Brain Imaging

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Removing Part of Skull Makes for Better Brain Scans

By Tia Ghose Removing a chunk of the skull can make way for stronger, clearer signals from a common method of monitoring brainwaves. The skull-free electroencephalography could make neural prostheses like bionic arms or eyes less invasive. “It’s notoriously hard to have a long-term electrode implanted in the brain,” said University of California at Berkeley neuroscientist Bradley Voytek, lead author of the study to be published in a forthcoming issue of the Journal of Cognitive Neuroscience. So if you can get around that by just having a small hole drilled into the skull, that would be very helpful.” Doctors sometimes treat patients who have suffered severe head trauma, such as gunshot or knife wounds, with what is known as a hemicraniectomy. A surgeon cuts out a chunk of skull that’s the diameter of an orange or grapefruit, to give the brain room to swell. Surgeons usually reattach the piece of bone four to six months later, once the swelling has subsided and the skin has healed. In the meantime, the patient’s scalp and a helmet protect the exposed area. And doctors stitch the skull fragment into the abdomen, “bathed in the body’s own fluids,” to prevent it from deteriorating, Voytek said. Voytek’s team took advantage of this brief window of time to compare EEG signals from people with and without the skull as a barrier. Patients performed simple tasks like squeezing a person’s hand or listening to an “oddball stimulus” of three low-pitched sounds followed by a higher one, he said. Wired.com © 2009 Condé Nast Digital.

Conditional Consciousness: Predicting Recovery from the Vegetative State

By Katherine Harmon In patients who have survived severe brain damage, judging the level of actual awareness has proved a difficult process. And the prognosis can sometimes mean the difference between life and death. New research suggests that some vegetative patients are capable of simple learning—a sign of consciousness in many who had failed other traditional cognitive tests. To determine whether patients are in a minimally conscious state (in which there is some evidence of perception or intentional movement) or have sunk into a vegetative state (in which neither exists), doctors have traditionally used a battery of tests and observations. Many of them require some subjective interpretation, such as deciding whether a patient’s movements are purposeful or just random. “We want to have an objective way of knowing whether the other person has consciousness or not,” says Mariano Sigman, who directs the Integrative Neuroscience Laboratory at the University of Buenos Aires. That desire stems in part from surprising neuroimaging work that showed that some vegetative patients, when asked to imagine performing physical tasks such as playing tennis, still had activity in premotor areas of their brains. In others, verbal cues sparked language sectors. A recent study found that about 40 percent of vegetative state diagnoses are incorrect. To explore possible tests of consciousness in patients, Sigman and his colleagues turned to classical conditioning: they sounded a tone and then sent a light puff of air to the patient’s eye. The air puff would cause a patient to blink or flinch the eye, but after repeated trials over half an hour, many patients would begin to anticipate the puff, blinking an eye after only hearing the tone. © 1996-2009 Scientific American Inc.

Trawling the brain

By Laura Sanders The 18-inch-long Atlantic salmon lay perfectly still for its brain scan. Emotional pictures —a triumphant young girl just out of a somersault, a distressed waiter who had just dropped a plate — flashed in front of the fish as a scientist read the standard instruction script aloud. The hulking machine clunked and whirred, capturing minute changes in the salmon’s brain as it assessed the images. Millions of data points capturing the fluctuations in brain activity streamed into a powerful computer, which performed herculean number crunching, sorting out which data to pay attention to and which to ignore. By the end of the experiment, neuroscientist Craig Bennett and his colleagues at Dartmouth College could clearly discern in the scan of the salmon’s brain a beautiful, red-hot area of activity that lit up during emotional scenes. An Atlantic salmon that responded to human emotions would have been an astounding discovery, guaranteeing publication in a top-tier journal and a life of scientific glory for the researchers. Except for one thing. The fish was dead. The scanning technique used on the salmon — called functional magnetic resonance imaging — allows scientists to view the innards of a working brain, presumably reading the ebbs and flows of activity that underlie almost everything the brain does. Over the last two decades, fMRI has transformed neuroscience, enabling experiments that researchers once could only dream of. With fMRI, scientists claim to have found the brain regions responsible for musical ability, schadenfreude, Coca-Cola or Pepsi preference, fairness and even tennis skill, among many other highly publicized conclusions. © Society for Science & the Public 2000 - 2009

