[{"command":"openDialog","selector":"#drupal-modal","settings":null,"data":"\u003Cdiv id=\u0022republish_modal_form\u0022\u003E\u003Cform class=\u0022modal-form-example-modal-form ecl-form\u0022 data-drupal-selector=\u0022modal-form-example-modal-form\u0022 action=\u0022\/en\/article\/modal\/6432\u0022 method=\u0022post\u0022 id=\u0022modal-form-example-modal-form\u0022 accept-charset=\u0022UTF-8\u0022\u003E\u003Cp\u003EHorizon articles can be republished for free under the Creative Commons Attribution 4.0 International (CC BY 4.0) licence.\u003C\/p\u003E\n \u003Cp\u003EYou must give appropriate credit. We ask you to do this by:\u003Cbr \/\u003E\n 1) Using the original journalist\u0027s byline\u003Cbr \/\u003E\n 2) Linking back to our original story\u003Cbr \/\u003E\n 3) Using the following text in the footer: This article was originally published in \u003Ca href=\u0027#\u0027\u003EHorizon, the EU Research and Innovation magazine\u003C\/a\u003E\u003C\/p\u003E\n \u003Cp\u003ESee our full republication guidelines \u003Ca href=\u0027\/horizon-magazine\/republish-our-stories\u0027\u003Ehere\u003C\/a\u003E\u003C\/p\u003E\n \u003Cp\u003EHTML for this article, including the attribution and page view counter, is below:\u003C\/p\u003E\u003Cdiv class=\u0022js-form-item form-item js-form-type-textarea form-item-body-content js-form-item-body-content ecl-form-group ecl-form-group--text-area form-no-label ecl-u-mv-m\u0022\u003E\n \n\u003Cdiv\u003E\n \u003Ctextarea data-drupal-selector=\u0022edit-body-content\u0022 aria-describedby=\u0022edit-body-content--description\u0022 id=\u0022edit-body-content\u0022 name=\u0022body_content\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea ecl-text-area\u0022\u003E\u003Ch2\u003EBrainwave scanners unlocking the hidden lives of coma patients\u003C\/h2\u003E\u003Cp\u003EThis nightmare scenario is a reality for tens of thousands of people worldwide who have been diagnosed as being in a coma but can, in reality, understand what is going on around them.\u003C\/p\u003E\u003Cp\u003EA new, experimental technology has enabled a woman in Sicily, Italy, living with locked-in syndrome to successfully communicate with her family after years of silence.\u003C\/p\u003E\u003Cp\u003E\u2018The family was unsure if she was still there,\u2019 said Dr Christoph Guger, the founder of the Austrian company behind the device, known as mindBeagle. \u2018They had seen no sign of consciousness for so long.\u2019\u003C\/p\u003E\u003Cp\u003EThe technology, developed under the EU-funded ComaWare project, is shaped into a soft cap and is packed with electroencephalogram (EEG) electrodes that measure brain activity.\u003C\/p\u003E\u003Cp\u003EAs scientists learn more about comas, it has become clear that there are various states of consciousness along the spectrum from being in a coma to having normal brain function.\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EConscious\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003E\u2018Coma patients can be subdivided into several types,\u2019 said Dr Guger. \u2018People who are genuinely in a coma have no cognitive function and no motor responses \u2013 they cannot think and they cannot move. But some people may appear to be in a coma even though they are in fact conscious to some degree.\u2019\u003Cblockquote class=\u0022tw-text-center tw-text-blue tw-font-bold tw-text-2xl lg:tw-w-1\/2 tw-border-2 tw-border-blue tw-p-12 tw-my-8 lg:tw-m-12 lg:tw--ml-16 tw-float-left\u0022\u003E\n \u003Cspan class=\u0022tw-text-5xl tw-rotate-180\u0022\u003E\u201c\u003C\/span\u003E\n \u003Cp class=\u0022tw-font-serif tw-italic\u0022\u003E\u2018Some people may appear to be in a coma even though they are in fact conscious to some degree.\u2019\u003C\/p\u003E\n \u003Cfooter\u003E\n \u003Ccite class=\u0022tw-not-italic tw-font-normal tw-text-sm tw-text-black\u0022\u003E Dr Christoph Guger, Chief Executive, Guger Technologies\u003C\/cite\u003E\n \u003C\/footer\u003E\n\u003C\/blockquote\u003E\n\u003C\/p\u003E\u003Cp\u003EDifferentiating patients who are in a coma from those in a minimally conscious state is a major challenge. To the naked eye, they all appear unresponsive. \u2018The lack of feedback from the patient makes it exceedingly difficult to judge,\u2019 said Dr Guger.\u003C\/p\u003E\u003Cp\u003EThe standard tests to assess patients who appear to be unconscious are not always accurate, he adds. People who show no motor function are usually assessed once early in their illness, and that diagnosis informs their treatment for months or years to come.\u003C\/p\u003E\u003Cp\u003EResearchers now know that in patients who appear unconscious but are in fact aware, states of alertness may fluctuate during the day. This means that someone could be misdiagnosed as being in a coma even though for much of the day their brain is active.\u003C\/p\u003E\u003Cp\u003EDr Guger\u0026nbsp;explained:\u0026nbsp;\u2018mindBeagle first figures out whether the patient has any cognitive function and can understand what is going on around them. If they still have cognitive function we can communicate with people affected by locked-in syndrome by asking yes\/no questions and gauging their response by monitoring brain activity.\u2019\u003C\/p\u003E\u003Cp\u003EThe system has a number of features. A simple auditory test assesses the patient\u2019s capacity for hearing and understanding. By playing high- and low-pitched tones, instructing the patient to count only the high tones and then measuring brain waves, doctors can learn whether their apparently comatose patient is in fact tuned into their environment.\u003C\/p\u003E\u003Cp\u003E\u2018The EEG data picks up whether the patient can hear and distinguish between high and low tones,\u2019 Dr Guger said, noting that the test can be repeated at different times of the day to test whether the patient is particularly alert at certain times.