Twenty years ago groundbreaking research showed that a woman in a vegetative state was actually conscious – and since then these findings have been repeated in many more patients.
Yet in the past two decades progress in treating individuals occupying this twilight zone of wakefulness without obvious awareness has remained slow.
“I think this is one of the most difficult areas of clinical medicine that exists today, for lots of reasons,” says Prof Nicholas Schiff, a neurologist at Weill Cornell Medicine, the medical school of Cornell University in New York.
“Personally I think one of the reasons is that it makes people very uncomfortable, because we haven’t yet shown very clearly how to help people who are in this condition.”
But could brain-computer interfaces, which translate a person’s thoughts into an output in a computer, change all this?
In the coming years patients could, says Prof Schiff, be “put into a situation where they’re able to have their intentions of mind and thought read directly from neuronal activity”.
Work by Prof Adrian Owen, professor of cognitive neuroscience at Western University in Canada, has been pivotal in helping to improve the understanding of people in a vegetative state.
Breakthrough discovery
In 1997, while a research fellow at the University of Cambridge in the UK, Prof Owen began using scanners to analyse the brains of patients.
When shown pictures of friends and family, Kate Bainbridge, a patient at Addenbrooke’s Hospital in Cambridge who was in a vegetative state at the time, showed activity in the fusiform gyrus, part of the brain linked to facial recognition.
“I was really excited about this – the fact you had a patient who was completely non-responsive but her brain was activating to familiar faces,” Prof Owen says.
“It really blew my mind. I thought, ‘What does it mean?’ Is she really there or is her brain on some kind of autopilot where it can recognise faces? It initiated this fascination in this question of whether any of these patients were more than they appeared to be.”
Each time a suitable patient came into Addenbrooke’s Hospital, which is the major trauma centre for the east of England, Prof Owen would carry out tests – and many patients showed brain activity in response to speech or faces.
After seeing several dozen individuals, Prof Owen and his colleagues sought to confirm that the patients were actually conscious.
“Rather than being something automatic, it had to be something that came from the will of the person,” he said.
In work carried out two decades ago using functional magnetic resonance imaging scans, the brain of a vegetative state patient lit up in one region when she was asked to imagine playing tennis, and in another region when she was asked to pretend that she was walking around her home.
The results tallied with findings from healthy volunteers, indicating that the patient could understand and act upon the instructions she had been given.
“It’s fascinating that 20 years later, imagining playing tennis is still the gold standard,” says Prof Owen, who is the author of the book Into the Grey Zone: A Neuroscientist Explores the Border Between Life and Death.
“We’ve done it in different ways and so have other people, but no one has improved on it. It still seems to be the most straightforward way of determining if someone is aware or not.”
A 2024 paper, whose authors include Prof Schiff and Prof Owen, analysed findings from 353 patients to confirm earlier results that about a quarter of people regarded as being in a vegetative state are actually aware.
Someone may end up in a vegetative state for a variety of reasons, such as a stroke, a cardiac arrest − which can cause a loss of oxygen to the brain − or asphyxiation, perhaps from a swimming pool accident, from being buried under snow in an avalanche or from a failed hanging attempt.
Being in a vegetative state is not the same as being brain dead, because, as the UK’s National Health Service notes, with the vegetative state the brain stem is functioning and the person usually breathes unaided. While awake, people in a vegetative state typically cannot interact with their surroundings.
The brain imaging work, however, opened up the possibility of having interactions with those 25 per cent or so of patients who show awareness: they might be asked to think of playing tennis to answer yes to a question, or to think of walking round their home to answer no.
A lifeline for loved ones
The realisation that some of patients may actually be conscious has been, Prof Owen says, “amazing” for their relatives.
“It’s really changed the way families treat patients. You can see that every day,” he says. “Because these patients are largely inanimate and don’t really do anything, I think there was a time when they were treated more like objects than people.
“But they much more get treated like people now, certainly by the families that we interact with.”
While families may treat vegetative state patients differently, and nurses may, Prof Owen says, talk to them as if they are conscious, medical care has not moved on significantly.
Tests, such as the one about playing tennis versus walking round the house, have yet to be standardised so that they can be used routinely by clinicians to find out which patients are conscious.
