Despite myriad challenges, clinicians see room for progress.
Image credit: Shutterstock/David Tadevosian.
New Research In
Physical Sciences
Featured Portals
Articles by Topic
Biological Sciences
Featured Portals
Articles by Topic
It is the start of your day. As you shower and mull over all of the things you hope to accomplish, you pass out without warning. You awaken days later, in the hospital, on a ventilator, unable to move your arms or legs, unable to cry out. Worse yet, the nurses and doctors passing by do not seem to realize that you are wide awake. They talk about your coma, your physical needs, and your brain scan showing a brainstem stroke, oblivious that you can hear all that they are saying. Finally, one of them notices your eyes, moving ever so slightly, upward or downward. They instruct you to move them up if you can hear them. You comply. So begins a long, slow process of recovery as both you and the medical team realize you are “locked in.” Although communicating through eye movements is feasible, it is difficult, and you are desperate to find an easier means of expressing yourself. It turns out that an effective solution is right under your nose. In PNAS, Plotkin et al. (1) demonstrate the efficacy of sniffing as an interface for communication.
What is Locked-in Syndrome?
First described in 1966, the locked-in syndrome is distinctive for preserved consciousness and an inability to move the limbs, face, or vocal apparatus (2). It is classically associated with injury to the ventral pons, effectively cutting off the corticospinal and some of the corticobulbar motor pathways. This lesion location will spare the oculomotor nucleus in the midbrain and allow the patient to make volitional vertical gaze eye movements. In many cases this is the only direct means of communication. There are many possible causes for a lesion in the brainstem, including sudden hemorrhage from high blood pressure, as in the example above (3). Before the original description in 1966, the diagnosis …
1E-mail: grafton{at}psych.ucsb.edu.
Unlocking communication with the nose
Sign up for Article Alerts
Jump to section
You May Also be Interested in
Better explicating the strengths and shortcomings of these models will help refine projections and improve transparency in the years ahead.
Image credit: Witsawat.S.
Using CRISPR, researchers showed that a region some used to label “junk DNA” has a major role in a rare genetic disorder.
Image credit: Nathan Devery.
Mara Reed and Michael Manga explore why Yellowstone's Steamboat Geyser resumed erupting in 2018.
A study demonstrates how two enzymes—MHETase and PETase—work synergistically to depolymerize the plastic pollutant PET.
Image credit: Aaron McGeehan (artist).