Panel News Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge CB2 7EF In this issue....... Issue no.17 New facilities: MEG scanner, what does it do? People in a vegetative Depression: state: Trying to Are they understand aware? it better Also......... • PhD student research • A famous research participant • What’s going on at the bottom of the CBSU garden • Visiting Scientists • The Bioresource Welcome! This edition of Panel News begins with a very big thank you to all our Volunteers for their continued support - your help with our research is essential, and we could not carry on without you. The UK Medical Research Council (MRC) is a national organisation funded by the UK taxpayer. It promotes research into all areas of medical and related science with the aims of improving the health and quality of life of the UK public and contributing to the wealth of the nation. Here at the Cognition and Brain Sciences Unit we investigate fundamental human psychological functions in areas such as attention, memory and knowledge, emotion, speech and language, and develop experimental methods for doing this. The Memory Group focuses on the basis and organisation of long term memory, particularly episodic memory of past events, and semantic memory of words, people and things. Experiments with volunteers and patients show how these are normally structured and which abilities are retained or lost in disorders such as Alzheimer’s, semantic dementia, and head injuries. The Emotion Group research spans a broad range from the detailed analysis of perceptual mechanisms of emotion recognition, using neuroimaging, neuropsychological, and cognitive methodologies, through investigations of attention, executive and memory mechanisms in healthy participants and in those with emotional disorders, to the development of novel therapeutic interventions and their evaluation in clinical trials. Researchers in the Attention Group are studying how the brain copes with conflicting demands for its attention and what systems are involved. Problems of selective attention, spatial cognition, consciousness and cognitive control are investigated. Both normal cognition and disorders are studied, including unilateral neglect, blindsight, Parkinson’s Disease and attention deficit hyperactivity disorder. Behavioural studies are combined with a range of physiological methods, including functional neuroimaging. The Speech and Language programme is concerned with the study of human language as a cognitive, computational, and neural system and aims to explain how normal adults understand language. Finally, the Methods Research and Infrastructure Group develops and implements methods in support of the scientific research programmes at the CBSU. The expertise of the group is in the three principal areas of Statistics and Mathematics, Physics of Magnetic Resonance, and Imaging Data Analysis. Our on-site facilities have been greatly expanded recently, with the MRC demonstrating its confidence in our research by investing over three million pounds in the purchase of equipment. This means that we now have a functional Magnetic Resonance Imaging (fMRI) scanner housed in a new purpose-built building at the bottom of the garden, and a Magnetoencephalographic (MEG) scanner situated in our testing laboratory area. Having our own fMRI scanner means that we no longer have to conduct all of our studies at the Wolfson Brain Imaging Centre at Addenbrooke’s Hospital (although patient scanning is still carried out there). The MEG scanner provides us with a non-invasive neurophysiological technique that measures the magnetic fields generated by neuronal activity of the brain. Both these state-of-the art technologies are valuable resources made available for use by all our neuroscience partners in Cambridge (including several University departments) and will ensure that we remain at the forefront of research for many years to come. William D Marslen-Wilson (Director of the CBSU) 02 Panel News | CBSU | 2007 Contents Detecting awareness in the vegative state - 4 Are people in a vegative state really aware? The MEG scanner - See how the CBSU is keeping up 6 to date with the latest brain imaging techniques. What’s going on at the bottom of our garden - 8 Find out everything that’s been happening inside PhD research at the unit - Looking at what the 10 CBSU Students have been up to over the past year. The Bioresource - Find out about an exciting new 12 way you can volunteer to help medical reseach. Depression - Taking a look at depression and trying 14 to understand the effects of it. A famous participant in the CBSU’s research 16 programme - Find out who. Visiting Scientists - Find out about working at the 18 CBSU from a visiting scientists point of view. Panel News | CBSU | 2007 03 Detecting Awareness in the Vegetative State Adrian M. Owen (Attention Group) n 2006, scientists at the MRC Cognition and brains to the responses that we see in healthy Brain Sciences Unit, together with their volunteers undergoing the same experience in clinical colleagues at the Wolfson Brain our