Little Hope of Recovery for Ariel Sharon Despite Hopeful Signs From Israeli Leader

State-of Art Scans Offer Doctors Better Look Peek Inside Brain

‘Positive Indication’: Ariel Sharon, shown here in a 2005 photo, still has significant brain activity despite a severe stroke in 2006, doctors say.
getty images
‘Positive Indication’: Ariel Sharon, shown here in a 2005 photo, still has significant brain activity despite a severe stroke in 2006, doctors say.

By Reuters

Published January 29, 2013.
  • Print
  • Share Share
  • Multi Page

The state-of-the-art brain scans that allowed doctors to look inside the head of former Israeli prime minister Ariel Sharon show how advances in neuroscience are forcing a rethink of what it means to be in a long-term coma.

Neurologists who performed the tests said they hinted that Sharon, who has been in a coma since suffering a stroke in 2006, may have a degree of consciousness and be able to hear sounds or make out pictures.

“It’s encouraging to find these signs because it opens up the possibility of some meaningful communication,” said Paul Matthews, a professor of neurology at Imperial College London.

Until recently, he said, it had been assumed that many comatose patients diagnosed as being in a “vegetative state” had no meaningful awareness of their surroundings.

Yet progress in the use of functional magnetic resonance imaging (fMRI) scanners - machines that measure brain activity by detecting changes in blood flow - and in reading the signals they give has begun to change that view.

Compared with other “vegetative state” patients who have had similar tests and been described in scientific papers, Sharon’s responses were very faint, said Martin Monti, a cognitive psychologist from the University of California Los Angeles, who co-led the American-Israeli team that scanned Sharon’s brain.

There is little or no likelihood of a rapid recovery by Sharon, a former general, hawkish defence chief and leader of the right-wing Likud party who suffered his stroke weeks after leaving Likud to found a centrist group to pursue peace with the Palestinians.

But with more tests and research to devise a way for him to signal whether he is processing external information, it is possible that he, like others, could one day respond to questions about his state of mind and whether he is in pain.

“If it turns out that these signals are more robust, then there’s no doubt that we could use things like brain-computer interfaces (to communicate),” Monti told Reuters in an interview as he travelled from Israel back to the United States.

AWARENESS DETECTED

The science behind such possibilities has made significant advances in recent years, allowing some patients previously thought to be completely unaware to show they are in fact conscious and able - with help - to communicate.

A study published by Monti and colleagues in 2010 in the New England Journal of Medicine (NEJM) was among the first to show how fMRI scans allowed doctors to detect awareness and communicate with patients in a long-term coma.

“The technology is still very new and we haven’t by any means optimised this kind of work yet,” said Steve Williams, of King’s College London’s centre for neuroimaging sciences.

“But if you do see something, it must give so much hope. And if you can get robust and consistent activation of the brain … then you can take it a lot further.”

The experiments use imagery tasks - such as asking a patient to imagine playing tennis or walking from room to room in their home. The fMRI scanner maps the distinctive activity of the brain when each task is performed.

The patient is then asked to equate one of the imagery tasks to the answer “yes” and another to the answer “no”, and apply them to simple yes-or-no questions.

These tests “give us a lot of information about how we can contact these patients and stimulate them”, said Alon Friedman, a neurological director at Israel’s Soroka Medical Centre in Beersheba, who worked with Monti on Sharon’s scans.

Of the 54 patients described in the NEJM study, all diagnosed as being in a vegetative or minimally conscious state, five were able to “wilfully modulate their brain activity”, the researchers said, and one was able to answer yes-or-no questions during the scan.

EEG CAPS TO AID COMMUNICATION?

In the 84-year-old Sharon’s case, evidence that he was able to perform the imagery tasks “was there but was not as strong as we have seen in other patients”, Monti said.

“We’re very cautious. There is a little evidence that he might have been doing some of the things we asked of him, but it was extremely weak and faint so it is difficult to interpret.”

