A significant new study co-led by Mass General Brigham reveals that at least 25% of individuals with severe brain injuries, who appear unresponsive, may actually possess some level of consciousness.

The research indicates that these patients can respond to covert instructions, suggesting that existing rates of cognitive motor dissociation may be underestimated.

Out of the 241 unresponsive participants in the study, 60 demonstrated covert brain activity during scans, indicating cognitive motor dissociation, where cognitive abilities are present but motor responses are absent.

The study involved assessments using functional MRI (fMRI) and electroencephalography (EEG) to detect signs of consciousness in participants who did not respond to simple instructions.

Lead author Dr. Yelena Bodien emphasized the ethical implications of detecting cognitive awareness in unresponsive patients and the urgent need for improved communication methods.

Researchers stress the importance of identifying conscious individuals among the unresponsive, as this knowledge can significantly influence medical decisions regarding treatment and life support.

Currently, there are no standardized professional guidelines for assessing cognitive motor dissociation, highlighting a critical area for future research.

The researchers call for the development of standardized assessment tools and improved clinical infrastructure to effectively detect cognitive motor dissociation.

The findings suggest that approximately 25% of patients exhibited brain activity patterns similar to those of healthy individuals, indicating some level of awareness despite their unresponsive state.

The study's complexity is underscored by the fact that participants were assessed at varying times post-injury, complicating the diagnosis of cognitive motor dissociation.

Conducted across six medical facilities in four countries, this study marks the first multicenter investigation of its kind, providing a broader perspective on cognitive motor dissociation.

Published in the New England Journal of Medicine, the study raises important ethical and clinical questions regarding communication and rehabilitation for patients with cognitive motor dissociation.