A Canadian man who was believed to have been in a vegetative state for more than a decade, has been able to tell scientists that he is not in any pain.
It's the first time an uncommunicative, severely brain-injured patient has been able to give answers clinically relevant to their care.
Scott Routley, 39, was asked questions while having his brain activity scanned in an fMRI machine.
His doctor says the discovery means medical textbooks will need rewriting.
Vegetative patients emerge from a coma into a condition where they have periods awake, with their eyes open, but have no perception of themselves or the outside world.
Mr Routley suffered a severe brain injury in a car accident 12 years ago.
None of his physical assessments since then have shown any sign of awareness, or ability to communicate.
But the British neuroscientist Prof Adrian Owen - who led the team at the Brain and Mind Institute, University of Western Ontario - said Mr Routley was clearly not vegetative.
"Scott has been able to show he has a conscious, thinking mind. We have scanned him several times and his pattern of brain activity shows he is clearly choosing to answer our questions. We believe he knows who and where he is."
Prof Owen said it was a groundbreaking moment.
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