I just saw this on 60 minutes and thought it was awesome.
Watch the 60 minutes article:
(Aug 28th 2008)
"(CBS) This segment was originally broadcast on Nov. 25, 2007. It was updated on Aug. 28, 2008....
....What's even more remarkable is that another drug has recently been shown to have similar effects on some minimally conscious people. The case of George Melendez is perhaps the most dramatic of all. George suffered a brain injury when he crashed his car into a pond and nearly drowned. Weeks after the accident doctors told his mother, Pat Flores, her son would never get better.
"What you see lying there in the bed is as good as it gets," Pat remembers of the diagnosis for her son. "That's as good as it gets. He's never gonna be able to do anything. He is a vegetable."
George was in a minimally conscious state, but for years Pat was determined to reach him. She cared for him at home, while searching for new treatments.
Pat believes George was always there, just unable to communicate.
One night in 2002, unable to sleep because of his moaning, Pat gave George Ambien, a common sleeping pill used by millions of people.
"I noticed the room got quiet and in my mind, I'm thinking, 'Wow, that pill's really good. It really knocked him out.' And when I looked over, instead of seeing a sleeping George, I saw a very much awake George with his eyes wide open and just scanning the room and looking," Pat remembers.
For the first time in five years, Pat heard her son speak.
The next day, sensing she was on the verge of a breakthrough, Pat gave George another dose of Ambien through his feeding tube. George's step-father taped the transformation.
Within six minutes, George went from being unresponsive -- moaning and shaking -- to quiet, alert and answering questions.
Asked what kind of questions she asked her son, Pat says, "If he knew where he was at. If he knew what had happened to him. If he was in pain."
George told her he wasn't in pain. "He said no clearly, which that was a big relief," she recalls.
Pat doesn't know why the Ambien works, but she's been giving it to George every day now for the last five years.
60 Minutes helped arrange for George to see Dr. Schiff of Cornell. He performed exams to see if George's reaction to Ambien is real or just his mother’s wishful thinking.
First, Dr. Schiff did a PET scan of George's brain off Ambien. The frontal lobe, the area responsible for behavior and language, was yellow, indicating greatly reduced brain activity.
The next day, after he was given Ambien, George was put back in the scanner. The frontal lobe, seen earlier in yellow, was now bright red.
"So we've just learned something here. Today's scan looks like it's about two or three times as intense, metabolically," Dr. Schiff observed. "That’s like a big deal. His brain is turned on, with this stuff."
Asked if he has seen Ambien work on other patients, Dr. Schiff tells Cooper. "I have. And about a year and a half ago, I would've said, no. … And now, I've seen at least three cases."
"And do you think there are more people out there who could benefit?" Cooper asks.
"I think you're gonna find a subset of patients who respond to it," Schiff says
(CBS) Other Ambien "awakenings" have been reported around the world, and the medical community is taking notice.
There are several clinical trials of Ambien underway, but progress is slow, in part because minimally conscious people are scattered around the country in homes and nursing facilities, often far from research centers.
Another obstacle to treating these people is that they're frequently misdiagnosed -- said to be in a vegetative state, a more severe condition, considered hopeless after the first year.
"There have been some recent studies looking to see what the misdiagnosis rate was and they come up with a number of 40 percent," Dr. Schiff says.
"So the number of patients who are said to be in a vegetative state, who may actually be in a minimally conscious state, could be as high as 40 percent, 20, 30, 40 percent?" Cooper asks.
"In some context," Schiff says.
Why were people misdiagnosed?
Says Schiff, "You have to examine them repeatedly and at different times of the day, and sometimes just changing a patient’s posture, or giving them a tendon massage, may change their level sufficiently to elicit some response. So yeah, this is an evolving area of understanding."
Dr. Adrian Owen, a neuroscientist from the Medical Research Council in Cambridge, England, thinks new technology may help diagnose these people earlier and more accurately than a bedside exam.
Last year, he stunned the scientific world when he discovered that a woman who met the diagnostic criteria for being vegetative could actually respond to a command with her mind. To illustrate his study, Owen did a functional MRI scan of Cooper's brain to show how it activates when he imagines playing tennis.
"Imagine you’re on the center court at Wimbledon hitting that ball left hand, right hand -- forehand, backhand, whatever," Owen instructed.
Within minutes, the computer rendered a three-dimensional image of Cooper's brain.
"This region across here is known as the motor cortex, this area has turned on in response to you imagining moving your arm," Owen observed. "I can show you what happened in our patient who’d been diagnosed as vegetative. The motor cortex is almost in exactly the same place as in your brain, and it activates in almost exactly the same way, when she imagines playing tennis."
"What was that moment like, when you realized, 'Wait a minute. She’s actually responding to what I'm saying. She's in there?'" Cooper asks.
"It was an absolutely stunning moment. Because we had no way of knowing beforehand that not only was she not vegetative, she was entirely consciously aware," Owen says.
"Someone like Terri Schiavo would not have had brain activity that would have shown up in a functional MRI?" Cooper asks.
"No. There are many differences between a patient like Terri Schiavo and the patient that we scanned. The first thing is the type of brain damage," Owen says.
As for George Melendez, Dr. Schiff says he's progressed so much he's no longer minimally conscious, but severely disabled. Pat has increased George's Ambien dosage and is hopeful her son will continue to improve. But she remains a realist.
"I'm not gonna get the old George back. I'm not that naïve and that much in denial, to think that I'm gonna get 100 percent of who George was at one time," Pat says. "But hopefully, it will be a George that will be able to live on his own and have a productive life."
"That's what you want?" Cooper asks.
"Yes," Pat replies.
Asked if she thinks that's very possible, Pat tells Cooper, "It's possible.""
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