Media playback is unsupported on your device Media caption The moment when Prof Owen asked patient Scott whether he was in pain 
 
 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. 
 
 Panorama: Find out more Fergus Walsh presents The Mind Reader: Unlocking My Voice - a Panorama Special 
 
 BBC One, Tuesday, 13 November, at 22:35 GMT 
 
 BBC World News on Saturday, 17 November, at 09:10 GMT and on Sunday, 18 November, at 02:10 & 15:10 GMT Then available in the UK on the BBC iPlayer 
 
 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. 
 
 Read the blog Finding a voice for the brain injured 
 
 "Asking a patient something important to them has been our aim for many years. In future we could ask what we could do to improve their quality of life. It could be simple things like the entertainment we provide or the times of day they are washed and fed." 
 
 Scott Routley's parents say they always thought he was conscious and could communicate by lifting a thumb or moving his eyes. But this has never been accepted by medical staff. 
 
 Prof Bryan Young at University Hospital, London - Mr Routley's neurologist for a decade - said the scan results overturned all the behavioural assessments that had been made over the years. 
 
 FMRI SCANNING Functional Magnetic Resonance Imaging measures the real-time activity of the brain by tracking the flow of oxygen-rich blood 
 
 The patients were repeatedly asked to imagine playing tennis or walking around their home 
 
 In healthy volunteers each produces a distinct pattern of activity, in the premotor cortex for the first task and the parahippocampal gyrus for the second 
 
 It allowed the researchers to put a series of yes or no questions to severely brain-injured patients. A minority were able to answer by using the power of thought 
 
 In 2010 Prof Owen published research showing that nearly one in five of the vegetative patients were able to communicate using brain activity 
 
 "I was impressed and amazed that he was able to show these cognitive responses. He had the clinical picture of a typical vegetative patient and showed no spontaneous movements that looked meaningful." 
 
 Observational assessments of Mr Routley since he responded in the scanner have continued to suggest he is vegetative. Prof Young said medical textbooks would need to be updated to include Prof Owen's techniques. 
 
 The BBC's Panorama programme followed several vegetative and minimally-conscious patients in Britain and Canada for more than a year. 
 
 Another Canadian patient, Steven Graham, was able to demonstrate that he had laid down new memories since his brain injury. Mr Graham answers yes when asked whether his sister has a daughter. His niece was born after his car accident five years ago. 
 
 The Panorama team also followed three patients at the Royal Hospital for Neuro-disability (RHN) in Putney, which specialises in the rehabilitation of brain-injured patients. 
 
 It collaborates with a team of Cambridge University neuroscientists at the Wolfson Brain Imaging Centre at Addenbrooke's hospital, Cambridge. 
 
 Media playback is unsupported on your device Media caption Panorama's Fergus Walsh meets Professor Adrian Owen to learn what the brain is like when in a vegetative state 
 
 One of the patients is diagnosed as vegetative by the RHN, and he is also unable to show awareness in an fMRI machine. 
 
 A second patient, who was not able to be fully assessed by the RHN because of repeated sickness, is later shown to have some limited awareness in brain scans. 
 
 The Mind Reader: Unlocking My Voice - a Panorama Special - will be broadcast on Tuesday, 13 November, at 22:35 on BBC One. It wil be on BBC World News on Saturday, 17 November, at 09:10 GMT and on Sunday, 18 November at 02:10 & 15:10 GMT. Alternatively, catch up later on the BBC iPlayer using the link above. ||||| A patient is prepared for an MRI in a file photo. The medical advancement is being touted as the first of its kind in the world. It happened last June when doctors in London, Ont., used a functional magnetic resonance imaging machine (fMRI) to analyze brain activity patterns in Scott Routley. Photograph by: Miguel Alvarez , AFP/Getty Images 
 
 TORONTO - For more than a decade, Scott Routley has been living in a vegetative state. 
 
 He can't talk. He can't move. And although his eyes are open, no one is sure whether he can see. 
 
 But now, for the first time, doctors caring for the 39-year-old London, Ont., man say they know he's not in pain. 
 
 And they learned it from Routley himself, by analyzing his brain waves when they asked him. 
 
 "This was a landmark moment for us because for the first time, a patient can actually tell us information, important information about how they're feeling and their current situation," said lead researcher Dr. Adrian Owen on Tuesday. 
 
 The medical breakthrough, believed to be the only time a severely brain injured patient has been able to relay clinically relevant information to their doctors, is being touted as a new way to possibly improve their quality of care. 
 
 Owen, who is the head of the Brain and Mind Institute at the University of Western Ontario, says research published online last year in The Lancet shows that one in five of these patients are conscious, but essentially trapped in their bodies because they're unable to communicate verbally or physically. 
 
 His team has been working for the past year trying to determine whether Routley, who became vegetative following a car crash 12 years ago, had any "residual brain activity" and how much he was able to understand them. 
 
 Last June, the doctors employed a functional magnetic resonance imaging machine (fMRI) to see if they would be able to analyze his brain patterns. 
 
 They told Routley that they wanted him to imagine that he was playing tennis if he wasn't in pain or imagine that he was walking around his house if he was in pain. 
 
 The thought process involved in playing a complex sport like tennis triggers the part of the brain that controls motor skills, while thinking about walking around your house triggers visual associations — contained in a separate area of the brain. 
 
 With the fMRI, doctors were able to measure the activity in Routley's brain and conclude he was trying to tell them he was free of pain. 
 
 Owen says for now, this technology is effective in determining responses to simple yes or no questions but may eventually pave the way for vegetative patients to communicate on a regular basis using a computer-assisted interface. 
 
 "We can use this type of technology to ask them what sort of entertainment they want to be exposed to? Do they want to watch TV or do they want to listen to music? What type of music? What time would they like to be fed... activities of daily living which are entirely under the control of these people around them, the people caring for them," he said. 
 
 "We can now ask the patients about these things and give them a role in the decision making that governs their life." 
 
 Neurologist Dr. Bryan Young says Routley's family has always been "convinced" that he was awake and aware in his state. 
 
 He says this technology has the potential to become an instrumental tool for the medical community to assess whether a vegetative patient wants to live or die. 
 
 But Young warned that it would only be helpful if there was a reliable test available to determine if the patient was psychologically sound, and able to make and convey their wishes. 
 
 "One has to establish, though, that apart from these simple responses to these simple commands, they are able to think in a deeper and more profound way about their quality of life and their wishes and goals and what they would prefer," he said. 
 
 Routley, who is currently living at the Parkwood Hospital in London, is among several vegetative Canadian and British patients featured in a documentary airing Tuesday on the BBC.
– An intriguing medical breakthrough out of Canada—doctors say they have been able for the first time to communicate with a patient who has severe brain damage. Better yet, the message delivered by the patient was a great one: I'm not in pain. The Canadian Press and the BBC explain that doctors studied the patient's brain waves as they voiced a command: he should think about playing tennis if he were not in pain or about walking around the house if he were. The activities trigger different parts of the brain—motor skills vs. visual associations—and the man's brain waves suggested he was pain-free. "Scott has been able to show he has a conscious, thinking mind," says a British neuroscientist, referring to 39-year-old Scott Routley. "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." Routley has been in a vegetative state since a car accident 12 years ago.