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Drug Found to Aid Vegetative Patients

ScuttleMonkey posted more than 8 years ago | from the super-smelling-salts dept.

353

Oxygen99 writes "BBC News is reporting on some amazing effects of a drug called Zolpidem on patients suffering from persistent vegetative state. Apparently the drug, usually used to treat insomnia, activates dormant areas of the brain that can make patients aware of their surroundings and even hold conversations. This raises several interesting points including the diagnosis of PVS and the attendant ethics of the associated life support, as well as the way the brain responds to injury and damage."

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drug... vegetative.. lol... (-1, Troll)

Anonymous Coward | more than 8 years ago | (#15392591)

could it be... cannabis? ;P

in other news (1)

Adolf Hitroll (562418) | more than 8 years ago | (#15392675)

Teri'd have called it a "schiavolution"...

I call mine "Clifford" (-1, Offtopic)

Anonymous Coward | more than 8 years ago | (#15392899)

...because it is huge and red.

Re:I call mine "Clifford" (-1, Flamebait)

Anonymous Coward | more than 8 years ago | (#15393096)

Your asshole?

This could be an amazing discovery! (0, Troll)

onevulcanme (970002) | more than 8 years ago | (#15392592)

This could be a truly amazing discovery that could benefit many people. Just think of all the people who have had their nutrients cut off by their loved ones that could still be alive and functional today if they had access to this drug. It could provide hope for people who have been in comas for short periods of time, or long periods. Also, coming out of a coma is a very slow process and is not a sudden awakening. I wonder if it could help people recover more quickly from a coma? There is also obviously the danger that some people might want to take this drug for cognitive boosting effects which would not be a good thing if it was not highly tested before hand. For every drug that has a great benefit someone will want to use it for something else. Of course this is not always bad, but people need to be very, very cautious and realize that abusing drugs is not worth the risk personally, to someones health, or legally! Obey the law!

Re:This could be an amazing discovery! (0)

Anonymous Coward | more than 8 years ago | (#15392673)

Hey! Quit talking about me that way!

Important distinction (3, Informative)

fsckr (965056) | more than 8 years ago | (#15392692)

PVS is not brain death. The two are completely different and unlike the parent post implied, very few families would consider pulling the switch on a patient's with PVS. Patients with PVS react to pain and other extreme stimuli, so cutting off their nutrient supply is tantamount to starving them to death.
"PVS is also known as cortical death, although it is not the same as coma or brain death."
As opposed to brain death, PVS is not recognized as death in any known legal system.
- wikipedia article

Re:Important distinction (2, Interesting)

Oxygen99 (634999) | more than 8 years ago | (#15392733)

This distinction wasn't considered important in the case of Tony Bland [bbc.co.uk] , a PVS patient who was allowed to die in the UK several years ago. Although it isn't recognised as brain death, in this instance doctors allowed the feeding tubes to be removed, effectively, as you say, starving him to death. In the UK at least, it seems the two are usually equated.

Re:Important distinction (5, Insightful)

SatanicPuppy (611928) | more than 8 years ago | (#15393312)

My mother recently died in a similar manner; she was non-responsive, but not brain dead, and I asked that tubes be removed. She had zero chance of short-term meaningful recovery, and the long term was terminal brain cancer (the survival rate 96% of healthy patients her age was 2-6 months. The other 4% were dead in 10 months). She left very specific instructions regarding this possible eventuality (they included the words "Get Dr. Kervorkian"), so there was little debate from the rest of the family (none from the doctors).

I think you'll find that most patients die of pneumonia brought on by the morphine, and not by starvation. I sat by her bed for 10 days, and I can vouch for the level of comfort provided by the physicians...if her body showed any signs of distress, and we're talking elevated heart rate here, they took steps.

It is only a cruel way to die for the people who have to watch.

Re:Important distinction (0, Redundant)

onevulcanme (970002) | more than 8 years ago | (#15392743)

Do you remember the case of that poor woman in Florida who had her nutrition tube removed and who was slowly starved to death? I think her name was Terri Shrivo. Her parents desperately fought to keep her alive, because she could make sounds, move her limbs, keep solid eye contact on someone, some nurses had signed affidavits that they had secretly fed her jello against the wishes of her husband, and even at times attempted to speak (although it usually was not very clear at all). Despite the fact she was NOT brain dead her husband successfully had the courts order the feeding tube removed and Terri passed away after several days. It was downright horrible and state approved MURDER. Ths drug could have helped her have a normal life, but she did not live long enough to ever have the chance to try it! Following her case many other examples of situations came up where individuals who were NOT brain dead had their feeding tubes removed by family members. It is something that happens more often than most people realize. There are lots of people in nursing homes and many of them are simply not given the chance to live.

Re:Important distinction (5, Interesting)

Viol8 (599362) | more than 8 years ago | (#15392784)

"Her parents desperately fought to keep her alive, because she could make sounds, move her limbs, keep solid eye contact on someone"

So can an ant. It doesn't make them human. If the personality is gone
and theres no sign of intellect all you have left is a base functioning
brain.

"It was downright horrible and state approved MURDER."

In your opinion. Perhaps if you'd been her husband you might have a
different opinion. You sanctamonious types are all mouth. I'd love to see
one of have to see your wife be a vegetable for years or even decades
and see if you still have your arrogant self righteous opinions then.

"Ths drug could have helped her have a normal life, but she did not live long enough to ever have the chance to try it!"

And many people in the middle ages died because they couldn't wait 500
years for anti biotics to be invented. So fscking what?

Re:Important distinction (4, Interesting)

hackstraw (262471) | more than 8 years ago | (#15392964)

And many people in the middle ages died because they couldn't wait 500 years for anti biotics to be invented. So fscking what?

