X-Message-Number: 28162
From: "Basie" <>
Subject: Doctors say man's brain rewired itself
Date: Mon, 3 Jul 2006 17:37:18 -0400

Doctors say man's brain rewired itself By MARILYNN MARCHIONE, AP Medical 
Writer


Doctors have their first proof that a man who was barely conscious for 
nearly 20 years regained speech and movement because his brain spontaneously 
rewired itself by growing tiny new nerve connections to replace the ones 
sheared apart in a car crash.

Terry Wallis, 42, is thought to be the only person in the United States to 
recover so dramatically so long after a severe brain injury. He still needs 
help eating and cannot walk, but his speech continues to improve and he can 
count to 25 without interruption.

Wallis' sudden recovery happened three years ago, but doctors said the same 
cannot be hoped for people in a persistent vegetative state, such as 
Terry Schiavo, the Florida woman who died last year after a fierce 
right-to-die court battle. Nor do they know how to make others with less 
serious damage, like Wallis, recover.

"Right now these cases are like winning the lottery," said Dr. Ross Zafonte, 
rehabilitation chief at the University of Pittsburgh Medical Center, who was 
not involved in the research. "I wouldn't want to overenthuse family members 
or folks who think now we have a cure for this."

Wallis has complete amnesia about the two decades he spent barely conscious, 
but remembers his life before the injury. "He still thinks        Ronald 
Reagan is president," his father, Jerry, said in a statement, adding that 
until recently his son insisted he was 20 years old.

The research on Wallis, published Monday in the Journal of Clinical 
Investigation, was led by imaging expert Henning Voss and neurologist Dr. 
Nicholas Schiff at the Weill Medical College of Cornell University in New 
York City and included doctors at JFK Medical Center in Edison, N.J.

Wallis was 19 when he suffered a traumatic brain injury that left him 
briefly in a coma and then in a minimally conscious state, in which he was 
awake but uncommunicative other than occasional nods and grunts, for more 
than 19 years.

"The nerve fibers from the cells were severed, but the cells themselves 
remained intact," unlike Schiavo, whose brain cells had died, said Dr. James 
Bernat, a neurologist at Dartmouth-Hitchcock Medical Center in New 
Hampshire, who reviewed the research.

Nerve cells that have not died can form new connections; for example, nerves 
in the arms and legs can grow about an inch a month after they are severed 
or damaged. However, this happens far less often in the brain.

The new research suggests that instead of the sudden recovery Wallis seemed 
to make when he began speaking and moving three years ago, he actually may 
have been slowly recovering all along, as nerves in his brain formed new 
connections at a glacial pace until enough were present to make a network.

Researchers used a new type of brain imaging only available in research 
settings - not ordinary hospitals or rehabilitation centers - to establish 
the regrowth. It tracks the direction of water molecules in and around brain 
cells, an indicator of brain activity.

"It's a roadmap of how the connections are running," Schiff said.

Doctors compared Wallis' brain function to that of 20 healthy people and 
another minimally conscious patient who showed virtually no recovery for six 
years. All were imaged twice, 18 months apart.

In Wallis' brain, "what we first see is how overwhelmingly severe this 
injury was," with many abnormalities compared to the healthy people, Schiff 
said.

The second set of images showed changes from the first, strongly suggesting 
that new connections had formed. These correlated with areas of the brain 
that affect the ability to move and talk.

The other minimally conscious patient - a 24-year-old man who suffered a 
severe brain injury in a car accident when he was 18 - also had evidence of 
changes in nerve connections, but they were not organized in a way that made 
a difference in his ability to function.

"We'll have to understand more about why recovery occurred" in Wallis' case, 
Zafonte said. "The question is 'why?' It's not just 'wait.'"

Until that is known, imaging cannot be used to predict who will recover, or 
to help patients' brains rewire, he said.

The Charles A. Dana Foundation, which finances brain research, funded the 
scientific work. The lead author, Voss, also received money from the 
Cervical Spine Research Society, whose sponsors include companies that make 
spine care products. The British Discovery Channel and HBO paid to fly 
Wallis and family members to Cornell for tests.

"Most neurologists would have been willing to bet money that whatever the 
cause of it, if it hadn't changed in 19 years, wasn't going to change now," 
Bernat said. "So it's really extraordinary."

Wallis' father said his son is now able to make jokes. "That was something 
he wasn't able to do early in his recovery," Jerry Wallis said. "He now 
seems almost exactly like his old self. And he very often tells us how glad 
he is to be alive."

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