Neurology published an unsettling study of two brain-damaged men who are “minimally conscious”—able to breathe on their own but otherwise generally unresponsive. When neuroscientists scanned the patients’ brains as they played audiotapes of loved ones, the activity was strikingly normal.

The visual cortex of one of the men even lit up in a way that suggested he was visualizing the stories that his relatives told. One of the researchers told the New York Times that they’ve repeated the experiment on seven more patients and found the same results.

If the study holds water, we may need to rethink how we treat the estimated 300,000 Americans who are regarded as unreachable. The good news is that there are ways to communicate with some patients who seem completely unconscious. Spying into the brains of the unresponsive—as well as the “locked in,” patients who are fully conscious but paralyzed by diseases such as ALS—can create a vehicle for them to talk. This conceit is at the heart of brain-computer interfacing, a booming field in which scientists are crafting tools that translate mental activity into keystrokes, mouse movements, and even robotic control.

Now for the bad news: Brain-damaged, “minimally conscious” patients like the ones in the Neurology study may be so impaired that they’re unable to communicate with the outside world. Neurologists can usually figure out for sure if the mind of a locked-in patient is functioning well; the challenge is in setting it free. Doctors have a harder time figuring out the mental state of brain-damaged patients, especially if they can’t open their eyes. Since most of the brain interfaces that are in development require the subject’s eyes to be open wide, a patient whose eyes are shut—at least for now—is pretty much rendered mute.

More here.