A simple set of stickers attached to a patient’s head could soon help doctors talk to people who seem completely unresponsive.

In a new study from Columbia University, patients in intensive care units were able to change the pitch of a beeping sound using only their thoughts. Sensors on their scalps picked up their brain activity, and a computer translated those signals into real-time actions.

Finding Hidden Awareness in the ICU

Photo: Triff/Shutterstock

For a long time, doctors assumed that patients who could not move, blink, or follow instructions were entirely unconscious. However, recent work disputes that. According to the study, patients are awake on the inside, even if their bodies cannot carry out the brain’s orders.

“Research in the past decade by us and others has shown that many patients with acute brain injury who appear to be in a coma actually have some level of preserved consciousness, even though they are unable to speak or move their hands or eyes to communicate,” said Jan Claassen, MD, a professor of neurology at Columbia University Vagelos College of Physicians and Surgeons, who led the study.

His team previously discovered that about 15% of seemingly comatose patients showed signs of this hidden awareness, known as cognitive motor dissociation. The brain tries to move a hand or foot, but the message is cut off before it reaches the muscles.

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Getting Direct Answers

While other high-tech systems require surgery to implant microchips into the brain, the Columbia team wanted technology that is safer for critical hospital settings. They stuck with standard EEG equipment, which uses wires on the outside of the head to monitor brain activity.

A patient listens to a beeping tone through headphones. A recorded voice asks them to adjust the sound’s frequency by imagining opening and closing their hands. A bedside computer reads the electrical signals coming from the brain and changes the sound accordingly.

Out of 41 unresponsive patients tested just days after severe injuries, about one in three controlled the beeping sound with their minds.

“Our brain-computer interface is only a first step, but it shows that, in principle, we could hopefully, in the future, give some of these patients a voice,” Claassen said.

Researchers hope to refine the software so that patients can express basic needs, such as whether they are hungry or in pain. Family members who took part in the study even suggested using familiar voices for the prompts to make the process easier.