Courtroom First: Brain Scan Used in Murder Sentencing

By Alexis Madrigal Email Author A defendant’s fMRI brain scan has been used in court for what is believed to be the first time. Brain scan evidence that the defense claimed shows the defendant’s brain was psychopathic was allowed into the sentencing portion of a murder trial in Chicago, Science reported Monday. Brian Dugan, who had been convicted of the rape and murder of a 10-year old, was sentenced to death, despite the fMRI scans. “I don’t know of any other cases where fMRI was used in that context,” Stanford professor Hank Greely told Science. While the possibility of using fMRI data in a variety of contexts, particularly lie detection, has bounced around the margins of the legal system for years, there are almost no documented cases of its actual use. In the 2005 case Roper v. Simmons, the Supreme Court allowed brain scans to be entered as evidence to show that adolescent brains work differently than adult brains. That’s a far cry, though, from using fMRI to establish the truth of testimony or that specific structures within an individual defendant’s brain are legally relevant. It’s difficult to tell whether the Dugan case will be a watershed moment in the use of brain scan evidence in court, or if the evidence impacted the decision in this case. © 2009 Condé Nast Digital.

Watching the Brain Learn

By R. Douglas Fields Practice makes perfect, but how? Two groups of neuroscientists using MRI brain imaging announced last month that they were able to see changes inside the brains of people after mastering a new skill. The big surprise is that the part of the brain that changed has no neurons or synapses in it! The cerebral remodeling during learning was seen in the mysterious and still largely unexplored “white matter” region of the brain. “Grey matter” is synonymous with smarts, but in fact only half of the human brain is grey matter. White matter, the “other brain tissue”, is rarely mentioned. Neurons in the cerebral cortex are packed into in the top layers of the brain, where they are connected together through synapses. Learning takes place in the grey matter by linking neurons together into new circuits by strengthening synapses or forming new ones. But beneath the topsoil of the brain lies a dense network of fibers packed into a spaghetti-like snarl that is so complicated it is difficult to study or comprehend. These fibers are the wire-like axons projecting out from neurons in grey matter that transmit electrical impulses. Like buried telephone lines, these tightly bundled cables transmit information over long distances to communicate between distant regions of the cerebral cortex that are specialized to carry out different aspects of a complex cognitive function. © 1996-2009 Scientific American Inc.

Shedding light on how the brain works

By By Carolyn Y. Johnson More than two centuries ago, the Italian scientist Luigi Galvani found that electricity could make a dead frog’s leg kick, as if it were alive. Today, using the same basic principle but new tools, scientists are employing light to trigger brain cells - looking not for a kick, but for the origins of emotions, behaviors, and diseases in the brain. Advanced imaging technologies have given neuroscientists new ways to peer into the working mind, but a precise understanding of how 100 billion brain cells create everything from memories to mental illness has remained elusive. Now, by using gene therapy to insert light-sensitive proteins from algae and other organisms into brain cells, scientists are able to control specific brain circuits with light, and then watch what happens. It’s a big shift, said Dr. Karl Deisseroth, a neuroscientist and psychiatrist at Stanford University, who compares the difference between imaging the brain and triggering individual cells to learning the rules of football by watching the game on a high-end TV or by controlling players. “It wouldn’t matter how good your video camera was or your TV was; it would still be very mysterious, and that’s imaging,’’ Deisseroth said. The new technology, on the other hand, “allows you to play the role of coach and understand things.’’ © 2009 NY Times Co.

What’s my brain’s motivation?

By Nick Higham For an actor, the performance conditions weren’t exactly ideal: flat on her back in a large machine, under strict instructions to lie as still as possible, speaking in short bursts interspersed with the shrill sound of a magnetic resonance imaging scanner. But last week Fiona Shaw, one of Britain’s leading actresses - who has in her time played everything from the tragic heroine Medea to Shakespeare’s Richard II - volunteered in the cause of science to spend an hour having her brain scanned while “acting”. Professor Sophie Scott of the Institute of Cognitive Neuroscience at University College London wanted to know what happens physically in an actor’s head when they pretend to be someone else. She hoped that scanning Fiona’s brain in action would be able to tell us. The scanner works by measuring blood flow to different parts of the brain. The harder a part is working, the more blood flows into it. The parts of the brain that control speech are well known: what Prof Scott wanted to know was whether other parts of the brain would also “light up” when actors speak in character rather than as themselves. The results of the experiment will be on display as part of the Wellcome Collection’s new exhibition on identity. Prof Scott, who is also a Wellcome senior fellow, says our speech and the way we use language are important components of our identity - and one of the ways actors seek to convince their audience that they are another person is of course by changing their voice. For the experiment, Fiona Shaw performed snatches of T S Eliot’s poem The Waste Land. (Appropriately enough, given the circumstances, Eliot’s original title for the poem was He Do the Police in Different Voices.) (C)BBC

