Coma Patients Helped by Family Storytelling

By Sondra Forsyth

Sometimes, it seems, love can do what medicine can’t: Researchers have found that loved ones who talk to a patient in a coma can help him or her recover faster.

The study, from Northwestern Medicine and Hines VA Hospital, shows that telling the patient familiar stories stored in long-term memory can help awaken the unconscious brain.

Investigators analyzed reactions from coma patients who heard familiar stories repeated by family members four times a day for six weeks, via recordings played on headphones. They found that these patients recovered consciousness significantly faster and had an improved recovery when compared with patients who didn’t hear stories.

The findings were published in the journal Neurorehabilitation.

“We believe hearing those stories in parents’ and siblings’ voices exercises the circuits in the brain responsible for long-term memories,” said lead author Theresa Pape, a neuroscientist in physical medicine and rehabilitation at Northwestern University Feinberg School of Medicine and a neuroscientists at Hines VA. “That stimulation helped trigger the first glimmer of awareness.”

“It’s like coming out of anesthesia,” Pape said. “It’s the first step in recovering full consciousness.”

The familiar voices treatment also benefits families, she said. “Families feel helpless and out of control when a loved one is in a coma. It’s a terrible feeling for them. This gives them a sense of control over the patient’s recovery and the chance to be part of the treatment.”

The randomized, placebo-controlled study, called Familiar Auditory Sensory Training (FAST, consisted of 15 patients with traumatic closed head injuries who were in a vegetative or minimally conscious state. The average age of the 12 men and 3 women was 35; their injuries were caused by motorcycle or car accidents, bomb traumas or assaults. The treatment began an average of 70 days after injury.

The researchers did baseline testing to see how responsive patients were, and had the patients listen to familiar and non-familiar persons tell different stories to understand how much the blood oxygen levels in their brain while listening.

The biggest signs of recovery were seen in the first two weeks of treatment, with additional, smaller gains over the next four weeks. The researchers found that when the patients were undergoing an MRI while listening to family members, their brain showed increased neural activity.

The experts said it was important to choose a story that the patient would remember.  “It could be a family wedding or a special road trip together such as going to visit colleges,” Pape said. “It had to be something they’d remember, and we needed to bring the stories to life with sensations, temperature and movement. Families would describe the air rushing past the patient as he rode in the Corvette with the top down or the cold air on his face as he skied down a mountain slope.” Patients’ families recorded at least eight stories.

Pape said she is studying the results to see if FAST strengthens elongated fibers called axons, which transmit signals between neurons.