Westerners have an irrational fascination with these new drugs and yes, they do prolong life, but quality of life is most of the time in no way shape or form improved. I've seen family members whose bodies have basically failed, but the doctors have kept them physically alive for another couple of years, for nothing, at the cost of between $10,000-100,000 a piece.

I've been a victim of the FDA approved drug bullshit for almost 20 years, and now that I realize that the drugs made me worse over the years, which has been supported by medical studies, I'm off of the drugs, and at least for now, I'm fine, and I feel healthier than I have in over 20 years since before I started taking these things.

I will give western medicine 4 things. 1) Improved success in living for mothers and children during child birth. 2) Physical repair of broken things like hips and joints. 3) Improved quality and longevity of life because of antibiotics. 4) Immunizations for nasty things.

I'm sure that someone will add to the list, and I did not come up with that list via hard hours of research, its just one I've put together over the past few months of thinking about the stuff.

I was labeled as being mentally ill when I was 18, and have taken between 8-10 different maintenance drugs to help me "manage" my condition. Well, between 6-8 of those drugs are documented for making me worse, which is what I said word for word the last time I saw my doctor. So, he gave me another handful of drugs, that I never took and I threw in the trash. I have altered my diet, and am taking quality (read, not Centrum or anything like that) vitamins, herbs, and supplements, and I'm essentially symptom free, and I have had friends and coworkers comment on how much better I seem.

The drugs that were given to me gave me 1) Chronic diarrhea for over 18 months 2) Headaches 3) Vertigo to the point of almost getting in serious car accidents twice. 4) Depression, anxiety, confusion, and mania (what the drugs were supposed to treat) 5) Obsessive thoughts, usually in the form of a cheesy pop song that I could not get one line out of my head. 5) Daily dry heaves. 6) Paranoia 7) Generally a lower state of cognition and well being.

Oh, and if you think all of those things don't affect your personal and professional life, well, in my case they did.

The trend here is for the pharmaceutical companies to make "maintenance medications", not a cure or something that will drastically increase the speed of recovery and then forgo taking the drug. I strongly recommend that nobody take a drug that is prescribed by a doctor that has no time frame for when you are to stop taking the drug. At least, do plenty of research, and get second and third opinions before taking any maintenance drug.

Another thing to look into, is what you are eating. Most of the food in this country is either void of nutrients or has additives or pollutants in it or comes from unhealthy, uncared for animals. This is for another discussion.

Re:Important distinction (1)

DarkOx (621550) | more than 8 years ago | (#15393213)

You have a good point but we had alread taken steps to keep her alive artifically, and done so knowing she had suffered extensive injury. Maintianing that action constituted inaction, which is always preferable when no pressing need to act exists and its unclear what the results of action might be. Its the cautionary priciple. If you don't understand don't do it. We might have allowed someone who had the hope of recovery to die, when we should have waited and learned more. Treating her for the effects of her injury was already a path we had chosen to go down taking aditional steps to keep her beyond her natrual life would be an entirely new decision process and one where I might be very inclinded to take your view and let her go since she cant chose to be treated.

Re:Important distinction (1, Insightful)

Anonymous Coward | more than 8 years ago | (#15392788)

I have a living will which states I want to be shut off after 2 months unless there is good evidence I will recover over time without severe brain damage.
Trolling though you are , it does raise a few good issues. You should have a look into a few medical papers about PVS and higher brain function , may be an interesting read for you.

Re:Important distinction (2, Interesting)

FidelCatsro (861135) | more than 8 years ago | (#15392812)

Shockingly enough , and this may seem insensitive to say so but it makes a point.
Did anyone ask the patient in question about it.
So if they are brain dead then it is nothing to worry about and simply allowing the family to finally grieve .
If they are not brain dead, then can you imagine being in a PVS , unable to move , do anything for yourself , interact . A veritable life sentence in solitary for the innocent.
To me , letting someone die seems far far less cruel than that.
If there is now medicine which may help some people recover , then that is wonderful but sometimes there is nothing you can do for someone.

Re:Important distinction (2, Insightful)

Richard_at_work (517087) | more than 8 years ago | (#15392826)

How long should they have kept her alive artificially? Until her parents had died? What then? Who makes the decision after that point? She cant afterall die naturally, the doctors could always keep the body functioning well past a normal lifetime, so when should treatment be withdrawn to allow her to die?

Point is, she was being kept alive artificially, she could not communicate and she showed no signs of intelligence. Her brain patterns were nowhere near normal. In these situations, people will believe out of desperation any little grunt or sniffle is an attempt to communicate.

All of the evidence presented by the postmortem showed that the husbands case was proven - she had no brain function to speak of.

Re:Important distinction (1)

vandan (151516) | more than 8 years ago | (#15392848)

Stop spreading trash. All of your points have been refuted many times. Why not deal with the fact that shit happens and people have to pass on? Why spread these lies and religious self-richeous bullshit, when it had nothing to do with you, and all your arguements have been dimissed by doctors, scientists, and courts alike?

Re:Important distinction (0)

Anonymous Coward | more than 8 years ago | (#15392900)

Didn't you know that Christianity has major roots in the fear of death? John 3:16, one of the most famous bible quotes, is about how you never die if you believe. It's really quite interesting from a psychological perspective.

Re:Important distinction (0)

Anonymous Coward | more than 8 years ago | (#15392860)

Her neocortex had dissolved and been replaced with spinal fluid. I guarantee this pill can only activate your brain if in fact you still have one.

Re:Important distinction (0)

Anonymous Coward | more than 8 years ago | (#15392980)

Good lord, I knew this was going to bring you guys out of the woodwork.

"because she could make sounds"
So, sounds have to be proof of conscousness? *rips a loud one* Oops, sorry.

"move her limbs" Your spinal cord can move your limbs. That would be the point of those reflex tests you get as a kid.

"keep solid eye contact on someone" which is particularly amazing, because not only was that part of her brain dead, but _gone_, as proven by the autopsy. Oh, BTW, drugs can't help what isn't there.