\u003C\/p\u003E\u003Cp\u003EThe system also uses tactile stimulation to check awareness and ask patients to answer questions. By stimulating the left or right hand, for example, patients can be asked to focus on the side of their body that is vibrating. By measuring brain activity, scientists can tell whether the subject is successfully responding to vibrations.\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003ECommunication mode\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003E\u2018This is also the communication mode,\u2019 says Dr Guger. \u2018We can ask them to imagine moving their left or right hand. We then observe changes in the sensory motor cortex (which controls movement).\u2019\u003C\/p\u003E\u003Cp\u003EIf a patient is asked a question and told that moving their left hand means \u2018yes\u2019, while moving the right hand means \u2018no\u2019, they are able to respond by thinking about moving the appropriate hand. Although they may not actually move a muscle, the mindBeagle wearable EEG device effectively reads their thoughts.\u003C\/p\u003E\u003Cp\u003EThe device is also being used in a Harvard-linked hospital in the US to assess unconscious patients admitted to the emergency department, and a university in Oregon is testing the system for use in locked-in patients.\u003C\/p\u003E\u003Cp\u003EMeanwhile a hospital in Liege, Belgium, uses mindBeagle to differentiate between various stages of consciousness, helping doctors to separate patients with locked-in syndrome from those in a permanent vegetative state.\u003C\/p\u003E\u003Cp\u003EIn future, the approach could be used to help paralysed people to communicate and in the rehabilitation of stroke victims.\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EMobile diagnosis\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EWearable EEG systems also promise to revolutionise epilepsy care. Around \u003Ca href=\u0022http:\/\/www.epilepsy.com\/learn\/epilepsy-101\/who-gets-epilepsy\u0022 target=\u0022_blank\u0022 rel=\u0022noopener noreferrer\u0022\u003E65 million people worldwide\u003C\/a\u003E live with epilepsy, which is usually diagnosed by a specialist reading an EEG scan which lasts around 20 minutes.\u003C\/p\u003E\u003Cp\u003EPatients are often prescribed medication and asked to keep a diary which can later be reviewed with their doctor. \u2018If the first drug is not working, they change it and repeat the process, which takes a lot of time,\u2019 said Professor Esther Rodriguez-Villegas of Imperial College London, UK.\u003C\/p\u003E\u003Cp\u003EHowever, she believes this short assessment does not always collect enough information about the patient\u2019s brain. If a longer EEG could be offered more frequently it could provide doctors with more information, making it easier to manage epilepsy with medication.\u003C\/p\u003E\u003Cp\u003EShe said: \u201820 minutes is not always enough time to figure out what is going on. However, EEG requires access to specialist equipment and staff so it\u2019s a catch-22 because time and resources are limited.\u2019\u003C\/p\u003E\u003Cp\u003EThe solution is to develop a simple, lightweight version of EEG that patients can wear for longer periods, allowing doctors to collect the most pertinent data on their brain in various states \u2013 including during epileptic seizures.\u003C\/p\u003E\u003Cp\u003EThrough the WEEG project, funded by the EU\u0027s European Research Council (ERC), Prof. Rodriguez-Villegas has developed a device that balances the desire for a wearable solution with the need for sufficient battery life to last several hours.\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EUnder a hat\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003E\u2018The whole idea is to make something that\u2019s small enough to be worn under a hat \u2013 or even integrated into a hat \u2013 and is light enough to wear while walking around during the day,\u2019 she explained. \u2018The reason existing EEG machines are so big is that they are heavy on power consumption so that was the challenge we needed to overcome.\u2019\u003C\/p\u003E\u003Cp\u003EThe solution lay in microchips with integrated circuits that consume less power than a single neuron in the brain. This means a very small, long-life battery is enough to power the system without adding weight.\u003C\/p\u003E\u003Cp\u003EThe device uses novel algorithms and collects data which can be viewed in real time, but Prof. Rodriguez-Villegas believes a health professional will still be required to interpret the information. \u2018Fully automated diagnosis would be a big challenge, so doctors are still part of the picture for diagnosing epilepsy.\u2019\u003C\/p\u003E\u003Cp\u003EThe next step for the wearable EEG is to explore its potential in monitoring the brainwaves of people with sleep disorders. Prof. Rodriguez-Villegas has won a new ERC grant to develop a consumer product which could be worn overnight. If her proof-of-concept research is successful, it could deliver a nightcap that serves data for breakfast.\u003C\/p\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n \u003Cdiv id=\u0022edit-body-content--description\u0022 class=\u0022ecl-help-block description\u0022\u003E\n Please copy the above code and embed it onto your website to republish.\n \u003C\/div\u003E\n \u003C\/div\u003E\n\u003Cinput autocomplete=\u0022off\u0022 data-drupal-selector=\u0022form-xhofa7pmjmcx9ih55uihhjvandzdrujde0zyca521ug\u0022 type=\u0022hidden\u0022 name=\u0022form_build_id\u0022 value=\u0022form-xhOfA7pmJMCX9Ih55UIhhJvaNdzDruJdE0zYca521ug\u0022 \/\u003E\n\u003Cinput data-drupal-selector=\u0022edit-modal-form-example-modal-form\u0022 type=\u0022hidden\u0022 name=\u0022form_id\u0022 value=\u0022modal_form_example_modal_form\u0022 \/\u003E\n\u003C\/form\u003E\n\u003C\/div\u003E","dialogOptions":{"width":"800","modal":true,"title":"Republish this content"}}]