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 one of the few people known to have recovered so dramatically so long after a serious 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 at a rehabilitation center in Mountain View, Arkansas, but doctors said the same cannot be hoped for people in a persistent vegetative state. 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 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," he said.
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 on Monday in the Journal of Clinical Investigation, was led by imaging expert Henning Voss and neurologist Nicholas Schiff at the Weill Medical College of Cornell University in New York City and included doctors at JFK Medical Center in Edison, New Jersey.
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.
Nerve cells that have not died can form new connections; for example, nerves in the arms and legs can grow about 2.5cm 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.
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