Familiar Voices

In 2010 Godfrey Catanus, then a youth minister in Irvine, Calif., suffered a blood clot in his liver, followed by a brain hemorrhage. He underwent brain surgery and fell into a coma.

Godfrey and his wife, Corinth, a neonatal intensive care nurse, had grown up in the Chicago suburbs, and after raising funds from their church community, she arranged to have him flown to the Rehabilitation Institute of Chicago for treatment.

Godfrey had been in a coma for three months when Corinth enrolled him in a Northwestern Medicine and Hines VA Hospital study to explore the power of familiar stories to help awaken the unconscious brain and speed recovery from a coma.

Patients in the study, led by Feinberg School of Medicine neuroscientist Theresa Pape, heard familiar stories repeated by family members four times a day for six weeks, via recordings played over headphones. 

Corinth recorded stories about their first kiss and her cravings for chicken nuggets when she was pregnant with their second daughter. (See the CBS This Morning feature on Theresa's Pape's research.)

The recordings helped awaken Godfrey and pull him back to consciousness. According to the study, patients who heard familiar stories recovered consciousness significantly faster and had an improved recovery compared with patients who heard only silence. 

“We believe hearing those stories in parents’ and siblings’ voices, when the stories are repeated multiple times, exercises the circuits in the brain supporting the retrieval of long-term memories,” says Pape. “That stimulation helped trigger the first glimmer of awareness.”

With that awareness, coma patients wake more easily, become more cognizant of their environment and may start responding to directions. When patients become more aware of their environment, they can more actively participate in physical, speech and occupational therapy, all essential for their rehabilitation and further recovery.

For years Pape worked with coma patients as a speech therapist at RIC. “The one thing families told me was, ‘Well, you know, he responds to me better because he knows me.’ I watched and realized they were right, sometimes patients do respond better to the families. That’s how the seed was planted.”

Pape speculated that if therapists could stimulate and exercise people’s brains when they are unconscious, it would help them recover. She developed the Familiar Auditory Sensory Training protocol and secured funding from Veterans Affairs to test her theory.

The recent study, randomized, double blinded and placebo controlled, included 15 patients who were in a coma. Eight patients heard stories; the other seven heard silence. 

Parents and siblings, armed with family photo albums and videos, worked with therapists to construct the stories — five minutes in length — about happy, sad and neutral events that the patient and family member participated in together. “The stories should be about an event that is easy to recreate,” says Pape. “If it’s a story about a downhill ski trip, you want the patient to almost feel the cold wind blowing in his face, making his nose numb. You want to pick stories that come to life in his mind visually.”

When patients like Godfrey in the study heard the voice of a family member calling out their names and reciting stories while they were in an MRI, their brains showed increased neural activity, indicated by bright yellow and red areas, or regions, involved with understanding language and retrieving long-term memories.

“That’s why I think the FAST treatment works,” says Pape, “because we’re referencing those very well-established networks that have to exist in order for us to create long-term memories or encode them in our brain.” Pape is continuing to study what occurs at the neural network level to support the gains achieved by the patients who heard familiar voices.

And telling those old familiar tales benefits the families too. Just ask Corinth Catanus.

“The stories I told him helped Godfrey recover from his coma, and they helped me feel I could do something for him,” says Corinth. “That gave me hope.”

Today Godfrey is still severely disabled, but he writes weekly devotionals that appear in his church bulletin, and he communicates with his wife and two daughters by typing on his iPad.

See the CBS This Morning feature on Theresa's Pape's research.

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