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General Health : Mental Health Last Updated: Apr 20, 2011 - 9:38:09 AM

Miracle man's brain recovers by reestablishing long-forgotten nerve connections
By Kathy Jones
Jul 4, 2006 - 3:03:00 PM

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4 July, ( - A man who was in coma for nearly 20 years has shown a miraculous recovery prompting doctors to reassess the brain's capacity for repairing itself. Terry Wallis, 42 was involved in a car accident in 1984 and had slipped into a coma called as "minimally conscious state" (MCS) after that.

For 19 long years after that Wallis was barely aware of what went on around him. Then one fine day - June 11, 2003 to be exact - Wallis uttered his first word. "Mom," he called out at the sight of his mother. His electrifying recovery was widely reported at that time and three years hence, Wallis continues to show a fair degree of improvement.

Doctors who were astonished at his recovery have delved into the depths of his brain to find out exactly what took place in its recesses. Their report can be accessed in the July issue of the Journal of Clinical Investigation.

"This is the only patient who was known to emerge after such a long time from such a state," said senior author Dr. Nicholas Schiff, associate professor of neurology and neuroscience at Weill Cornell Medical College in New York City. "This particular story of a man 20 years out recovering and sustaining the recovery and moving on is certainly, to my knowledge, unique and never studied."

Schiff first met Wallis in April 2004. He recalls that Wallis was a lost man with severe speech and motor impairment. "He had a very inarticulate speech pattern but was fluent in language and had recovered a good deal of what appeared to be his baseline personality," he continued. "We were told that prior to that event he could look at you, follow you around room, nod his head or grunt inconsistently but not communicate."

Two years after he began uttering words, Wallis is more alert has improved his language skills and can move his feet although he cannot walk. "That was surprising to us, because we had definitely predicted that he wouldn't recover any function in his limb movements and strengths," Schiff said.

Henning Voss, lead author of the study and assistant professor of physics and radiology at Weill Cornell Medical College, said that initially it is difficult to understand Wallis, but he can communicate quite effectively. "He still can't walk, but he can move his legs and a little bit also his hands, and he can talk."

So what exactly went right in Wallis's brain?

Researchers used a new technique called diffusion tensor imaging (DTI) to scan his brain. Additionally state-of-the-art structural and functional neuroimaging techniques were put to use to see what had changed in Wallis's brain.

His brain images were compared with 20 healthy people's brain images as well as that of another patient who had been in an MCS for six years with no sign of recovery.

The first scan was conducted eight months after Wallis uttered his first words. These images revealed that Wallis had suffered severe damage to his white matter, but in one region of his brain there was an increase in tissue bulk. White matter is that part of the brain which transmits information. It contains nerve fibers wrapped in an insulating fatty substance, called myelin.

The information transmitted by white matter is processed by gray matter.

Doctors conducted a second scan on Wallis's brain after 18 months. They found increased white matter in a second area of his brain. This area is associated with movement and co-ordination. Dr Voss said that the increase in white matter here was physically reflected in the improvement shown by Wallis.

Researchers believe that the only explanation is that structures called axons have re-grown. Axons are thin connections that make links between different brain cells. "We are thinking there must be a reason why he came out of the minimally conscious state at some point, and our interpretation is that there was a very slow and ongoing self-healing process in the brain," Dr Voss explained.

Additionally Wallis also started taking some medications like the anti-depressant drug Paxil. Dr Schiff says this could have played a role as well. "I have become more willing to believe over time that that might have played a role," he said. "I kind of doubt that axonal regrowth is the whole story."

This case has convinced doctors that there is more to the brain's capacity of self-healing than mere chance. "The first thing is that we have to better understand the self-healing processes and, once we know more about it, then we can think about how to support this process," Voss said.

More patients need to be studied before arriving at any conclusions. But the recovery posted by Wallis must also be accepted, Schiff said. "This happened, and we should adapt to that as a medical reality and rethink the way we are tracking patients and what kind of access patients with severe brain injury have to basic clinical follow up."

Brain Injuries
* A brain injury is defined as a blow or jolt to the head or a penetrating head injury that disrupts the function of the brain, according to the Brain Injury Association of America.

* Around 1.4 million suffer a brain injury in the US each year. Of there
* 50,000 die;
* 235,000 are hospitalized; and
* 1.1 million are treated and released from an emergency department.

* The Centers for Disease Control and Prevention estimates that at least 5.3 million Americans currently have a long-term or lifelong need for help to perform activities of daily living as a result of a head or brain injury.
For more information, visit Brain Injury Association.

© 2004-2008 by unless otherwise specified

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