What is it like to be vegetative or minimally conscious?
OBJECTIVE
Patients in a vegetative or minimally conscious state continue to pose problems in terms of diagnosis, prognosis and treatment. Despite recent waves of international media attention following Terri Schiavo's death and the 'miracle recovery' of Terry Wallis, research efforts aimed at increasing our knowledge about brain function in these conditions remain scarce and must address a series of difficulties, including financial and ethical barriers. Here we review current possibilities and limitations of clinical and para-clinical assessment of chronic disorders of consciousness.


RESULTS
During the past year the field has witnessed publication of significant, yet isolated, case reports in top-ranking journals, including Science and Nature. Such milestone reports and other impressive recent technological advances in the study of vegetative and minimally conscious patients reveal enthralling areas of science that must find their way to clinical medical reality.


CONCLUSIONS
Consciousness is a subjective experience whose study has remained within the purview of philosophy for millennia. That has finally changed, and empirical evidence from functional neuroimaging offers a genuine glimpse at a solution to the infamous mind-body conundrum. New technological and scientific advances offer the neurological community unique ways to improve our understanding and management of vegetative and minimally conscious patients.
Laureys
Steven
S
Coma Science Group, Cyclotron Research Centre and Neurology Department, University of Liège, Liège, Belgium. steven.laureys@ulg.ac.be
Boly
Melanie
M
D001921:Brain / Q000033:anatomy & histology / Q000473:pathology / Q000503:physiopathology*; D003243:Consciousness / Q000502:physiology*; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000639:trends; D006801:Humans; D008134:Long-Term Care / Q000941:ethics; D010146:Pain / Q000175:diagnosis / Q000503:physiopathology; D018458:Persistent Vegetative State / Q000175:diagnosis* / Q000503:physiopathology*; D020127:Recovery of Function / Q000502:physiology