If further tests on Sharon were to detect a more robust response, scientists say the next step would be to investigate ways to make communication easier.

One possibility being explored in some vegetative state patients who show an ability to control brain processes is the use of electroencephalography (EEG) caps, which attach electrodes to the scalp and record electrical brain activity.

Research published in 2011 showed that scientists using these devices were able to communicate with people who had been considered to be in a vegetative state for more than a year.

Because the caps are mobile, they allow communication to be more frequent, since putting a patient into an fMRI scanner every time doctors want to ask a question is invasive, disruptive and expensive.

“If you can put an EEG cap on somebody’s head, and the computer is trained to recognise different brain states, that’s like having a language,” Monti said. “You could then imagine we could proceed from there.”


The Jewish Daily Forward welcomes reader comments in order to promote thoughtful discussion on issues of importance to the Jewish community. In the interest of maintaining a civil forum, The Jewish Daily Forwardrequires that all commenters be appropriately respectful toward our writers, other commenters and the subjects of the articles. Vigorous debate and reasoned critique are welcome; name-calling and personal invective are not. While we generally do not seek to edit or actively moderate comments, our spam filter prevents most links and certain key words from being posted and The Jewish Daily Forward reserves the right to remove comments for any reason.





Find us on Facebook!
  • "I’ve never bought illegal drugs, but I imagine a small-time drug deal to feel a bit like buying hummus underground in Brooklyn."
  • We try to show things that get less exposed to the public here. We don’t look to document things that are nice or that people would like. We don’t try to show this place as a beautiful place.”
  • A new Gallup poll shows that only 25% of Americans under 35 support the war in #Gaza. Does this statistic worry you?
  • “You will stomp us into the dirt,” is how her mother responded to Anya Ulinich’s new tragicomic graphic novel. Paul Berger has a more open view of ‘Lena Finkle’s Magic Barrel." What do you think?
  • PHOTOS: Hundreds of protesters marched through lower Manhattan yesterday demanding an end to American support for Israel’s operation in #Gaza.
  • Does #Hamas have to lose for there to be peace? Read the latest analysis by J.J. Goldberg.
  • This is what the rockets over Israel and Gaza look like from space:
  • "Israel should not let captives languish or corpses rot. It should do everything in its power to recover people and bodies. Jewish law places a premium on pidyon shvuyim, “the redemption of captives,” and proper burial. But not when the price will lead to more death and more kidnappings." Do you agree?
  • Slate.com's Allison Benedikt wrote that Taglit-Birthright Israel is partly to blame for the death of American IDF volunteer Max Steinberg. This is why she's wrong:
  • Israeli soldiers want you to buy them socks. And snacks. And backpacks. And underwear. And pizza. So claim dozens of fundraising campaigns launched by American Jewish and Israeli charities since the start of the current wave of crisis and conflict in Israel and Gaza.
  • The sign reads: “Dogs are allowed in this establishment but Zionists are not under any circumstances.”
  • Is Twitter Israel's new worst enemy?
  • More than 50 former Israeli soldiers have refused to serve in the current ground operation in #Gaza.
  • "My wife and I are both half-Jewish. Both of us very much felt and feel American first and Jewish second. We are currently debating whether we should send our daughter to a Jewish pre-K and kindergarten program or to a public one. Pros? Give her a Jewish community and identity that she could build on throughout her life. Cons? Costs a lot of money; She will enter school with the idea that being Jewish makes her different somehow instead of something that you do after or in addition to regular school. Maybe a Shabbat sing-along would be enough?"
  • Undeterred by the conflict, 24 Jews participated in the first ever Jewish National Fund— JDate singles trip to Israel. Translation: Jews age 30 to 45 travelled to Israel to get it on in the sun, with a side of hummus.
  • from-cache

Would you like to receive updates about new stories?




















We will not share your e-mail address or other personal information.

Already subscribed? Manage your subscription.