Arkansan’s brain grew new nerves
Posted on Tuesday, July 4, 2006
Doctors have their first proof that an Arkansas 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 pickup crash.
Terry Wallis, 42, is one of the few people in the United States known to have recovered so dramatically so long after a severe 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’ recovery transpired three years ago at a rehabilitation center in Mountain View in Stone County, but doctors said the same cannot be hoped for people in a persistent vegetative state, such as Terri Schiavo, the Florida woman who died last year after a fierce right-to-die court battle. 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 Dr. 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.”
Wallis remembers nothing 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 Wallis of Big Flat, Ark., said in a statement, adding that until recently his son insisted he was 20 years old.
His son spends almost all of his waking hours in bed, listening to country and western music in a two-room bungalow.
He wears an open, curious expression and speaks in a slurred but coherent voice. He volleys a visitor’s pleased-to-meet-you with “Glad to be met,” and can speak haltingly of his family’s plans to light fireworks at his brother’s house nearby.
The research on Wallis, published Monday in the Journal of Clinical Investigation, was led by imaging expert Henning Voss and neurologist Dr. Nicholas Schiff at the Weill Medical College of Cornell University in New York City and included doctors at JFK Medical Center in Edison, N. J.
This weekend Wallis said he felt good, but he showed no memory of the study. After prompting from his mother, he did remember the trip back from the researchers ’ laboratory in New York.
“Gasoline,” he said, referring to a stop the airplane made to refuel. “We stopped for gasoline.”
His mother, Angilee Wallis, said, “He is starting to learn things now. That right there is new.”
In recent weeks, she said, he has also shown hints of self-awareness, alluding to his disabled condition for the first time.
His parents live with and care for their son in a white clapboard cabin, with a small concrete porch surrounded on all sides by acres of trees.
Wallis was 19 when he suffered the traumatic brain injury in 1984 that left him briefly in a coma and then in a minimally conscious state. He and his wife, Sandi, then 17, had been married only four months. The couple’s newborn daughter, Amber, was 6 weeks old.
Until June 2003, he remained awake but uncommunicative other than occasional nods and grunts.
“The nerve fibers from the cells were severed, but the cells themselves remained intact,” unlike Schiavo, whose brain cells had died, said Dr. James Bernat, a neurologist at Dartmouth-Hitchcock Medical Center in New Hampshire who is familiar with the research.
Nerve cells that have not died can form new connections; for example, nerves in the arms and legs can grow about an inch 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.
Researchers used a new type of brain imaging available only in research settings — not ordinary hospitals or rehabilitation centers — to establish that regrowth occurred. It tracks the direction of water molecules in and around brain cells, an indicator of brain activity.
“It’s a road map of how the connections are running,” Schiff said.
The Charles A. Dana Foundation, which finances brain research, funded the scientific work. The lead author, Voss, also received money from the Cervical Spine Research Society, whose sponsors include companies that make spine-care products. The British Discovery Channel and HBO paid to fly Wallis and family members to Cornell for tests.
“Most neurologists would have been willing to bet money that whatever the cause of it, if it hadn’t changed in 19 years, wasn’t going to change now,” Bernat said. “So it’s really extraordinary.”
Wallis’ family was no less shocked at what at the time seemed to be Terry Wallis’ sudden, miraculous change.
Angilee Wallis walked into her son’s room at the Stone County Nursing Home and Rehabilitation Center on June 12, 2003, and called out her usual greeting: “Who’s here ? Who is it who came to visit you today ?”
After 19 years without a response, she nearly dropped to the floor when he answered, “Mom.”
Shortly after, Dr. James Zini strode into the room. Within minutes, he and Terry Wallis were debating Pepsi versus Coke.
“What would you do if I gave you a Coke ?” Zini asked.
“I would pour it out,” Wallis replied.
That comment — along with numerous revelations about Wallis’ family — quickly made international news, and not all of it flattering to the family.
A typical headline, this one from Sydney, Australia: “Family feud swirls around coma man (wife has three kids with another man, his daughter is a stripper )”
In the years after her husband’s accident, Sandi Wallis refused to divorce him. But she had three children with another man, and, at one point, a relationship with Terry’s brother, Perry.
She and the Wallises bickered for weeks before she was allowed to see her husband. The daughter, Amber, also went to see her father. It was the first time she’d ever heard his voice.
Wallis has a granddaughter now, Amber’s child Victoria.
He does not feel any physical pain, he told his parents, and he has no real sense of time. He also said recently that he was “proud” to be alive.
“It is good to know all that,” said his father.
“It’s good to hear him say that, because if he didn’t say so, you’d just have no way to know.” Information for this article was contributed by Marilynn Marchione of The Associated Press, Benedict Carey of The New York Times and Cathy Frye of the Arkansas Democrat-Gazette.
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