Turning to technology
Key to further progress could be brain-computer interfaces, which allow the brain to communicate directly with an external device.
While a decade ago these might have let a person to control a mouse over a keyboard, today they can enable a patient to talk just by thinking in a certain way.
Prof Schiff, the senior author of the 2024 study, describes the field as being “just pre-tipping point”.
“For the last 10 years it’s been obvious to me that we have tools to try, in the form of brain-computer interface technologies, that could work in some people,” he says.
“We’re trying to partner with people to do that, trying to get the resources to do that. It’s going to be complicated, it’s probably going to fail a lot and it’s going to be costly.”
He predicts that, five years from now, some vegetative state patients will have been able to express themselves through a brain-computer interface, providing testimony that could spur further progress.
“They will be able to advocate for others who are not yet able to do that,” he says. “It may take more than one or two people. It may take a while. This takes a long time for people to get their minds around. This is not an easy space to navigate.”
Just as this area of medicine may be poised for a breakthrough in clinical practice, the original work led by Prof Owen continues to captivate observers.
“There’s interest in making a movie now, which is quite exciting,” Prof Owen says. “There is a script being circulated and financing in place, so I think a movie will appear in the next couple of years, which is quite exciting.
“It’s such a fascinating story – a fascinating science story, but I think the fact people continue to be interested in it shows it’s a really interesting human-interest story as well.”
Test
Director: S Sashikanth
Cast: Nayanthara, Siddharth, Meera Jasmine, R Madhavan
Star rating: 2/5
How to volunteer
The UAE volunteers campaign can be reached at www.volunteers.ae , or by calling 800-VOLAE (80086523), or emailing info@volunteers.ae.
How to help
Send “thenational” to the following numbers or call the hotline on: 0502955999
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Boulder shooting victims
• Denny Strong, 20
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• Rikki Olds, 25
• Tralona Bartkowiak, 49
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• Teri Leiker, 51
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THE BIO
Born: Mukalla, Yemen, 1979
Education: UAE University, Al Ain
Family: Married with two daughters: Asayel, 7, and Sara, 6
Favourite piece of music: Horse Dance by Naseer Shamma
Favourite book: Science and geology
Favourite place to travel to: Washington DC
Best advice you’ve ever been given: If you have a dream, you have to believe it, then you will see it.
UAE%20v%20West%20Indies
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COMPANY PROFILE
Name: Kumulus Water
Started: 2021
Founders: Iheb Triki and Mohamed Ali Abid
Based: Tunisia
Sector: Water technology
Number of staff: 22
Investment raised: $4 million
Saudi Cup race day
Schedule in UAE time
5pm: Mohamed Yousuf Naghi Motors Cup (Turf), 5.35pm: 1351 Cup (T), 6.10pm: Longines Turf Handicap (T), 6.45pm: Obaiya Arabian Classic for Purebred Arabians (Dirt), 7.30pm: Jockey Club Handicap (D), 8.10pm: Samba Saudi Derby (D), 8.50pm: Saudia Sprint (D), 9.40pm: Saudi Cup (D)
MATCH INFO
FA Cup fifth round
Chelsea v Manchester United, Monday, 11.30pm (UAE), BeIN Sports
Electric scooters: some rules to remember
- Riders must be 14-years-old or over
- Wear a protective helmet
- Park the electric scooter in designated parking lots (if any)
- Do not leave electric scooter in locations that obstruct traffic or pedestrians
- Solo riders only, no passengers allowed
- Do not drive outside designated lanes
Trippier bio
Date of birth September 19, 1990
Place of birth Bury, United Kingdom
Age 26
Height 1.74 metres
Nationality England
Position Right-back
Foot Right
Company%20Profile