Hypnosis has ‘real’ brain effect

Hypnosis has a “very real” effect that can be picked up on brain scans, say Hull University researchers. An imaging study of hypnotised participants showed decreased activity in the parts of the brain linked with daydreaming or letting the mind wander. The same brain patterns were absent in people who had the tests but who were not susceptible to being hypnotised. One psychologist said the study backed the theory that hypnosis “primes” the brain to be open to suggestion. Hypnosis is increasingly being used to help people stop smoking or lose weight and advisers recently recommended its use on the NHS to treat irritable bowel syndrome. It is not the first time researchers have tried to use imaging studies to monitor brain activity in people under hypnosis. But the Hull team said these had been done while people had been asked to carry out tasks, so it was not clear whether the changes in the brain were due to the act of doing the task or an effect of hypnosis. In the latest study, the team first tested how people responded to hypnosis and selected 10 individuals who were “highly suggestible” and seven people who did not really respond to the technique other than becoming more relaxed. The participants were asked to do a task under hypnosis, such as listening to non-existent music, but unknown to them the brain activity was being monitored in the rest periods in between tasks, the team reported in the journal Consciousness and Cognition. In the “highly suggestible” group there was decreased activity in the part of the brain involved in daydreaming or letting the mind wander - also known as the “default mode” network. BBC © MMIX

Signature of consciousness captured in brain scans

by Anil Ananthaswamy A telltale signature of consciousness has been detected that takes us a step closer to disentangling the brain activity underlying conscious and unconscious brain processes. It turns out that there is a similar pattern of neural activity each time we become conscious of the same picture, but not if we process information from the image unconsciously. These contrasting patterns of activity can now be detected via brain scans, and could one day help determine if patients with brain damage are conscious. They might even be used to probe consciousness in animals. “It’s very exciting work,” says neuroscientist Raphaël Gaillard of the University of Cambridge, who was not involved in the work. “The use of a reproducibility measure to disentangle conscious and non-conscious processes is genuinely new.” Gaillard has previously shown that coordinated activity across the entire brain is one of the signatures of consciousness . Consistent signals So far, efforts to find a brain signature of consciousness have focused on the intensity of neural activity, how long it lasts, and whether signals tend to be synchronised across different regions of the brain. “We were looking for something other than the intensity and duration of the neural activity that characterises conscious neural processing,” says Aaron Schurger of Princeton University in New Jersey, who led the new work. © Copyright Reed Business Information Ltd.

Head-mounted microscope sees brain beneath the skull

A small microscope that can be mounted on an animal’s head should offer a front-row view of how its brain processes visual and other stimuli on the move. A laser inside the device scans the activity of neurons through a tiny hole in the skull, made prior to the experiment under anaesthetic. When the microscope was attached to freely moving rats looking at screens, it produced images of brain cells that had been labelled with a fluorescent dye. Compared with previous methods – which require restraining animals and inserting electrodes – this technique is much less invasive, revealing brain activity in animals that are moving and interacting with their environment in a more natural way. It was developed at the Max Planck Institute for Biological Cybernetics in Tübingen, Germany. Journal reference: Proceedings of the National Academy of Sciences, DOI: 10.1073/pnas.0903680106 © Copyright Reed Business Information Ltd.

Brain scanners can tell what you’re thinking about

by Ewen Callaway, Chicago WHAT are you thinking about? Which memory are you reliving right now? You may think that only you can answer, but by combining brain scans with pattern-detection software, neuroscientists are prying open a window into the human mind. In the last few years, patterns in brain activity have been used to successfully predict what pictures people are looking at, their location in a virtual environment or a decision they are poised to make. The most recent results show that researchers can now recreate moving images that volunteers are viewing - and even make educated guesses at which event they are remembering. Last week at the Society for Neuroscience meeting in Chicago, Jack Gallant, a leading “neural decoder” at the University of California, Berkeley, presented one of the field’s most impressive results yet. He and colleague Shinji Nishimoto showed that they could create a crude reproduction of a movie clip that someone was watching just by viewing their brain activity. Others at the same meeting claimed that such neural decoding could be used to read memories and future plans - and even to diagnose eating disorders. Understandably, such developments are raising concerns about “mind reading” technologies, which might be exploited by advertisers or oppressive governments (see “The risks of open-mindedness”). Yet despite - or perhaps because of - the recent progress in the field, most researchers are wary of calling their work mind-reading. Emphasising its limitations, they call it neural decoding. © Copyright Reed Business Information Ltd

The Root of Thought: What Do Glial Cells Do?