fMRI scanner in Chaucer Road. Last year we Imaging Centre, Addenbrooke’s Hospital, made a startling discovery. We showed that a I patient who had been diagnosed as vegetative showed that a woman who had been diagnosed as in a vegetative state was in fact consciously could not only understand speech, but she could aware and was able to make responses using only also respond in ways that allowed us to conclude her brain. The discovery, published in the journal that she was consciously aware. The woman had Science, showed for the first time that functional sustained a severe traumatic brain injury in a road magnetic resonance imaging (fMRI) could be traffic accident. She was physically unresponsive used to determine if such patients are consciously and fulfilled all the criteria for a diagnosis of aware when existing clinical techniques are vegetative state according to international unable to provide that information. The finding was reported in over 350 newspapers around the world and was widely discussed on television, radio, in print and on line. The vegetative state is one of the least understood and most ethically troublesome conditions in modern medicine. The term describes a unique disorder in which patients who emerge from coma appear to be awake, but show no signs of awareness. Such patients will not respond in any way to external stimulation (e.g. from their friends and family) and show no signs of understanding language. For the last 10 years, we have been conducting a collaborative series of Figure 1: Three voluteers brain responses investigations with colleagues at the Wolfson to being asked to imagine playing tennis. Brain Imaging Centre, Addenbrooke’s Hospital, to establish whether any of these patients do, in guidelines. 6 months after the accident, we fact, retain any cognitive functions, despite mapped her brain activity while we asked her appearances to the contrary. We do this by to imagine playing tennis or moving around her scanning patients under certain conditions (for home. We found that she was able to do this, example, we might play them speech sounds) activating different areas of her brain in the same and comparing the responses that we see in their way as healthy volunteers (see Figure 1). This 04 Panel News | CBSU | 2007 finding confirmed that, despite the diagnosis of vegetative state, the patient retained the ability to understand spoken commands and to respond to them through her brain activity, rather than through speech or movement. In short, the fact that she was able to imagine particular tasks when asked to do confirmed beyond any doubt that she was consciously aware of herself and her surroundings. In September 2006, we published this startling discovery in the journal Science. The immediate response was a storm of media interest from around the world, including articles in more than Above: The brain response in the woman 350 newspapers, news reports on BBC News at who was diagnosed as vegetative (top) and Ten, ITN News, Channel 4 News and CNN and radio in a group of healthy volunteers (bottom) on more than 20 national and international radio when asked to imagine playing tennis in their stations. Over the following months, the research heads. Imaginary movements (such as was featured on a number of documentaries for playing tennis) activate the same areas of television and radio and was the subject of several the brain as actual movements. The response lengthy articles in magazines and journals. Much in the patient was indistinguishable from of this coverage (including televisions and radio that observed in the healthy volunteers reports) has been gathered together by the CBSU confirming that she was consciously aware. librarian and can be viewed on our website: http://www.mrc-cbu.cam.ac.uk/~adrian/Site/ Newslist.html More importantly, the research has brought attention to this complex condition and has provided new impetus for our own work, and the work of other groups in this area. For example, we have subsequently begun collaborations with colleagues in Italy, Germany and the USA to establish whether this type of approach could be extended to provide a way of communicating with some patients who may be aware, but unable to move or speak. We have also seen an increase in the number of vegetative patients being scanned at Addenbrooke’s Hospital and have found similar patterns of responses in at least one other patient with a severe brain injury. But it is important to emphasise that if we don’t see a response in a vegetative patient it does not necessarily mean that they are not aware. For example, just like the healthy volunteers who help us with our research by being scanned at Chaucer Road, some patients can’t help but fall asleep while they are being scanned! Panel News | CBSU | 2007 05 MEG magnetoencephalography Yury Shtyrov (Speech and Language Group) n late 2006 – early 2007, the CBSU’s brain the older and more established EEG, this method imaging facilities were enriched by a new does not require attaching large numbers MEG (magnetoencephalography) laboratory.