As for the nurses? You mean the one that has no record of employment there and the other one that was fired from the place either shortly before or after Mr. Shivo had shown up with the remains of his wife?

Oh, and she wasn't braindead, because that was not her medical condition. She did have some portions of her brain that where still alive, albiet inactive. The overwelming majority, however was dead and replaced by spinal fluid. Mostly dead != all dead.

"Ths drug could have helped her have a normal life." No, the thalamus, hypothalamus, and at least some portion reponcible for at least one sence and at least one set of motor control would have to be active for anything resembling an actual stimulus responce to occur, much less a "normal life."

You also ignore that this had been ongoing for over 14 years and that Mr. Shivo had specifically tried experimental brain stimulation treatments throughout her past.

Not that you care about any of this. You'd probably be parading the same line if the remains of her brain was replaced by oatmeal, so of cource the facts don't matter because that koolaid they offer you tastes so good going down...

Re:Important distinction (3, Informative)

Loquax (921849) | more than 8 years ago | (#15393258)

onevulcanme-- As a Catholic who agrees with your desire to see all life cherished and preserved, I agree with your sentiment, but as a person who values logic, reason and most importantly, the law, I have to point out a few things. First, Mr. Schivo was given guardianship of Terri by a court of law. You and I may disagree with the judges decision, but we have to respect the law. I prayed daily for that Michael would reverse his stance and hand guardianship over to her parents, but in the end, he exercised his rights under our legal system. If you don't approve of that, cool, but in the end, in this case, it was nobody's decision but his that mattered. Second, as a pro-life Christian who also believes that it is wrong to bear false witness against another, I am embarassed and hurt that people chose to villify Michael Schivo. I understand her parents were not happy with him, I understand that emotions (and not reason) guide any parent's wishes for a terminally ill child, but the rest of us should have taken a step back and realized that none of us had any business judging the man. Have whatever opinion you like, but don't judge a man evil or damned in the eyes of God. We as Christians are forbidden to "judge" (in the sted of God) another, nor are we to slander a man. Michael Schivo was accused way after the point by Christians of beating her to death (way beyond what the scientific proof held), of being a money grubber looking to get his hands on her cash, and of being evil. I saw several interviews with Michael Schivo, and I felt (and still feel) that he was a man plauged by a complicated situation who acted out of love for a woman he made a promise to long ago. God only knows what was truly in his heart, and I hope and pray that it was good intent. The more Christian way to have handled this would have been to leave the man alone with his charge, his wife, and pray for him, and later petition our legislatures to assume a pro-life stance of preserving life in questionable situations such as these. It should be assumed that in absense of a living will or final directive that the person wanted to be preserved. I'm sure it would have been a relief to Michael Schivo to know that the decision was out of his hands in the case of questionable desires from Terri. I personally have written out a living will that directs my wife and thoes I love to take specific actions and filed it with a lawyer. I encourage everyone who feels one way or the other about the sanctity of life and the meaning of death to do the same, but for God's sake (litterally) make up your mind about what life and living mean to you and take a stand.

Re:Important distinction (0)

Anonymous Coward | more than 8 years ago | (#15393391)

Yeah, that was pretty funny.

DURRRRHHHH *DROOL*

Hahah, I couldn't stop laughing at those videos the news kept showing. Great stuff.

What is death? (0)

PIPBoy3000 (619296) | more than 8 years ago | (#15393285)

After studying biology for a number of years, I've come to the conclusion that life and death are human-created concepts, sort of like "freedom" or "justice". There's no obvious scientific definition as to what makes this blob of matter alive and this other blob dead.

I'm also a believer that "self" and "other" are equally invalid scientific concepts. Where do "I" end and "you" start if the things you're reading now are actively changing connections in your brain.

What that means is that we should treat life and death as an ethics problem. Science can help identify the how, but it's up to people to decide what should be done.

Re:This could be an amazing discovery! (1, Funny)

Just Some Guy (3352) | more than 8 years ago | (#15392994)

There is also obviously the danger that some people might want to take this drug for cognitive boosting effects which would not be a good thing if it was not highly tested before hand.

Especially since it's "usually used to treat insomnia" (summary). There's not much use for an IQ of 180 if you're asleep.

Great! (5, Funny)

William Robinson (875390) | more than 8 years ago | (#15392594)

Apparently the drug, usually used to treat insomnia, activates dormant areas of the brain that can make patients aware of their surroundings and even hold conversations.

Great!!! Finally they found medicine for my boss!!

FP, BTW?

Re:Great! (-1, Offtopic)

Anonymous Coward | more than 8 years ago | (#15392605)

Sir, from my anthropological observations, tradition begs me to tender the question:
Can this pill fix BSOD's then?

Although it also occurs to one that the phosphor children might also inquire, in the jocular:
Does it run Linux?

Finally my colleagues of oft-observed that in the vein of the frustrated technical support gentleman:
Will this cure my users then?

Respectfully,
Amused of 19th Century England

Re:Great! (0)

Anonymous Coward | more than 8 years ago | (#15392700)

Sir,
Whoever cranked the moderation cantilever to its 'Offtopic' position has a temeric audacity I am assured. I will in good time cast a smite upon thy children and thine children's children.

If I might venture the countanance, you Sir are yourself in need of this pill. Post-haste!

I bid thee good tidings,
Respectfully,
Amused of 19th Century England

Re:Great! (0)

Anonymous Coward | more than 8 years ago | (#15392897)

"Finally my colleagues of oft-observed...."

Oh, of they?

Re:Great! (0)

Anonymous Coward | more than 8 years ago | (#15393055)

Sir,
Once more I am compelled to correct a textual instransigency due to the relative unfamiliarity of myself with this invigorating new medium. This plasticised arrangement of tactile blocks that rests before me is indeed a new contrivance to myself, and perhaps in my haste to register an opinion on this electric fishwife I have belied my unfamiliarity with said contrivance.