By Andrew Koob Andrew Koob received his Ph.D. in neuroscience from Purdue University in 2005, and has held research positions at Dartmouth College, the University of California, San Diego, and the University of Munich, Germany. He’s also the author of The Root of Thought, which explores the purpose and function of glial cells, the most abundant cell type in the brain. Mind Matters editor Jonah Lehrer chats with Koob about why glia have been overlooked for centuries, and how new experiments with glial cells shed light on some of the most mysterious aspects of the mind. LEHRER: Your new book, The Root of Thought, is all about the power of glial cells, which actually make up nearly 90 percent of cells in the brain. What do glial cells do? And why do we have so many inside our head? KOOB: Originally, scientists didn’t think they did anything. Until the last 20 years, brain scientists believed neurons communicated to each other, represented our thoughts, and that glia were kind of like stucco and mortar holding the house together. They were considered simple insulators for neuron communication. There are a few types of glial cells, but recently scientists have begun to focus on a particular type of glial cell called the ‘astrocyte,’ as they are abundant in the cortex. Interestingly, as you go up the evolutionary ladder, astrocytes in the cortex increase in size and number, with humans having the most astrocytes and also the biggest. Scientists have also discovered that astrocytes communicate to themselves in the cortex and are also capable of sending information to neurons. Finally, astrocytes are also the adult stem cell in the brain and control blood flow to regions of brain activity. Because of all these important properties, and since the cortex is believed responsible for higher thought, scientists have started to realize that astrocytes must contribute to thought. © 1996-2009 Scientific American Inc.

Brain Scans Link ADHD To Biology

By Katherine Ellison For decades, attention-deficit hyperactivity disorder has sparked debate. Is it a biological illness, the dangerous legacy of genes or environmental toxins, or a mere alibi for bratty kids, incompetent parents and a fraying social fabric? With 4.5 million U.S. children having received a diagnosis of the disorder — and more than half of them taking prescription drugs to control it — the question has divided doctors and patients, parents and teachers, and mothers and fathers. Scientists maintain that they’ve been narrowing in on the origins and mechanics of disabling distraction, while gathering increasing evidence that ADHD is as real as such less controversial disorders as Down syndrome and schizophrenia. Their most recent progress is described in a Sept. 9 report in the Journal of the American Medical Association, based on a new study that indicates a striking difference in the brain’s motivational machinery in people with ADHD symptoms. “This is another big piece in the puzzle saying that there is something there, that this is not simply a matter of anxious parents,” said James Swanson, a co-author of the report and a developmental psychologist based at the University of California at Irvine. The JAMA study said that, compared with a group of healthy subjects, brain scans of 53 adults with ADHD revealed a flaw in the way they process dopamine, which among other things, alerts people to new information and helps them anticipate pleasure and rewards. Swanson speculated that people with ADHD may even have a net deficit of dopamine. © 2009 The Washington Post Company

Scanning Dead Salmon in fMRI Machine Highlights Risk of Red Herrings

By Alexis Madrigal Email Author Neuroscientist Craig Bennett purchased a whole Atlantic salmon, took it to a lab at Dartmouth, and put it into an fMRI machine used to study the brain. The beautiful fish was to be the lab’s test object as they worked out some new methods. So, as the fish sat in the scanner, they showed it “a series of photographs depicting human individuals in social situations.” To maintain the rigor of the protocol (and perhaps because it was hilarious), the salmon, just like a human test subject, “was asked to determine what emotion the individual in the photo must have been experiencing.” The salmon, as Bennett’s poster on the test dryly notes, “was not alive at the time of scanning.” methodsIf that were all that had occurred, the salmon scanning would simply live on in Dartmouth lore as a “crowning achievement in terms of ridiculous objects to scan.” But the fish had a surprise in store. When they got around to analyzing the voxel (think: 3-D or “volumetric” pixel) data, the voxels representing the area where the salmon’s tiny brain sat showed evidence of activity. In the fMRI scan, it looked like the dead salmon was actually thinking about the pictures it had been shown. “By complete, random chance, we found some voxels that were significant that just happened to be in the fish’s brain,” Bennett said. “And if I were a ridiculous researcher, I’d say, ‘A dead salmon perceiving humans can tell their emotional state.’” © 2009 Condé Nast Digital.

