London, Ont. researchers develop tool to detect consciousness in ICU

fNIRS used in the study. (Source: LHSC)

Researchers at the Lawson Health Research Institute and Western University have developed a new tool, being used at the London Health Sciences Centre (LHSC), to detect consciousness in patients who have suffered a severe brain injury.

The tool is used on patients in the intensive care unit (ICU) and are in a coma.

The discovery was published in the Proceedings of the National Academy of Sciences (PNAS), by the research team led by Dr. Karnig Kazazian, Dr. Androu Abdalmalak and Dr. Derek Debicki.

Researchers used a functional near infrared spectroscopy (fNIRS), which is a portable brain imaging technique, to see if unresponsive patients had preserved consciousness, by recording brain activity.

The technique was used to see if patients could feel pain, hear what’s around them and retain preserved conscious awareness.

According to a news release from the LHSC, the technique was tested on 100 healthy people, before using fNIRS on a patient in the ICU.

Despite being unresponsive, the patient showed the appropriate brain responses to the instruction of “imagine playing a game of tennis”.

“These findings could fundamentally change the way patients are cared for,” said Dr. Kazazian, research associate at the Lawson Health Research Institute and LHSC. Kazazian is also an associate scientist and medical student at Western.

“Deploying a simple tool like fNIRS at the bedside has the potential to provide clinicians information about preserved brain function that standard clinical tools are not capable of doing.”

This finding follows more than 20 years of research from Western neuroscientist, Dr. Adrian Owen.

Owen first found some unresponsive patients are entirely aware, through results of brain recordings.

“Families and patients with severe brain injuries want to know whether their loved ones will be able to recover from their injuries,” said Dr. Debicki, a neurologist at LHSC, assistant professor of Neurology at Schulich Medicine and Dentistry and a scientist at Lawson.

“fNIRS is an exciting new tool that we can use at the bedside in the ICU to improve the way we answer this very important, complex question.”

Dr. Abdalmalak, a former research associate in the Owen Lab at Western University, said next steps will expand the testing to a bigger group of patients, allowing researchers to explore the potential of using fNIRS to communicate with ICU patients.