I do however have a friend in you Kind Sir, for I see that you too are a proponent of the King's English.

Felicitations upon this fraught sojourn,
Respectfully,
Amused of 19th Century England

Re:Great! (3, Funny)

RsG (809189) | more than 8 years ago | (#15392606)

"Great!!! Finally they found medicine for my boss!!"

Nah, at a guess the drug will only work when the vegatable has a still-functional brain :-P After all, there has to be something to repair, right?

Gaba stuff (4, Interesting)

jimmyhat3939 (931746) | more than 8 years ago | (#15392599)

It's interesting to me that these things seem to always deal with Gaba. Is Gaba the only thing in our brains?

Most anti-anxiety medications work by fooling around with how Gaba is handled in the brain. I can't remember whether they inhibit it or make it more effective. Now here you have this thing saying that people in vegitative states have something wrong with their Gaba receptors.

Maybe someone who understands a little bit about brain chemistry (if such a person even exists) can shed some light on this. For instance, does this finding imply that you could induce a vegitative state in someone by stopping the action of Gaba in their brains, only to "restart" them once they're needed again?

Re:Gaba stuff (2, Funny)

LiquidCoooled (634315) | more than 8 years ago | (#15392645)

I found your hypothosis intruiging, so I went out to try it.

I could not find a simple way to stop the action of the gaba in the brains without physically removing their head (a messy procedure).

I did however find that if you remove the Gaba there is no way to restart the action afterwards.

Re:Gaba stuff (3, Funny)

Mostly a lurker (634878) | more than 8 years ago | (#15392653)

does this finding imply that you could induce a vegitative state in someone ... only to "restart" them once they're needed again?
As most wives will tell you, this is eaily achieved by means of a TV remote control.

Re:Gaba stuff (0)

Anonymous Coward | more than 8 years ago | (#15392657)

GABA is the main excitatory neurotransmitter. Its the ++.

Re:Gaba stuff (3, Informative)

dirtyhippie (259852) | more than 8 years ago | (#15392716)

Neuropsychopharmacology [wikipedia.org] is what you speak of.

GABA is far from the "only thing in our brains". Other neurotransmitters include serotonin (important in depression and hallucinogens), acetylcholine (why people smoke), dopamine (why some drugs are addictive), (nor)?epinephrine, glutamate and aspertate, etc. etc. The descriptions of what these chemicals do, of course, is vastly oversimplified here.

As for what anti-anxiety meds do, they mimic the effect of the naturally occuring GABA neurotransmitter, and have an inhibitory affect on cells with GABA receptors.

You *could* induce a vegitative state in someone by stopping the action of GABA, but it wouldn't exactly be "persistent" - GABA helps control some rather important functions in the brain stem, like breathing and heartbeat - in short, they'd die ;)

Re:Gaba stuff (1, Informative)

Anonymous Coward | more than 8 years ago | (#15392803)

I happen to be a med student but this isn't medical advice. I don't mean to come down on you but you have to be very careful when you analyze the neurological effects of drugs. Your post is mostly correct until the last sentence which is off.

Zolpidem is a potent agonist of GABA A receptors. This means that it causes them to "open" and allow cholride ions in to hyperpolarize the cell membrane. This inhibits the firing of the neuron. Stopping the action of GABA could disrupt the delicate membrane potential balance mediated by a whole host of neurotransmitters.

The intravenous general anesthetic etomidate acts by potentiating GABA(A) receptors although different subunit type than zolpidem. Stopping the action of GABA would not cause someone's brain to shut down in the way the OP is thinking.

Let us doctor types handle the heavy lifting while you guys do your geeky thing. Merely summarizing Wikipedia articles doesn't make you a doctor or pharmD.

Re:Gaba stuff (1)

dirtyhippie (259852) | more than 8 years ago | (#15393030)

> Stopping the action of GABA would not cause someone's brain to shut down in the way the OP is thinking.

I didn't claim it would. Perhaps you missed the part at the end where I said they'd *die* ?

> Let us doctor types handle the heavy lifting while you guys do your geeky thing. Merely summarizing Wikipedia articles doesn't make you a doctor or pharmD.

I hope your healing abilities are better than your psychic abilities (or ability to detect sarcasm).

Re:Gaba stuff (2, Funny)

Just Some Guy (3352) | more than 8 years ago | (#15393017)

glutamate and aspertate

Our brain is umami and sweet at the same time? Maybe zombies are just looking for low-calorie Oriental fare.

Re:Gaba stuff (1)

lbmouse (473316) | more than 8 years ago | (#15393234)

A dirtyhippie explaining "why some drugs are addictive". Go figure.

Explanation (0, Funny)

Anonymous Coward | more than 8 years ago | (#15392620)

Persistent vegetative state: the point at which the brain reaches extremely low levels of activity, with a notable lack of higher order cognitive reasoning, commonly found in those reading slashdot.

Perfect for IT (5, Funny)

s0l3d4d (932623) | more than 8 years ago | (#15392641)

A person in a vegetative state will appear to be awake and may have their eyes open, but will show no awareness of their surroundings.

They will not be able to interact with other people, and will show no responses to sounds or things that happen around them.

But they will show signs of movement, and cycles of sleep and may be able to breathe on their own.


So what would happen if they would start to give these drugs to technical support people and system admins? Would they also start to show responses to their environment, and manage to hold a conversation?

Re:Perfect for IT (0)

Anonymous Coward | more than 8 years ago | (#15392696)

So what would happen if they would start to give these drugs to technical support people and system admins? Would they also start to show responses to their environment, and manage to hold a conversation?

It would probably have the same effect on end users. Perhaps they might listen to support and admins more, and maybe coherently be able to describe the problem they are having.

Ahhhh.... the possibilities!