%3Cp%3E%3Cstrong%3EName%3A%20%3C%2Fstrong%3EDirect%20Debit%20System%3Cbr%3E%3Cstrong%3EStarted%3A%3C%2Fstrong%3E%20Sept%202017%3Cbr%3E%3Cstrong%3EBased%3A%3C%2Fstrong%3E%20UAE%20with%20a%20subsidiary%20in%20the%20UK%3Cbr%3E%3Cstrong%3EIndustry%3A%3C%2Fstrong%3E%20FinTech%3Cbr%3E%3Cstrong%3EFunding%3A%3C%2Fstrong%3E%20Undisclosed%3Cbr%3E%3Cstrong%3EInvestors%3A%3C%2Fstrong%3E%20Elaine%20Jones%3Cbr%3E%3Cstrong%3ENumber%20of%20employees%3A%3C%2Fstrong%3E%208%3Cbr%3E%3C%2Fp%3E%0A
MATCH INFO
What: 2006 World Cup quarter-final
When: July 1
Where: Gelsenkirchen Stadium, Gelsenkirchen, Germany
Result:
England 0 Portugal 0
(Portugal win 3-1 on penalties)
More on Quran memorisation:
Killing of Qassem Suleimani
Mohammed bin Zayed Majlis
Tomb%20Raider%20I%E2%80%93III%20Remastered
%3Cp%3EDeveloper%3A%20Aspyr%0D%3Cbr%3EPublisher%3A%20Aspyr%0D%3Cbr%3EConsole%3A%20Nintendo%20Switch%2C%20PlayStation%204%26amp%3B5%2C%20PC%20and%20Xbox%20series%20X%2FS%0D%3Cbr%3ERating%3A%203%2F5%3C%2Fp%3E%0A
Learn more about Qasr Al Hosn
In 2013, The National's History Project went beyond the walls to see what life was like living in Abu Dhabi's fabled fort:
The low down on MPS
What is myofascial pain syndrome?
Myofascial pain syndrome refers to pain and inflammation in the body’s soft tissue. MPS is a chronic condition that affects the fascia (connective tissue that covers the muscles, which develops knots, also known as trigger points).
What are trigger points?
Trigger points are irritable knots in the soft tissue that covers muscle tissue. Through injury or overuse, muscle fibres contract as a reactive and protective measure, creating tension in the form of hard and, palpable nodules. Overuse and sustained posture are the main culprits in developing trigger points.
What is myofascial or trigger-point release?
Releasing these nodules requires a hands-on technique that involves applying gentle sustained pressure to release muscular shortness and tightness. This eliminates restrictions in connective tissue in orderto restore motion and alleviate pain. Therapy balls have proven effective at causing enough commotion in the tissue, prompting the release of these hard knots.
From Zero
Artist: Linkin Park
Label: Warner Records
Number of tracks: 11
Rating: 4/5
Skewed figures
In the village of Mevagissey in southwest England the housing stock has doubled in the last century while the number of residents is half the historic high. The village's Neighbourhood Development Plan states that 26% of homes are holiday retreats. Prices are high, averaging around £300,000, £50,000 more than the Cornish average of £250,000. The local average wage is £15,458.
The Voice of Hind Rajab
Starring: Saja Kilani, Clara Khoury, Motaz Malhees
Director: Kaouther Ben Hania
Rating: 4/5
2020 Oscars winners: in numbers
- Parasite – 4
- 1917– 3
- Ford v Ferrari – 2
- Joker – 2
- Once Upon a Time ... in Hollywood – 2
- American Factory – 1
- Bombshell – 1
- Hair Love – 1
- Jojo Rabbit – 1
- Judy – 1
- Little Women – 1
- Learning to Skateboard in a Warzone (If You're a Girl) – 1
- Marriage Story – 1
- Rocketman – 1
- The Neighbors' Window – 1
- Toy Story 4 – 1
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Mohammed bin Zayed Majlis
Museum of the Future in numbers
- 78 metres is the height of the museum
- 30,000 square metres is its total area
- 17,000 square metres is the length of the stainless steel facade
- 14 kilometres is the length of LED lights used on the facade
- 1,024 individual pieces make up the exterior
- 7 floors in all, with one for administrative offices
- 2,400 diagonally intersecting steel members frame the torus shape
- 100 species of trees and plants dot the gardens
- Dh145 is the price of a ticket
Simran
Director Hansal Mehta
Stars: Kangana Ranaut, Soham Shah, Esha Tiwari Pandey
Three stars
If you go
The flights
There are various ways of getting to the southern Serengeti in Tanzania from the UAE. The exact route and airstrip depends on your overall trip itinerary and which camp you’re staying at.
