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Biology 202
2003 First Web Paper
On Serendip

Locked-In Syndrome: Giving Thought The Power Of Action?

Priya Raghavan

Imagine a world in which human communication is executed through the simplicity of thought. No muscle action- no nodding, smiling, slapping, pointing, speaking, or feeling...just through the immobile and inconspicuous medium of thought. This is an example of a locked-in patient. In a locked-in condition, the patient's ability to move his/her limbs, neck, and even muscles is brought to an abrupt halt. Messages ordered by the brain do not reach the muscles that consequently carry out the physical tasks of the brain. The locked-in syndrome leaves the victim completely paralyzed sparing only the eye muscles in most cases.

The reason for this disability is most commonly due to lesions in the nerve centers that control the muscle contractions, or a blood clot that blocks circulation of oxygen to the brain stem. Brain-stem strokes, accidents, extreme spinal-cord injuries, and neurological diseases are other main causes for the syndrome (5). Axons that carry brain signals leave the larger motor areas on the surface of the brain and direct their signals towards the brain stem. It is here where they converge linking one another to form a tightly packed bundle called the motor tract. The brain stem motor tract is extremely sensitive; thus even the slightest impact of a stroke can lead to destruction of the axon bundles resulting in a total paralysis (1). For a locked-in patient, depending on the severity of the stroke, the sensory tracts may or may not be affected. These tracts also form axon bundles and determine the functioning of the feel, touch, and pressure perceptions.

What is interesting is that while total paralysis of the external body is a likely possibility, the eye muscles and brain functioning remain intact and undamaged in most cases.It is rather remarkable to see the wonders of human life; where a person in a locked-in state is often mistaken to being a vegetable while in reality, barring very serious stroke effects, they are regular people who hear, understand, and think as coherently if not better than the next person.

The story of jean-Dominique Bauby is not only inspirational but has motivated scientists around the world to enhance technological means to broaden brain communication. Bauby, a 42 year old editor-in-chief of a French Magazine suffered from a severe brain-stem stroke in 1995. His body was instantly paralyzed leaving him with only one functioning eye muscle. Bauby is praised to this day for his ability to invent life for himself in the most appalling of circumstances. In fact, he astounded the international community when he came out with his own book, "The Diving Bell and the Butterfly"(2).

In this book is explained the number of medical staff and nurses who ignore or overlook the feelings and views of the patient whose only fault is his/her lack of physical or verbal communication. A strong prognosis needs to be recognized and respected for the acknowledgement of the rich mind trapped in a locked-in body. Bauby in his book said, " How many people in this state in enclosed half-lit hospital beds are never stimulated, never recognised as peoples with intact minds who can still contribute of only their talents are acknowledged?" Roger Rees of Flinders University in Adelaide agrees, " Can we make the quantum leap from befuddled locked-in thinking, to behaviour which acknowledges that while their physical world may be closed forever, their inner world is full of rich memories and imaginings whose journey can still be nourished and enhanced (3)?"

In a somewhat angelic disguise are present in this world doctors like Birbaumer. In 1995, Birbaumer, a German scientist on receiving a $1.5 million Leibniz prize focused on training paralyzed people to write out their thoughts with their brains. How this is a possible is indeed the miracle of knowledge and dedication of scholars in the field of science and technology. To establish a tool for communication between the brain and scientist, one must first fill in the missing pieces of the puzzle. Under normal circumstances, a series of electrical impulses are transmitted by the brain cells that flow along the nerves which in turn trigger the release of chemicals, which signal the muscles to flex and contract. Locked-in muscles do not receive any of these chemical messages (2).

Today's science, or rather, tomorrow's cure has shown the significance of computer technology. By implementing glass electrodes into the brains of locked-in patients, it is now possible to observe the growth of brain cell that contains growth- accelerating molecules. The glass electrode in return detects and transmits the brain signals to the computer. The latter translates the signals into screen movements that produce speech imitating the thoughts of the patient. All this is done by the powers of brain and mind- none of it involving the body (4).

The above experiment is indeed fascinating but at the same time a little frightful. Looking into the future of genetic engineering and biotechnology, we must be certain to honor our ethical responsibilities. Abusing science to satisfy one's political or personal appetite is disrespectful and dangerous to the stability of peace. Today it is about reading peoples' minds for them, what then does tomorrow behold? As long as research is done with the intention of bringing hope and light into a person's life, I continue to admire in awe the achievements in science today.


1. 1) National Health Institute Page, excellent for Science and Health information.

2. 2) Ian Parker, " Reading Minds": The New Yorker, January 20, 2003.

3. 3) abc home page, good website.

4. 4) Cleveland Clinic Websire, vast research material.

5. 5) National Institute of Health, one of my favorite websites for the field of health.

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