Collecting Family Stories to Tell

The next step was having families work with therapists to identify and construct the important stories about events that the patient and family participated in together.

“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.”

Families brought in an armful of photo albums to come up with topics for the stories. Then parents and siblings recorded at least eight stories, which they practiced reciting naturally and using the patient’s nickname.

After six weeks of listening to the recorded stories, Pape repeated the earlier baseline tests in an MRI. In one, patients listened to familiar and unfamiliar voices telling the same story they heard at baseline (a short joke about a man buying ice-cream and getting a pickle with it.)

The MRI image showed a change in the oxygen level, indicating greater responsiveness to the unfamiliar voice telling a story. The oxygen level did not change for the familiar voice, which remained the same as baseline.

“This indicates the patient’s ability to process and understand what they’re hearing is much better,” Pape said. “At baseline they didn’t pay attention to that non-familiar voice. But now they are processing what that person is saying.’‘

In another test, patients listened to a small bell ringing as before. But this time, patients’ brains responded less to the bell, indicating they were better able to discriminate what’s important to listen to.

“Mom’s voice telling them familiar stories over and over helped their brains pay attention to important information rather than the bell,” Pape said. “They were able to filter out what was relevant and what wasn’t.”

The biggest gains in recovery came in the first two weeks of the treatment, with small incremental gains over the next four weeks.

Pape is currently analyzing her data to determine if the FAST intervention strengthened the brain’s wiring, the elongated fibers called axons that transmit signals between neurons.

Recording and playing the stories is something all families can do when a loved one is in a coma. It is logical that people in a coma as a result of a stroke would also respond favorably to the treatment, Pape said.

“This gives families hope and something they can control,” Pape said. She recommends families work with a therapist to help them construct the stories. The recorded stories can augment the other therapies a patient is undergoing.

Why Pape Launched the Study

Pape was inspired to launch the study based on families’ feedback while she worked as a speech therapist for coma patients with traumatic brain injuries. Families often told her the patient responded better to them than to a stranger. Pape began to observe the patients with families and saw they were right.

Pape speculated that if therapists could stimulate and exercise people’s brains when they are unconscious, it would help them recover. She developed the protocol to see if it worked. The study was funded by V.A.‘s Rehabilitation, Research and Development Service.

Patient Godfrey Catanus Emerges from Coma

Corinth Catanus’s voice, recorded on a CD, playfully reminded her husband, Godfrey, of the morning she craved chicken nuggets during her second pregnancy.

“Remember the morning I had a craving for chicken nuggets, and no fast food restaurant sold it that early in the morning?” she asked. He drove to several fast-food locations across town before work to find them, she recalled, only to discover they were the wrong kind when he arrived home. That night he renewed his quest until he snagged the exact ones she coveted.

Family stories like these - recorded by Corinth and Godfrey’s brothers - were played through headphones for Godfrey four times a day while he lay in a three-month coma. He was part of a Northwestern Medicine and Hines V.A. clinical trial that studied whether repeated stimulation with familiar voices could help repair a coma victim’s injured brain networks and spur his recovery.

Those recordings helped awaken Godfrey from his vegetative state and pull him back to consciousness, based on the new study findings.