Flydubai flies direct from Dubai to Kilimanjaro International Airport from Dh1,350 return, including taxes; this can be followed by a short flight from Kilimanjaro to the Serengeti with Coastal Aviation from about US$700 (Dh2,500) return, including taxes. Kenya Airways, Emirates and Etihad offer flights via Nairobi or Dar es Salaam.
Our family matters legal consultant
Name: Hassan Mohsen Elhais
Position: legal consultant with Al Rowaad Advocates and Legal Consultants.
BACK%20TO%20ALEXANDRIA
%3Cp%3E%3Cstrong%3EDirector%3A%20%3C%2Fstrong%3ETamer%20Ruggli%3C%2Fp%3E%0A%3Cp%3E%3Cstrong%3EStarring%3A%20%3C%2Fstrong%3ENadine%20Labaki%2C%20Fanny%20Ardant%3C%2Fp%3E%0A%3Cp%3E%3Cstrong%3ERating%3A%20%3C%2Fstrong%3E3.5%2F5%3C%2Fp%3E%0A
'The Batman'
Stars:Robert Pattinson
Director:Matt Reeves
Rating: 5/5
Pathaan
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When Umm Kulthum performed in Abu Dhabi
Known as The Lady of Arabic Song, Umm Kulthum performed in Abu Dhabi on November 28, 1971, as part of celebrations for the fifth anniversary of the accession of Sheikh Zayed bin Sultan Al Nahyan as Ruler of Abu Dhabi. A concert hall was constructed for the event on land that is now Al Nahyan Stadium, behind Al Wahda Mall. The audience were treated to many of Kulthum's most well-known songs as part of the sold-out show, including Aghadan Alqak and Enta Omri.
Volvo ES90 Specs
Engine: Electric single motor (96kW), twin motor (106kW) and twin motor performance (106kW)
Power: 333hp, 449hp, 680hp
Torque: 480Nm, 670Nm, 870Nm
On sale: Later in 2025 or early 2026, depending on region
Price: Exact regional pricing TBA
Specs
Engine: 51.5kW electric motor
Range: 400km
Power: 134bhp
Torque: 175Nm
Price: From Dh98,800
Available: Now
The specs
- Engine: 3.9-litre twin-turbo V8
- Power: 640hp
- Torque: 760nm
- On sale: 2026
- Price: Not announced yet
2025 Fifa Club World Cup groups
Group A: Palmeiras, Porto, Al Ahly, Inter Miami.
Group B: Paris Saint-Germain, Atletico Madrid, Botafogo, Seattle.
Group C: Bayern Munich, Auckland City, Boca Juniors, Benfica.
Group D: Flamengo, ES Tunis, Chelsea, (Leon banned).
Group E: River Plate, Urawa, Monterrey, Inter Milan.
Group F: Fluminense, Borussia Dortmund, Ulsan, Mamelodi Sundowns.
Group G: Manchester City, Wydad, Al Ain, Juventus.
Group H: Real Madrid, Al Hilal, Pachuca, Salzburg.
The specs
Engine: 1.5-litre turbo
Power: 181hp
Torque: 230Nm
Transmission: 6-speed automatic
Starting price: Dh79,000
On sale: Now
The%20specs
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Sheer grandeur
The Owo building is 14 storeys high, seven of which are below ground, with the 30,000 square feet of amenities located subterranean, including a 16-seat private cinema, seven lounges, a gym, games room, treatment suites and bicycle storage.
A clear distinction between the residences and the Raffles hotel with the amenities operated separately.
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UAE currency: the story behind the money in your pockets
Without Remorse
Directed by: Stefano Sollima
Starring: Michael B Jordan
4/5
The specs
Engine: Direct injection 4-cylinder 1.4-litre
Power: 150hp
Torque: 250Nm
Price: From Dh139,000
On sale: Now
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BMW M5 specs
Engine: 4.4-litre twin-turbo V-8 petrol enging with additional electric motor
Power: 727hp
Torque: 1,000Nm
Transmission: 8-speed auto
Fuel consumption: 10.6L/100km
On sale: Now
Price: From Dh650,000