Brain Scans for Schizophrenia?

By Michael Torrice If you’re at risk for heart disease, doctors can monitor your cholesterol. But psychiatrists don’t have an analogous test for mental illnesses. That may change with a new discovery: Scientists have pinpointed a small spot in the brain that has a 71% chance of predicting whether high-risk patients will develop schizophrenia. About 75% of diagnosed schizophrenics show early, fleeting signs of the disease before they fully develop it. These so-called prodromal symptoms include mild hallucinations, such as hearing your name in the wind, or a sudden, unfounded suspicion that your friends are talking about you behind your back. Some patients may even experience a full psychotic episode–similar to what schizophrenics experience chronically–which lasts only a couple of days. Not all prodromal patients develop psychotic disorders: Two-and-a-half years after first experiencing these symptoms, only 35% receive a schizophrenia diagnosis. Predicting who gets that diagnosis is “a little better than flipping a coin,” says Scott Schobel, a psychiatrist at Columbia University. To help understand how these patients progress from mild hallucinations to schizophrenia, Schobel and his colleagues compared brain activity between 18 schizophrenic and 18 healthy patients. The scientists used a high-resolution version of functional magnetic resonance imaging, which measures brain activity through changes in blood volume, to take detailed snapshots of the subjects’ brains while they lay in the scanner. © 2009 American Association for the Advancement of Science.

The Dawning Age of Mind-Reading Machines

By Hilmar Schmundt Imagine controlling machines, typing text or juggling balls using nothing but the power of thought. What sounds like far-fetched science fiction is gradually becoming possible, providing hope for disabled patients — and new gimmicks for the computer gaming industry. My original plan was to write this article with nothing but the power of thought, but the technology of transforming ideas into characters is still crude and prone to error. The first word alone took a few minutes, and even after that the result was still “diz” instead of “this.” Still, that little sentence is like a little miracle. The old dream of mind-reading is slowly becoming reality — though this time around it is the product of machines rather than the minds of fiction writers. “The advances are tremendous,” says Christoph Guger, the developer of a brain-reading system. “In the past, you would have had to train for days. Today, entering text takes only a few minutes.” Guger is an engineer and a businessman. But with his hair falling past his jacket’s collar, he looks the part of a start-up entrepreneur. Still, he is certainly not new to the business. His company, Guger Technologies, which is based in the Austrian city of Graz, has been a supplier to countless brain-research laboratories for years. In addition to scalpels and medications, though, Guger also sells thought-transport technology. © SPIEGEL ONLINE 2009

The Brain Economy

Michael L. Anderson Psychology generally approaches the study of the mind by starting with behavior, and trying to infer the hidden mechanisms that produce it. Neuroscience, in contrast, begins by examining the smallest, deepest parts of the mechanism–genes and neurons–and tries to determine which behaviors these help produce. Ideally, the “outside-in” and “bottom-up” approaches are complementary, but each suffers from some inherent limitations. In psychology, the trouble is that for every piece of observed behavior, there are innumerable mechanisms that could have produced it. Similarly, the neurosciences have been hampered by the dearth of technologies allowing them to observe the brain in action. Knowing how the brain’s smallest parts operate isn’t the same as knowing how those parts interact to generate behavior. Advanced imaging technologies have long promised to help bridge the gap between psychology and neuroscience by allowing us to peer “inside the box” and observe the living, working brain. Functional magnetic resonance imaging has been among the most important of these, but since fMRI doesn’t measure brain function directly–it detects changes in blood oxygenation levels from which we infer neural activity–it leaves us in roughly the same position as a psychologist observing behavior. But thanks to a new way of using MRI scanners to take a different kind of picture–a technique called Diffusion Tensor Imaging–things have just gotten a lot more interesting. By tracking the motion of water molecules in the brain, DTI allows you to see where nerve fibers lead and to map the fiber bundles wiring together various parts of the cortex. Such a map is called a “connectome.” 2009 Forbes.com LLC

