Brain scans used to read minds of intensive care patients

By Clare Wilson

When a person sustains a severe brain injury that leaves them unable to communicate, their families and doctors often have to make life-or-death decisions about their care for them. Now brain scanners are being tested in intensive care to see if mind-reading can enable some patients to have their say, New Scientist can reveal.

At the moment, doctors ask the families of people who have a poor prognosis and cannot communicate if they think their relative would want to continue life-sustaining treatments such as being on a ventilator. “Life would be so much easier if you could just ask the person,” says Adrian Owen at the University of Western Ontario in Canada.

Owen’s team previously developed a brain-scanning approach for a much smaller group of people – those in states between consciousness and being in a coma, for example those in a vegetative state. Such people show few signs of awareness and have to be fed through a tube.

Owen found that some of these people can direct their thoughts in response to instructions, which can be picked up on brain scans. If someone is asked to imagine playing tennis, for instance, the part of their brain involved in movement lights up in the scan.

This has let his and other teams ask those who are able to respond in this way yes/no questions, which can give people a say over their living conditions. About a fifth of people the technique is tried on can respond.

Owen is now using the same technique on people who are in intensive care in the first few days after sustaining a severe brain injury. In such circumstances, just over a quarter of people end up having their treatment withdrawn due to a poor prognosis.

For example, in some cases doctors may predict that if the person survives, they would be paralysed and unable to speak. “A decision will typically be made in the first 10 days about whether to go on or pull the plug,” says Owen.

His team has so far used brain scanning on about 20 such people in intensive care to try to communicate with them. Owen won’t yet reveal how many responded to questions, nor whether he asked them if they wanted to live or die.

But he says he has also made progress in developing a new brain imaging technique. The original method uses fMRI machines. To use them the person has to be taken to a separate room and put inside a scanner, and their tubes and equipment have to be changed to allow this to happen. “It’s really challenging and dangerous,” says Owen.

The new approach uses functional near-infrared spectroscopy, which can be done at the bedside and requires only a headset. Although the method visualises only a small part of the brain, this is enough to let someone answer a yes/no question by imagining playing tennis to give the answer “yes”.

In a paper published last week, Owen’s team showed this allowed volunteers without brain injury to accurately answer questions three-quarters of the time (Frontiers in Neuroscience, The team has also used it successfully to speak to people with a condition that causes complete paralysis (see “Temporarily locked in”, below).

As well as conveying information about a person’s wishes, bedside mind-reading may also be useful for shedding light on their prognosis. Among people in a vegetative state, those who can respond to instructions in a brain scanner are more likely to recover, says Owen.

Continued treatment

He believes the technique is more likely to lead to ventilator treatment being continued than stopped. “Negative findings are hard to interpret,” he says. “Positive findings are easier.”

“This is potentially exciting but I wouldn’t want people to get their hopes up because this might only be applicable to a very small group of people,” says Paul Dean of the UK’s Intensive Care Society.

If doctors are able to communicate with people in this way, they would have to be confident the patient had the legal mental capacity to make life or death decisions, says Jenny Kitzinger at Cardiff University, UK. “Have they understood the question, have they understood the diagnosis?”

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Goats reveal their feelings with the sound of distinctive bleats

By Clare Wilson

“Maaah.” Goat calls might all sound the same to us, but the animals seem to recognise when one of their herd-mates is happy or sad from their bleats alone.

When goats hear a series of calls that change in emotional tone, they look towards the source of the sound – and their heart-rate readings indicate the animals’ own emotions are swayed by the noises.

Luigi Baciadonna of Queen Mary University of London and colleagues recorded goats bleating in different emotional states to see how they are affected by hearing each other’s calls.

To elicit positive sounds, they recorded goats that could see someone approaching with a bucket of food. To get negative ones they let an animal see another being fed while not getting any food themselves, or kept one in isolation for five minutes. “This was not extreme distress – I don’t think most people could tell the difference in their calls,” says Baciadonna.

