The persistent vegetative state (PVS) is a condition in which awareness of the self and the environment is absent. However, neuroimaging studies suggest that normal brain activity in response to speech and faces can remain in the PVS, although it is not clear if this activity reflects higher levels of perception and cognitive processes, as only meaningless stimuli were used as control conditions.¹ One way to investigate such higher cognitive processes is to examine whether differential activity can be evoked by different contents of language.

We examined brain activity in a patient in the PVS during hearing his own first name compared with another name. Previous studies found activation of the medial prefrontal cortex (MPFC) in healthy subjects during hearing their own name and self referential processing.²

We investigated the case of a 50-year-old man, who had a myocardial infarction with cardiac arrest in March 2003. The diagnosis of PVS was confirmed by two neurologists. The patient showed normal hypothalamic and brain stem autonomic functions and a normal sleep–wake cycle, but no signs of awareness. Magnetic resonance imaging of the brain showed diffuse symmetric leucoencephalopathy and brain atrophy. Positron emission tomography showed an overall reduction in resting brain metabolism (especially marked in the bilateral frontal, parietal and cingulate cortex, as well as in the precuneus). The functional magnetic resonance imaging (fMRI) study was carried out in January 2004; the patient’s …