Many degrees of separation in dementia brains

by Celeste Biever YOU might expect the brain of someone with a mental disorder to be disorganised. But it’s the nature of the disorganisation that’s important - a finding that one day could help early diagnosis of different types of dementia. We already know that the different regions of healthy brains are linked in a so-called small-world network, which makes communication very efficient. For people with Alzheimer’s or other types of dementia, however, it’s a different story. In small-world networks - which also emerge, for example, in social networks - each node is connected to a lot of nearby nodes, but also has a few links to distant ones. Because of this, any node can communicate with almost any other in just a few hops. This may explain the brain’s formidable ability to process masses of information rapidly. “A small world, in theoretical terms, is the optimal network,” says Willem de Haan of the VU University Medical Center in Amsterdam, the Netherlands. De Haan’s team used scalp electrodes to measure the brain activity of resting volunteers, of whom 20 had mild to moderate Alzheimer’s, 15 had a rare form of dementia called frontal temporal lobe dementia (FTLD), and 23 were healthy. The researchers figured out the underlying network structure of the volunteers’ brains from the electrical activity in different regions over time. © Copyright Reed Business Information Ltd.

Are the Brains of Reckless Teens More Mature Than Those of Their Prudent Peers?

By Robert Epstein and Jennifer Ong Thrill seeking and poor judgment go hand in hand when it comes to teenagers—an inevitable part of human development determined by properties of a growing but immature brain. Right? Not so fast. A study being published tomorrow turns that thinking upside down: The brains of teens who behave dangerously are more like adult brains than are those of their more cautious peers. Psychologists have long believed that the brain’s judgment-control systems develop more slowly than emotion-governing systems, not maturing until people are in their mid-20s. Hence, teens end up taking far more risks than adults do. Evidence supporting this idea comes from studies looking at functional and structural properties of gray matter, the important part of the brain that contains the neurons that relay brain signals. At least two observations undermine this theory, however. First, American-style teen turmoil is absent in more than 100 cultures around the world, suggesting that such mayhem is not biologically inevitable. Second, the brain itself changes in response to experiences, raising the question of whether adolescent brain characteristics are the cause of teen tumult or rather the result of lifestyle and experiences. Because brain research is virtually always correlational in design, determining whether brain properties are causes or effects is impossible. Now neuroscientists Gregory S. Berns, Sara Moore and Monica Capra of Emory University suggest that teen risk-taking is associated not with an immature brain but with a mature, adultlike brain—exactly the opposite of conventional wisdom. © 1996-2009 Scientific American Inc.

Expanding waistlines may cause shrinking brains

by Nora Schultz BRAIN regions key to cognition are smaller in older people who are obese compared with their leaner peers, making their brains look up to 16 years older than their true age. As brain shrinkage is linked to dementia, this adds weight to the suspicion that piling on the pounds may up a person’s risk of the brain condition. The brains of elderly obese people looked 16 years older than the brains of those who were lean Previous studies suggested that obesity in middle age increases the risk of dementia decades later, which is accompanied by increased brain shrinkage compared with leaner people. Now brain scans of older people have revealed the areas that are hardest hit, as well as the full extent of brain size differences between obese people and those of average weight. From brain scans initially carried out for a different study, Paul Thompson from the University of California in Los Angeles and colleagues selected 94 from people in their 70s who were still “cognitively normal” five years after the scan. This was to exclude people with disorders that might have confused the results. The researchers then transformed these scans into detailed three-dimensional maps. People with higher body mass indexes had smaller brains on average, with the frontal and temporal lobes - important for planning and memory, respectively - particularly affected (Human Brain Mapping, DOI: 10.1002/hbm.20870). While no one knows whether these people are more likely to develop dementia, a smaller brain is indicative of destructive processes that can develop into dementia. © Copyright Reed Business Information Ltd
January 30th, 2010 | Category: Uncategorized |

1 Comment so far

  1. Anwer Kamal Pasha
    January 30th, 2010

    | 2:40 pm

    Great effort to present many views together. View of caregivers is very important but that is often given no place.My experience tells that the brain shock in result of head trauma is little different than coma and patients in this shock lose their motor function and some or most of them are conscious but they are not able to communicate. We are experiencing here gradual improvement of some patients and their consciousness is now clear without any doubt.

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