Bleats with meaning
Then, to a different goat, the team played a bleat every 20 seconds, with nine positive ones followed by three negative or vice versa. At the start, the animal looked towards the source of the sound, but this tailed off as it got used to it. When the switch between emotional bleats happened, the goat was more likely to look again – but only with the second call of the batch of three. “There’s a bit of a delay in spotting the difference,” says Baciadonna.

The team also tried to see how the goats hearing the recordings felt, by measuring the variation in time between each heartbeat. In people, a high value for this is linked with more positive mood, while low values correlate with feeling depressed or stressed. Sure enough, when goats heard the happy bleats, their heart-rate variability was higher than when they heard the sad ones.

“I don’t doubt any of this,” says David Harwood, senior vice-president of the UK’s Goat Veterinary Society. “Goat owners are always telling us how intelligent their animals are.”

Journal reference: Frontiers in Zoology , DOI: 10.1186/s12983-019-0323-z

Mystery of what sleep does to our brains may finally be solved

By Clare Wilson

It is one of life’s great enigmas: why do we sleep? Now we have the best evidence yet of what sleep is for – allowing housekeeping processes to take place that stop our brains becoming overloaded with new memories.

All animals studied so far have been found to sleep, but the reason for their slumber has eluded us. When lab rats are deprived of sleep, they die within a month, and when people go for a few days without sleeping, they start to hallucinate and may have epileptic seizures.

One idea is that sleep helps us consolidate new memories, as people do better in tests if they get a chance to sleep after learning. We know that, while awake, fresh memories are recorded by reinforcing connections between brain cells, but the memory processes that take place while we sleep have remained unclear.

Support is growing for a theory that sleep evolved so that connections in the brain can be pruned down during slumber, making room for fresh memories to form the next day. “Sleep is the price we pay for learning,” says Giulio Tononi of the University of Wisconsin-Madison, who developed the idea.

Now we have the most direct evidence yet that he’s right. Tononi’s team measured the size of these connections or synapses in brain slices taken from mice. The synapses in samples taken at the end of a period of sleep were 18 per cent smaller than those in samples taken from before sleep, showing that the synapses between neurons are weakened during slumber.

A good night’s sleep

Tononi announced these findings at the Federation of European Neuroscience Societies meeting in Copenhagen, Denmark, last week. “The data was very solid and well documented,” says Maiken Nedergaard of the University of Rochester, who attended the conference.

“It’s an extremely elegant idea,” says Vladyslav Vyazovskiy of the University of Oxford

If the housekeeping theory is right, it would explain why, when we miss a night’s sleep, the next day we find it harder to concentrate and learn new information – we may have less capacity to encode new experiences. The finding suggests that, as well as it being important to get a good night’s sleep after learning something, we should also try to sleep well the night before.

It could also explain why, if our sleep is interrupted, we feel less refreshed the next day. There is some indirect evidence that deep, slow-wave sleep is best for pruning back synapses, and it takes time for our brains to reach this level of unconsciousness.

Waking refreshed

Previous evidence has also supported the housekeeping theory. For instance, EEG recordings show that the human brain is less electrically responsive at the start of the day – after a good night’s sleep – than at the end, suggesting that the connections may be weaker. And in rats, the levels of a molecule called the AMPA receptor – which is involved in the functioning of synapses – are lower at the start of their wake periods.

The latest brain-slice findings that synapses get smaller is the most direct evidence yet that the housekeeping theory is right, says Vyazovskiy. “Structural evidence is very important,” he says. “That’s much less affected by other confounding factors.”

Protecting what matters

Getting this data was a Herculean task, says Tononi. They collected tiny chunks of brain tissue, sliced it into ultrathin sections and used these to create 3D models of the brain tissue to identify the synapses. As there were nearly 7000 synapses, it took seven researchers four years.

The team did not know which mouse was which until last month, says Tononi, when they broke the identification code, and found their theory stood up.

“People had been working for years to count these things. You start having stress about whether it’s really possible for all these synapses to start getting fatter and then thin again,” says Tononi.

The team also discovered that some synapses seem to be protected – the biggest fifth stayed the same size. It’s as if the brain is preserving its most important memories, says Tononi. “You keep what matters.”