Re:Perfect for IT (1)

bombadillo (706765) | more than 8 years ago | (#15393040)

They system admins just need a good night's sleep without the pager going off. No drugs are needed but recreational drugs are welcome!

It just has to be said (0)

Anonymous Coward | more than 8 years ago | (#15392647)

Gaba Gaba hey!

Who knew the Ramones lyrics were so deep?

Oblig. Terri Schiavo comment. (0, Troll)

RyuuzakiTetsuya (195424) | more than 8 years ago | (#15392663)

Goddamit.

It's bound to happen.

Did we pull the plug too early? Was her brain already beyond the rescue point? Would this have helped?

Re:Oblig. Terri Schiavo comment. (3, Insightful)

smcavoy (114157) | more than 8 years ago | (#15392720)

the autopsy showed she was a vegetable and not just in a vegetative state.
She died years ago.

Re:Oblig. Terri Schiavo comment. (-1, Troll)

Anonymous Coward | more than 8 years ago | (#15392904)

You mean the autopsy by the "husband's" doctor? The one person who wanted her taken off the feeding tube and would not allow the parent's doctors as observers?

Re:Oblig. Terri Schiavo comment. (1)

pe1rxq (141710) | more than 8 years ago | (#15392993)

Bullshit....

The autopsy was watched closely by a lot of people who would have jumped at any chance to discredit it. They failed. She had no brain worth mentioning left.

Re:Oblig. Terri Schiavo comment. (5, Informative)

pedantic bore (740196) | more than 8 years ago | (#15392729)

Pull the plug too early? Her husband would say "we" waited many years too long...

According to the autopsy [washingtonpost.com] , this drug would have had to have done a lot more than described here. Maybe if they'd given it to her when she first fell into a coma (we'll never know) but by the time she died, her brain was irreperable.

Re:Oblig. Terri Schiavo comment. (4, Informative)

RsG (809189) | more than 8 years ago | (#15392731)

I seem to recall that her autopsy found what was essentially mush where her neocortex would be. I would tend to guess that that kind of damage really is irreparable - but IANANeurologist, so I don't know for sure.

Assuming we could fully repair braindeath (ie, restore the brain when higher functions have been lost), what would remain of the original person? Would we have an adult with infantile brain capabilities, a blank slate? How much of a person's identity is hardcoded? And what are the ethics of the situation - do we revive someone knowing that we'd be making them start over from scratch (and maybe not even that - most of early learning is made possible by infantile brain "plasticity", which an adult brain lacks).

It's not an easy question...

Re:Oblig. Terri Schiavo comment. (1)

KiloByte (825081) | more than 8 years ago | (#15392770)

You would have to grow that person all the brain parts they're missing first.

But of course, we'll have a lawsuit from Terri Schiavo's parents in no more than a few days.

Re:Oblig. Terri Schiavo comment. (1)

RsG (809189) | more than 8 years ago | (#15393039)

Yes, well I did specify that we'd need to be able to reverse braindeath (something this new drug doesn't do). That would mean something like cloning technology or medically created regeneration.

But I was thinking more specifically of the Schiavo case the OP brings up. Assuming we could have restored the parts of her brain that had liquified, would we have done her any good to do so? After all, instead of death, what you're instead giving the person is a sort of brain wipe.

Do we consider a person dead if the human aspect (the conscious mind) is gone? And is giving the braindead a new mind actually healing them, or merely condeming them to an existance of perpetual infancy? Because in the case of Terri Schiavo, even with miracle technology that we don't have yet, those are the only forseeable options.

You cannot expect to restore software when the hard drive has not only crashed and died, but has actually melted, no matter what kind of data recovery you have... and the information kept on a hard drive is more recoverable than the information stored in a human brain. Like I said, the ethics are complicated.

Re:Oblig. Terri Schiavo comment. (2, Informative)

demonlapin (527802) | more than 8 years ago | (#15393308)

Do we consider a person dead if the human aspect (the conscious mind) is gone?

A private service by me to all of Slashdot who doesn't understand:

Brain death is defined legally as cessation of all brain activity, with the caveat that it is not due to a reversible cause. Brain dead people are, simply, legally dead. While we generally leave someone on ventilators and the like for a short period of time after brain death, because families often feel like death is when the heart stops (and they want to be there), there is no legal requirement to do so. Once a diagnosis of brain death is made, I can fill out a death certificate and turn off all the machines.

PVS is not the same; PVS patients have some brainstem activity but no evident higher function.

So, to answer your question, no, we don't. But you probably wouldn't want to live like that.

Re:Oblig. Terri Schiavo comment. (0)

Anonymous Coward | more than 8 years ago | (#15393373)

The plasticity is an interesting question: what makes you think that the neuron used in refurbishing the brain would not be as plastic those in an infant. I think a much more interesting issue would be related to the neuronal pruning that goes on in late adolescence --- if you rebuild the brain would it automagically re-prune? What if it pruned differently -- could you take a musician and tweak them into an accoutant or vice versa?

Re:Oblig. Terri Schiavo comment. (2, Interesting)

RsG (809189) | more than 8 years ago | (#15393447)

I don't know whether that plasticity would return or not. Actually, if we could restore a braindead person, then giving them back all the mental maeliability they had as an infant would probably be trivial. The real pain would be rehab; imagine trying to re-teach everything - absolutely everything - a person learns in their childhood all over again.

As for the pruning thing, that is a very interesting question. I guess we could probably do it if we could pull off all the other miracles we're talking about in getting a braindead person healthy. The problem might be testing it - this is not the sort of thing you can easily test on animals, and the ethical problems with human trials would be a big hurdle.

The funny thing actually is that if we had the techology to cause neurological plasticity and neuron pruning, we'd probably ban it, fear it, or at least put heavy restrictions on it, given the abuses that could come out of it. Can you imagine what a totalitarian government would do with a way "reeducate" dissidents? We've already got people up in arms over GM tech, stem cells and human cloning, and those are all relatively minor by comparison.

