Formula One legend Michael Schumacher is "very altered and deteriorated" six years on from his skiing accident, a top neurosurgeon has warned.
Nicola Acciari, who is based in Bologna, claims he is now "a person very different from the one we remember on the track".
"We must imagine a person very different from the one we remember on the track, with a very altered and deteriorated organic, muscular and skeletal structure,' Acciari told Italian newspaper Contro Copertina.
"All as a result of the brain trauma he suffered."
The warning comes after Jean Todt, Schumacher's former manager at Ferrari, last year assured fans that he was "still fighting".
"I'm always careful with such statements, but it's true. I saw the race together with Michael Schumacher at his home in Switzerland," he said.
"Michael is in the best hands and is well looked after in his house. He does not give up and keeps fighting.
"His family is fighting just as much and of course our friendship cannot be the same as it once was just because there's no longer the same communication as before."