Researchers in Canada say they have used a short film by Alfred Hitchcock to uncover consciousness in a patient in a vegetative condition who for 16 years had been completely unresponsive.

Using the film and an MRI scanner, the researchers found that healthy study participants displayed a shared display of synchronized brain activity; the unresponsive patient showed brain responses strongly resembling those of healthy study volunteers, indicating he was both consciously aware and that he understood what was happening in the movie.

The study, conducted at Western University in Ontario, used a short Hitchcock film, further edited to 8 minutes to make the MRI scanning sessions brief, in which a young boy finds his uncle's handgun which he partially loads and then plays with around his house and outside, unaware of any potential danger.

The researchers said they chose the film by Hitchcock, often called "The Master of Suspense," for its linear but engaging story line capable of evoking robust brain activity.

"For the first time, we show that a patient with unknown levels of consciousness can monitor and analyze information from their environment, in the same way as healthy individuals," says Lorina Naci, lead researcher for the study published in the U.S. journal Proceedings of the National Academy of Sciences.

Unresponsive patients who are potentially conscious are unable to speak or display voluntary behavior to convey their conscious experiences to others, the researchers note.

"We already know that up to one in five of these patients are misdiagnosed as being unconscious and this new technique may reveal that that number is even higher," Naci says.

The study findings may offer a better tool for gauging responsiveness in patents who may have been misdiagnosed as lacking any consciousness, the researchers say, by providing evidence of a brain-injured patient's "intact conscious experiences."

This could provide better understanding of their condition and directly impact their ongoing care, they say.

"This approach can detect not only whether a patient is conscious, but also what that patient might be thinking," says Adrian Owen, head of the Cognitive Neuroscience and Imaging department of the university's Brain and Mind Institute.

"Thus, it has important practical and ethical implications for the patient's standard of care and quality of life."

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