Re:Oblig. Terri Schiavo comment. (1)

Lord Kano (13027) | more than 8 years ago | (#15393409)

Assuming we could fully repair braindeath (ie, restore the brain when higher functions have been lost), what would remain of the original person? Would we have an adult with infantile brain capabilities, a blank slate? How much of a person's identity is hardcoded?

Starting over with a blank slate is better than starving to death.

Another question is would this enable a person to feel pain that they wouldn't have otherwise.

LK

Re:Oblig. Terri Schiavo comment. (5, Informative)

clickclickdrone (964164) | more than 8 years ago | (#15392869)

For those that didn't bother to read the medical reports and instead relied on the newspapers/media, Terri's brain had totally atrophied away, it was gone. Her skull contained the brain stem, a bit of shrivelled brain and an awful lot of fluid. There really was no hope, she was long gone.

Re:Oblig. Terri Schiavo comment. (0)

Anonymous Coward | more than 8 years ago | (#15393185)

The woman was in a state of living death. It was an abomination to even keep her alive that long in the first place.

Sign me up! (1)

kjart (941720) | more than 8 years ago | (#15392704)

activates dormant areas of the brain that can make patients aware of their surroundings and even hold conversations

Sounds like something every slashdot reader needs! Now if only there was a drug to make you move out of your parent's basement........

I've always found that... (4, Funny)

Anonymous Coward | more than 8 years ago | (#15392705)

Salad dressing always seems to bring my vegetables to life.

*cue cricket cheeps*

What?

Thank Donald Sutherland and Jane Fonda ... (-1, Troll)

YeeHaW_Jelte (451855) | more than 8 years ago | (#15392712)

... for preventing this invention from being swept under the carpet!

Of Brains and Religion (0, Troll)

TwelveInches (976724) | more than 8 years ago | (#15392740)

Oh boy. If you thought the Catholic Church was angry about the Da Vinci Code, wait until you see how this drug that undoes the veggie-mental-state will annoy them.

Re:Of Brains and Religion (1)

jamesh (87723) | more than 8 years ago | (#15393192)

I think you might be a bit confused. It's the Scientologists that don't want your mental state improved with medication. They want you nice and stupid and gullible.

The Catholics are the ones that don't want you preventing pregnancy (be it masturbation, contraception, or abortion). Queue the Monty Python 'Sperm Song' :)

I don't see they could be angered by a drug which may (if the research is correct) result in less cases of pulling the plug on someone.

But maybe I missed your point...

One Big Problem (-1, Troll)

Jah-Wren Ryel (80510) | more than 8 years ago | (#15392751)

BBC News is reporting on some amazing effects of a drug called Zolpidem on patients suffering from persistent vegetative state.

Unfortunately, Zolpidem is made of 100% pure, 1st generation, fetal stem cells.
Leaving the Schiavo advocates with a huge dilemma!

Yoffi! (-1, Flamebait)

Hemi Rodner (570284) | more than 8 years ago | (#15392752)

Poor Ariel Sharon really needs that thingie. It sucks when he's asleep because they can't make satires of him.

just kill me (5, Interesting)

m874t232 (973431) | more than 8 years ago | (#15392762)

If my brain has been damaged so much that I can only be roused to awareness of my surroundings by a drug that artificially and temporarily activates bits and pieces of my brain, I just want to die quickly and painlessly. As far as I'm concerned, the biggest crime against me would be to keep me alive.

Re:just kill me (2, Insightful)

aadvancedGIR (959466) | more than 8 years ago | (#15392793)

I really agree, beside dignity issues, there truly are states worse than death. Too bad most doctors consider one more day of agony a great victory.

Re:just kill me (4, Insightful)

Itchy Rich (818896) | more than 8 years ago | (#15392832)

If my brain has been damaged so much that I can only be roused to awareness of my surroundings by a drug that artificially and temporarily activates bits and pieces of my brain, I just want to die quickly and painlessly. As far as I'm concerned, the biggest crime against me would be to keep me alive.

You say that now, but if it were to actually happen to you I very much doubt that you'd rather die than be dependent on that drug.

It's like all the people that say they'd rather die young, and can't stand the thought of growing old. When it actually happens to you and you're faced with the prospect of death you'll change your mind pretty fast.

Re:just kill me (2, Funny)

FlopEJoe (784551) | more than 8 years ago | (#15392916)

If my brain has been damaged so much that I can only be roused to awareness of my surroundings by a drug that artificially and temporarily activates bits and pieces of my brain...

Eh? Sounds like my morning coffee after a night too much cheer! (not to make light of folks with real mental distress)

Re:just kill me (2, Insightful)

MBGMorden (803437) | more than 8 years ago | (#15393338)

That's nice to know. Be sure to tell them that on your first awakening so that they can carry our your wishes afterwards.

That fact bears nothing on the usefulness of this drug though, as it's the lone opinion of yourself. Others may (and probably do) share that viewpoint, while still others will not. There are plenty of people who very much would like this, and as such it's a worthy pursuit.

Re:just kill me (1)

ChrisMaple (607946) | more than 8 years ago | (#15393448)

Your opinion is self-contradictory. The drug would allow you to control yourself for a brief period, probably even commit suicide if that's what you wanted. You would have an improved chance to reach a state where the drug would not be required. Without the drug, you would be at the mercy of those taking care of you, with nothing but your "living will" document to protect you.

Where's.... (1)

Misch (158807) | more than 8 years ago | (#15392794)

Where's Robin Williams and Robert De Niro [imdb.com] when you need a movie made?

Re:Where's.... (1)

arivanov (12034) | more than 8 years ago | (#15393233)

Unless I am mistaken Awakenings was based on real series of medical cases. In fact there was a documentary preceding the movie.

