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Some comatose patients with a severe injury might be paying closer attention to their surroundings than previously thought, a new study says.

Comatose Patients Have Ability to Understand

About one in four patients respond to instructions covertly, with their brains showing activity even though their bodies aren’t moving, researchers found.

When asked to imagine opening and closing their hand, comatose patients displayed brain activity showing they were repeatedly following this instruction, MRI and EEG brain scans revealed. This shows that some patients with severe brain injury are paying attention to the world around them.

For the study, researchers scanned 241 people with brain injury who showed no outward signs of consciousness, such as being able to respond to simple instructions.

The study included data from participants in six different sites in the United States, Britain and Europe, collected over 15 years.

The patients all sustained severe brain injuries, often from either a stroke, cardiac arrest or a traumatic event.

MRI and EEG brain responses showed that 60 of the people (25 percent) were indeed trying to respond to these instructions but had no control over their bodies. This phenomenon is called cognitive motor dissociation, researchers said. Patients understand language, remember instructions and can sustain attention, but the link between thinking and motor abilities is broken.

The findings suggest that covert awareness is more common than originally thought. Small studies previously estimated that around 10 to 20 percent of unresponsive patients had it. The new study is larger than the ones prior.

The study was published in the “New England Journal of Medicine.”

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