’s. “These patients have emotions; they may feel pain; studies have shown they have a better outcome [than vegetative patients]. Distinguishing between unconscious, and a little bit conscious, is very important.”

Detecting human consciousness following brain injury remains exceedingly difficult. Vegetative patients are typically diagnosed by a bedside clinical exam, and remain “neglected” in the health care system, Laureys says. Once diagnosed, “they might not be [re-examined] for years. Nobody questions whether or not there could be something more going on.” That’s about to change.

Laureys has collaborated previously with British neuroscientist Adrian Owen, based at Western University in London, Ont., who holds the Canada Excellence Research Chair in Cognitive Neuroscience and Imaging. (Owen’s work was featured in Maclean’s in October 2013.) Together they co-authored a now-famous paper in the journal Science, in 2006, in which a 23-year-old vegetative patient was instructed to either imagine playing tennis, or moving around her house. Using functional magnetic resonance imaging, or fMRI, they saw that the patient was activating two different parts of her brain, just like healthy volunteers did. Laureys and Owen also worked together on a 2010 follow-up study, in the New England Journal of Medicine, where the same technique was used to ask a patient to answer “yes” or “no” to various questions, presenting the stunning possibility that some vegetative patients might be able to communicate.

In the new Lancet paper, Laureys used two functional brain imaging techniques, fMRI and positron emission tomography (PET), to examine 126 patients with severe brain injury: 41 of them vegetative, four locked-in (a rare condition in which patients are fully conscious and aware, yet completely paralyzed from head-to-toe), and another 81 who were minimally conscious. After finding that 13 of 42 vegetative patients showed brain activity indicating minimal consciousness, they re-examined them a year later. By then, nine of the 13 had improved, and progressed into a minimally conscious state or higher.

The mounting evidence that some vegetative patients are conscious, even minimally so, carries ethical and legal implications. Just last year, Canada’s Supreme Court ruled that doctors couldn’t unilaterally pull the plug on Hassan Rasouli, a man in a vegetative state. This work raises the possibility that one day, some patients may be able to communicate through some kind of brain-machine interface, and maybe even weigh in on their own medical treatment. For now, doctors could make better use of functional brain imaging tests to diagnose these patients, Laureys believes. Kate Bainbridge, who was one of the first vegetative patients examined by Owen, was given a scan that showed her brain lighting up in response to images of her family. Her health later improved. “I can’t say how lucky I was to have the scan,” she said in an email to Maclean’s last year. “[It] really scares me to think what would have happened if I hadn’t had it.”

https://ca.news.yahoo.com/one-third-of-vegetative-patients-may-be-conscious–study-195412300.html

New research shows that elephants know how dangerous people are from how they speak

When an elephant killed a Maasai woman collecting firewood near Kenya’s Amboseli National Park in 2007, a group of young Maasai men retaliated by spearing one of the animals.

“It wasn’t the one that had killed the woman, says Graeme Shannon, a behavioral ecologist at Colorado State University, in Fort Collins. “It was just the first elephant they encountered—a young bull on the edge of a swamp.”

The Maasai spiked him with spears and, their anger spent, returned home. Later, the animal died from his wounds.

Elephants experience those kinds of killings sporadically. Yet the attacks happen often enough that the tuskers have learned that the Maasai—and Maasai men in particular—are dangerous.

The elephants in the Amboseli region are so aware of this that they can even distinguish between Ma, the language of the Maasai, and other languages, says a team of researchers, who report their findings today in the Proceedings of the National Academy of Sciences.

The results add to “our growing knowledge of the discriminatory abilities of the elephant mind, and how elephants make decisions and see their world,” says Joyce Poole, an elephant expert with ElephantVoices in Masai Mara, Kenya.

Indeed, previous studies have shown that the Amboseli elephants can tell the cattle-herding, red-robed Maasai apart from their agricultural and more blandly dressed neighbors, the Kamba people, simply by scent and the color of their dress.

The elephants know too that walking through villages on weekends is dangerous, as is crop raiding during the full moon.

They’re equally aware of their other key predator, lions, and from their roars, know how many lions are in a pride and if a male lion (the bigger threat because he can bring down an elephant calf) is present.

And they know exactly how to respond to lions roaring nearby: run them off with a charge.

Intriguingly, when the Amboseli elephants encounter a red cloth, such as those worn by the Maasai, they also react aggressively. But they employ a different tactic when they catch the scent of a Maasai man: They run away. Smelling the scent of a Kamba man, however, troubles them far less.

“They have very clear behavioral responses in all of these situations,” says Karen McComb, a behavioral ecologist at the University of Sussex, in the United Kingdom. “We wondered if they would react differently to different human voices.”

To find out, she and her colleagues played recordings to elephant families of Maasai and Kamba men, as well as Maasai women and boys, speaking a simple phrase in their language: “Look, look over there, a group of elephants is coming.”

Over a two-year period, they carried out 142 such playbacks with 47 elephant families, each time playing a different human voice through a concealed speaker placed 50 meters (164 feet) from the animals. They video-recorded the elephants’ reactions to the various human voices, including a Maasai man’s voice they altered to sound like a woman’s.

As soon as an elephant family heard an adult Maasai man speak, the matriarch didn’t hesitate, the researchers say. “She instantly retreats,” Shannon says. “But it’s a silent retreat. They sometimes make a low rumble, and may smell for him, too, but they’re already leaving, and bunching up into a defensive formation. It’s a very different response to when they hear lions.”

In contrast, the voices of Kamba men didn’t cause nearly as strong a defensive reaction: The elephants didn’t consider the Kamba a serious threat.

“That subtle discrimination is easy for us to do, but then we speak human language,” says Richard Byrne, a cognitive biologist at the University of St. Andrews, in Scotland. “It’s interesting that elephants can also detect the characteristic differences between the languages.”

The Amboseli elephants were also sufficiently tuned in to the Maasai language that they could tell women’s and boys’ voices from men’s, seldom turning tail in response. “Maasai women and boys don’t kill elephants,” Shannon points out. Nor were the elephants tricked by the man’s altered voice; when they heard it, they left at once.

“The elephants’ decision-making is very precise,” McComb says, “and it illustrates how they’ve adapted where they can to coexist with us. They’d rather run away than tangle with a human predator.”

Why, one wonders, don’t elephants retreat when poachers descend on them?

“Unfortunately, there are going to be things they cannot adapt to, things such as humans’ ability to come after them with automatic weapons or mass poisonings,” McComb says. “And in those situations, we have to protect them—or we will lose them, ultimately.”

http://news.nationalgeographic.com/news/2014/03/140310-elephants-amboseli-national-park-kenya-maasai-kamba-lions-science/?google_editors_picks=true

Thanks to Da Brayn for bringing this to the It’s Interesting community.