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Chances are you wouldn't have trouble reciting the Pledge Of Allegiance, but recently, a team of doctors stared transfixed as a 38-year-old man said the first 16 words of the pledge. That's because he had spent years in a minimally conscious state, unable to speak or interact with the world.
Well, that changed, as NPR's Nell Boyce reports, after doctors implanted electrodes in his brain.
NELL BOYCE: The man's mother didn't want to give her name, but in a press conference today she explained what happened eight years ago to her son.
Unidentified Woman: He was robbed. He was beaten. He was kicked about in his head. His skull was completely crushed in.
BOYCE: He had emergency surgery and then his mother met with a doctor.
Unidentified Woman: He said - I'm going to tell you this, he said. If your son pulls out of this, he will be a vegetable the rest of his life.
BOYCE: The doctor wasn't quite right. Her son did not end up in what's called a persistent vegetative state - that means no signs that a person is aware of their surroundings; no responses to the outside world. Instead, her son was minimally conscious. He sometimes seemed like he was trying to communicate. He might nod his head or mouth a word. But mostly, he barely moved and kept his eyes closed. He spent years like this.
Unidentified Woman: And each time I visited my son in the nursing home, and on my way home - excuse me - I would cry, because it was just so hard for a mother to see her child like that, and I prayed for a miracle.
BOYCE: Then, she was contacted by a team of doctors. They wanted to test a new treatment. It's a device sort of like a pacemaker.
Joseph Giacino works at the JFK Johnson Rehabilitation Institute in New Jersey. He says the device has a box that goes in the chest and wires that go to the brain.
Dr. JOSEPH GIACINO (Associate Director of Neuropsychology, JFK Johnson Rehabilitation Institute): And at the end of those wires are the electrodes. And it's the electrode tips that are implanted in specific brain structures.
BOYCE: In this case, the thalamus. It's known to play a role in sleep and wakefulness. The scientists hope that by prodding it, they could boost the activity of other parts of the brain. Giacino says they did the surgery over a year ago.
Dr. GIACINO: We immediately saw some changes, this was within, literally, within the first day.
BOYCE: The man's eyes opened. He would turn his head to look at people who were speaking. Now, he can drink from a cup and chew so he doesn't need a feeding tube. What's more, he talks. If you ask him to complete sentences like, I eat my dinner with a, he'll say, fork. He remembers things, like the Pledge of Allegiance. But Giacino says he can't seem to form new memories.
Dr. GIACINO: What he has learned is that he's in a hospital. He knows that. But he - if you ask him why, he just sort of, you know, shrugs his shoulders or he'll say, I don't know.
BOYCE: His mother is overwhelmed by these changes.
Unidentified Woman: He can express pain, he can cry, and he can laugh. The most important part is he can say mommy and pop. He can say I love you, mommy.
BOYCE: The researchers say the man's progress is encouraging, but they're not jumping to any conclusions.
Dr. GIACINO: For this particular person, they were improved by this, and that's great. But we don't know until we do the research whether anybody else will improve.
BOYCE: Nicholas Schiff was part of the research team. He works at the Weill Cornell Medical College in New York. He hopes this case report in the journal Nature will help convince skeptics that people in minimally conscious states are treatable.
Dr. NICHOLAS SCHIFF (Physician, Weill Cornell Medical College): You can't continue to make the blanket argument that this is just never going to work and there's no evidence to support even doing the research.
BOYCE: Schiff says his study is continuing. The researchers hope to try the implants on about a dozen more people.
Gregory O'Shanick is impressed by the result so far. He's medical director of the Brain Injury Association of America. One thing he liked is how the researchers first used advanced brain scans to confirm that their subject had hidden but functioning brain pathways.
Dr. GREGORY O'SHANICK (National Medical Director, Brain Injury Association of America): Those were almost like the screening test to see if this was going to work. And with that kind of precision, it had incredible results.
BOYCE: Researchers say that kind of hidden brain activity doesn't exist in people in persistent vegetative states, so this approach would not be expected to help them. For example, a similar brain implant did not help Terry Schiavo, the Florida woman whose condition sparked a national debate two years ago.
Nell Boyce, NPR News.
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