“Scientists have discovered a “signature” in brain activity that could explain why some severely brain injured patients awake from a minimally conscious state as result of sleep aid drugs and other medication. This is according to a study published in the journal eLife.”
Comas are a scary thing. On Reddit, a few people who came out of comas commented that the experience is very unlike how fiction likes to portray it. They recalled a few seconds before they went out (one guy cited a motorcycle accident), then the next second, to them, they were in a bed, sometimes pantomiming the experience. That sounds utterly terrifying to have such a massive lapse in memory.
The article I am responding to reports that patients using the sleep drug Ambien have been shown to awaken from this “minimal cognitive state.” The article goes on to show how little we really understand the brain and damage to it:
Using electroencephalography (EEG) to monitor the patients’ brain waves when using Ambien, the researchers found that although their brains were damaged in different ways, they all demonstrated the same low frequency waves in their readings. In detail, these brain waves were found to be most active in the frontal cortex – a region known to be very dependent on other brain structures in order to be active, mostly the central thalamus and the striatum. These two areas work together to support a variety of functions, including short-term memory, reward, motivation, attention, alertness and sleep.
Essentially, despite everyone studied suffering damage through very different means, they all displayed the same net results in their brains. This notion leads me to believe that this minimal cognitive state,with my absolutely cursory understanding of brain evolution, could be a manner of self-preservation and protection that we evolved over the eons. It’s fascinating to think that early humans, who would have been less cautious in their lives, would have been more susceptible to potentially debilitating head injuries, and should they incur an injury like this, would they go into a low level catatonia, only to be perceived as dead? That’s kind of a chilling notion. How many early humans were presumed dead and left semi-conscious to decay?
The link between Ambien, a powerful sedative, and awakening these with brain damage is equally fascinating. The article says:
The investigators explain that in healthy people who use Ambien, it produces sedation and causes them to sleep. But in those who suffer severe brain damage, it activates the brain further following its activation of the “sleeping” cells, causing the patients to become more awake. […] “What we think is happening in these patients is that the initial excitation produced by Ambien turns on a specific circuit. The drug creates the opportunity for the brain to effectively catch a ride on this initial wave of excitation, and turn itself back on.”
So, in essence, Ambien acts as a reset charge for the brain. The article mentions that Ambien doesn’t really repair the damage, so much as act as a vehicle for repair, and that for true results, regular use must continue. L-Dopa (dopamine) is suggested as another drug that may recreate these benefits.
Considering the scary experience for insomnia that is Ambien, I think finding uses like this for drugs is imperative to keeping them around. The pharmaceutical industry is too quick to create a drug that does X with Y side effects rather than creating a drug that targets a particular function of the body and can be used for many reasons. With the growing call to legalize illicit substances, many of which have beneficial health properties, I think more studies like this will be funded with a great sense of regularity. Showing that despite the drug’s downsides there are many benefits will lead to them being embraced by the public.