Terri Shivo (-1, Troll)

Edward Teach (11577) | more than 8 years ago | (#15392804)

Well, guess that whole "starve her to death" thing was a bit premature...

Re:Terri Shivo (1)

Hao Wu (652581) | more than 8 years ago | (#15392816)

But it was for 'the greater, common good....'

Re:Terri Shivo (4, Insightful)

vandan (151516) | more than 8 years ago | (#15392831)

No. Terry's cerebral cortex had completely disintegrated. There was nothing to re-activate. No amount of praying or injecting or stimulating her could have changed the fact that her brain was simply no longer capable of higher-level thoughts, as the part responsible for such thought had 'turned to jelly'.

Re:Terri Shivo (-1, Flamebait)

Anonymous Coward | more than 8 years ago | (#15392961)

According to who? Oh, right, the people who ordered her killed. What do you know, the people directly responsible for her death determined their actions were justified. Amazing. Too bad they wouldn't allow her parents' doctors to examine her.

Even so, it's still wrong, because the only reason Mr. Shiavo wanted her dead was to be able to inherit her money and belongings. Otherwise he could simply have divorced her and moved on with his life.

Her parents wanted to see their daughter live. Her husband wanted her money. I suppose it comes as no surprise that the courts chose to go with money over life.

Re:Terri Shivo (1)

Welsh Dwarf (743630) | more than 8 years ago | (#15393085)

This is the second thread on this, give it a break ok?

Mr Shiavo had already spent years keeping her alive, and paying for her treatement, when he could have just 'divorced and moved on' as you say. Also, the autopsy was performed by several doctors (not just one), and was overseen by people on both sides of the agenda, the point is that there was no brain left, and hadn't been for years.

Re:Terri Shivo (2, Informative)

jonnythan (79727) | more than 8 years ago | (#15393304)

No, according to the autopsy [wikipedia.org] .

The brain itself weighed 615 g, only half the weight expected for a female of her age, height, and weight. Microscopic examination revealed extensive damage to nearly all brain regions, including the cerebral cortex, the thalami, the basal ganglia, the hippocampus, the cerebellum, and the midbrain. The neuropathologic changes in her brain were precisely of the type seen in patients who enter a PVS following cardiac arrest. Throughout the cerebral cortex, the large pyramidal neurons that comprise some 70 percent of cortical cells--critical to the functioning of the cortex--were completely lost.

The damage was, in the words of Thogmartin, "irreversible, and no amount of therapy or treatment would have regenerated the massive loss of neurons."

Starving... (2, Insightful)

electrosoccertux (874415) | more than 8 years ago | (#15392955)

If she was dead, why not use a faster means of death? Like lethal injection or something. We wouldn't cruelly starve an animal to death. I think that would have been too quick; would have looked too much like murder (as if starving her were any better). It's odd that the painful of treatements was the more socially acceptable.

Re:Starving... (1)

JamesP (688957) | more than 8 years ago | (#15393086)

Because the same people who opposed the "killing" of Terri Schiavo (all in name of God, blah, blah, blah) are in fact torturers and would never allow Terri to be respectfully put to rest.

Re:Starving... (0)

Anonymous Coward | more than 8 years ago | (#15393157)

I recall reading that she'd be sedated before dehydration set in.

Society prevents me from killing myself, but I am permitted to refuse vital medical treatment even though the result will be the same. It's the usual religious crap that holds accepting the brutality of nature as being somehow more moral than upholding the liberty of a thinking being. (Pope John Paul II actually argued in favor of suffering.)

Re:Starving... (1)

RsG (809189) | more than 8 years ago | (#15393217)

Sociey doesn't prevent you from killing yourself - it only treats you the same way it treats anyone else found ODing or bleeding to death, or whatever. It's just that medical proffesionals aren't instruced by law or common practice to treat possible suicide cases any differently. Technically suicide is legal in most places, though assisted suicide is another matter.

As for refusing medical treatment, that depends on the circumstances. You'll note that, for example, people in mental hospitals can't refuse to take their meds. If you're bleeding on the sidewalk, I don't think the paramedics are going to listen to you if you tell them to stop trying to treat your wounds.

I'm not disagreeing with you, but I think you misunderstand why we as a society try and save people from suicide attempts, and allow people to refuse things like chemo.

Troll, please do not feed (1)

ianscot (591483) | more than 8 years ago | (#15393098)

We've modded that "insightful"? A post that shows no signs of knowing thing one about the Schiavo case?

but... (2, Funny)

Shivetya (243324) | more than 8 years ago | (#15392813)

does it work on managers?

Disappointing article... (0)

Anonymous Coward | more than 8 years ago | (#15392818)

What a disappointing BBC article. I never enjoy reading news sites attempt to dumb-down research for masses because mistakes are made in the process. Maybe this is so because I happen to be in medical school but I'm sure other post-grads can relate when it comes to their respective fields.

Zolpidem is Ambien. The research (according to the BBC) is suggesting that Zolpidem alters the conformation of GABA A receptors in the "dormant" regions of the brain allowing some level or patient arousal. I just placed an order with the hospital library for the article so I should have it on my desk in a few hours if its available. Until then I'm going to cringe while I watch my fellow geeks attempt to hold a discussion about something they have no idea about. Oh wait, this is Slashdot (I almost forgot)...

Cool, but... (4, Insightful)

MWoody (222806) | more than 8 years ago | (#15392821)

This is great news, and fascinating from a technical standpoint. But I cringe to think of the unfortunate side effect of something like this: think of the countless grieving families who, on the advice of their doctors, pulled the plug. Particularly those who did so recently. Imagine the horror to imagine that this drug could have brought their loved ones back.

