What if consciousness isn’t as cut-and-dry as we imagined?

That’s the question Dr. Adrian Owen and his colleagues at Western University’s Brain and Mind Institute have been asking for the past several years.

For Owen, a cognitive neuroscientist from Gravesend, England — and now the author of Into the Gray Zone, an exploration into his work — it all began with a patient breakthrough in 1997. At the time, he and his colleagues in Cambridge, England were dealing with a patient who had lapsed into a state of unconsciousness and was presumed to be in a vegetative state. Suddenly, inspiration struck.

“My colleagues and I thought it would be a good idea to put her into the brain scanner to try and work out whether there were any signs of residual activity — and there were,” says Owen.

“I don’t know whether she was conscious or not, but there were certainly parts of her brain that were still responding, and that was the first indication any of us ever had that some of these patients aren’t what they appear to be.”

“What we’re most interested in is finding out if the patient knows where they are, who they are, what has happened them — because it’s very easy to imagine that they might be in a state of complete confusion.” – Dr. Adrian Owen

Owen’s next big breakthrough came in 2006 — and it all happened thanks to a game of tennis.

“At that point, we had been trying for many years to work out ways of detecting consciousness or any sort of cognitive function in patients who might otherwise appear to be in a vegetative state,” he says.

“We had tried all sorts of things, from having them listen to speech while their brains were being scanned to even telling them jokes, but we hadn’t really cracked it. And then we realized that we could ask people to imagine that they were performing a motor act — you know, moving their arms around — and if you imagine playing tennis, that’s a very good way of getting people to think about moving their arms around.”

The resulting brain scan, says Owen, was like a Christmas tree lighting up.

“Each time we asked her to do this, the same thing happened. Her brain would act in response to being asked to imagine playing tennis, and that was a clear signal for us that she was conscious and aware, she understood the instructions we were giving her, and she knew what we were asking her to do.”

The work exploded, carrying his research to the pages of The New York Times and onto the BBC, CBC, CNN, and NPR. In 2010, Western University offered Owen a $10-million Canada Excellence Research Chair to continue his work in London, Ont. In the past half-decade, Owen and his colleagues have continued their work, looking at other, less-demanding ways of detecting consciousness. One study tested the effectiveness of detecting consciousness by measuring patients’ responses to suspenseful scenes in Alfred Hitchcock’s films. Other work has focused on the similarities between sleep and unconsciousness.

“The holy grail is to try and find a method for detecting conscious and detecting residual cognitive function that doesn’t require that the patient responds — some method where we can simply scan the patient lying in brain scanner and know that they were conscious.” – Dr. Adrian Owen

“What we’re most interested in is finding out if the patient knows where they are, who they are, what has happened them — because it’s very easy to imagine that they might be in a state of complete confusion,” says Owen.

“Once we’ve established a good line of communication, then we’ll start to explore more clinically important questions, like, What do they like to do? How do they like to be entertained? Do they like to watch TV or listen to the radio? Most importantly […] we ask whether [they’re] in any pain. Because I think that’s an extremely important question, and of course, it’s something that we can do something about.”

“For us,” he adds, “the holy grail is to try and find a method for detecting conscious and detecting residual cognitive function that doesn’t require that the patient responds — some method where we can simply scan the patient lying in brain scanner and know that they were conscious.”

As for what keeps him going 20 years after his first breakthrough?

“It’s the few moments where something really fantastic, really amazing happens, that drives my team and I on,” says Owen.

“It’s tremendously exciting when you realize that you’re able to do something that’s never been done before.”

Photo from owenlab.uwo.ca.