I'm not saying that the decision not to perpetuate the incurably brain dead is the wrong one, nor am I placing blame on the medical community in any way. But you can't expect laypeople to understand the difference, really, and the pain of not knowing if the decision was the right one... Of constantly wondering, down where logic doesn't really help, if there was a chance...

Re:Cool, but... (2, Interesting)

RsG (809189) | more than 8 years ago | (#15393175)

Well, to point out the obvious, long term PVS leads to degradation of the brain. In the Schiavo case that's being brought up in this thread, what remained of her brain had severly atropied, and much of the higher brain centers had been replaced with spinal fluid.

If someone's family memeber were brain dead, then waiting for a miracle cure might not be an option. After all, if it takes ten years for even a partial cure to become available, then that's ten years in which the afflicted is slipping further and further away. This sort of drug might help someone who gets hit by a car tommorow, but it probably won't do much good for someone who got hit by one years ago and has been dead to the world since.

Exciting... but unproven. (3, Insightful)

Puls4r (724907) | more than 8 years ago | (#15392829)

Aside from the obvious issues here of a very minimal sample size, it sounds like some doubts have been raised as to the accuracy of the original diagnosis of persistent vegetative state (PVS).

We understand very little of what causes a person to shutdown and go into PVS. As such, it is EXTREMELY hard to truly diagnosis and pinpoint what is going on. Normally, we wait. If they wake up, it wasn't PVS.

This is like a myriad of other diseases like SIDS that are vaguely defined. Many more incidents are attributed to the issue than are actually caused because we simply don't understand it.

Hyperactivity disorders in children are another perfect example of a rather subjective diagnosis leading to over-prescription and misunderstanding. All that said, hopefully another set of trials over a wider base of patients proves some hope. (insert the obligatory Robin Williams "awakenings" quote here).

I have plenty of Karma (-1, Troll)

The Ape With No Name (213531) | more than 8 years ago | (#15392841)

This article is a troll. It is nothing more than a troll. All this is going to do is result in some ugly flame war between the Right-Wing Americans (and the usual slashdot trolls) and Left-wing Americans (and the usual slashdot trolls). Why bother posting this dreck? Oh, yeah. Lots and lots of page views and advert $$$$. VA and OSDN! w000000t!

Re:I have plenty of Karma (1)

Random Destruction (866027) | more than 8 years ago | (#15392919)

You're right. Won't the BBC please think of the Americans?

Re:I have plenty of Karma (1)

The Ape With No Name (213531) | more than 8 years ago | (#15392950)

Slashdot article, Mr $uid > 500000.

Re:I have plenty of Karma (1)

tehcyder (746570) | more than 8 years ago | (#15393307)

Left-wing Americans
I think you miss-spelled "slightly-less-right-wing".

birth school work death (1)

digitaldc (879047) | more than 8 years ago | (#15392854)

...that can make patients aware of their surroundings and even hold conversations

It could be argued that this could not only help those in a vegetative state, but our society in general. ;)

It's not news yet (5, Insightful)

hey! (33014) | more than 8 years ago | (#15392855)

until it's been replicated and the results published in a peer reviewed neurology journal.

Over the years there have been miraculous cures for diseases that didn't pan out because they couldn't be replicated. Reasons for this might be: the study patients weren't really cured, the study patients improved, but didn't have the disease in question, scientific fraud, simple chance. This is the kind of result that has to be looked at skeptically, because if it were true, it would be true it would mean the bulk of what we think we know about the brain and its function is wrong.

It's possible, of course. Such possibilities are part of what makes science and exciting pursuit. It's also possible that the authors didn't do their study correctly. It's your choice as to what is most likely. If I had to bet, it would be the study population was not selected properly (i.e. they were in a coma, but not a PVS).

I checked out the journal in question. It is peer reviewed, but it is not a neuroscience journal per se. It is an interdisciplinary for various disciplines involved around rehab of brain damage patients. Although it's perfectly erspectable to publish in such a journal, the article would have a lot more initial credibility if it had been published in a journal specializing in basic neuroscience research. It would have to convince reviewers who would be forced by the publication to admit that they hold some significant misconceptions. It's a tough standard of truth, and it slows the spread of Truth (if you will), but it slows the spread of Error more.

If this is a legitimate result, the publication activity will be, to borrow a metaphor from Shaw, like the first pea in a handful of peas thrown at a wall: first one hits, then a couple, then a whole mass of them. Afterwards, the state of science will have changed in a fundamental way.

All right! (0)

Anonymous Coward | more than 8 years ago | (#15392874)

Hopefully they will make Awakenings Part 2!

What simple questions? (2, Funny)

suparjerk (784861) | more than 8 years ago | (#15392875)

It'd be cool to know exactly what "simple questions" were asked and what their responses were. My definition of a "simple question" might differ from theirs. Even if they had asked /complex/ questions, that doesn't necessarily mean the answer was correct or even intelligible.

Researcher: Hi there, can you see me? Patient: FFOOOOOOOOOMDE!

Sure, they interacted with the researcher and they answered a simple question. Their response could even arguably be considered a word, perhaps poorly pronounced, but... I fear the article leads this discovery to sound more amazing than it actually might be.

Re:What simple questions? (3, Interesting)

Tx (96709) | more than 8 years ago | (#15392928)

I was wondering the same thing. Like did "catch a basketball" mean a basketball thrown from across the room with the patient standing up, or dropped into his arms from a couple of inches with him sitting down. It's the usual frustrating lack of detail we get with mainstream media reporting of science issues. I understand they want to keep it simple, but make it too simple, and the report becomes almost meaningless.

NOOOO!!!! TERRYYYYYYYYYY!!!!!!!!!! (0, Flamebait)

modmans2ndcoming (929661) | more than 8 years ago | (#15392903)

She could have been saved!!!!!!!!

ok, I know she had no brain left due to the extent of time she was in a PVS, but early on in her diagnosis, this might have benefited her..... thank god this did not come out while the controversy was going.
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