Schumacher suffered serious brain injuries after hitting his head on a rock when skiing off-piste in the exclusive French resort of Meribel at the end of December, with attempts to bring him out of his medically-induced coma now in an eighth week.
The 45-year-old's manager Sabine Kehm confirmed 13 days ago that attempts to awaken the seven-time world champion are continuing and will do for "as long as it takes", warning that it can be a very long and drawn out process.
However, Dr Hartstein - who was a key figure in the paddock until the end of the 2012 season - has admitted that the longer it takes, the less likely it is that Schumacher will ever recover.
Writing on his personal blog, the American said: "As time goes on it becomes less and less likely that Michael will emerge to any significant extent."
A number of tributes and messages of support have been passed on in the hope that Schumacher will recover, and the support across the globe is not a surprise for the 58-year-old Professor.
"I always knew Michael was adored," Dr Hartstein continued.
"I spent years at circuits drenched in red by the Ferrari caps, flags, and shirts, and all of that for Michael. I'm still staggered by the depth and persistence of his fans' love for him.
"And whereas I worried more than a bit about what was going to happen when and if really bad news got announced, I've realised that perhaps the lack of status updates has given us all a chance to move on a bit, to process what's happening, and to start to... detach."
Reports earlier today claimed that Schumacher had lost up to 25 per cent of his body weight due to muscle atrophy, a condition common when patients are in a deep coma as their muscles are not being used.
Dr Hartstein said that it is "entirely possible and, in fact, probable" that Schumacher had lost a significant amount of weight.
"Happily, the consequences are not particularly dramatic, at least immediately," he added.
"To be blunt, a patient in coma doesn't really need his or her muscles . . . with the exception of the diaphragm. The diaphragm, which like the heart is pretty much always active, resists atrophy rather better than other muscles, but it does atrophy.
"And having a machine doing the breathing for you is one of the best ways to see how disuse atrophy affects the diaphragm too. Unfortunately, and assuming (as I have until now) that Michael is being ventilated by a respirator, there is probably some degree of diaphragmatic atrophy at this point."
Dr Hartstein went open to describe Schumacher's current state as a "persistent coma", and mentioned the "sever ramifications" that a lengthy period of time in a coma can cause.
"As mentioned previously, the longer one remains in a vegetative state, the less the likelihood of emerging, and the higher the chances of severe ramifications if the patient does in fact emerge," Dr Hartstein wrote.
"Most definitions consider the vegetative state to be permanent one year after the injury.
"Patients who are in a persistent/permanent vegetative state have lifespans that are measured in months to a few years. This depends on baseline function (extraordinary in the case of Michael, of course), the quality of nursing care, and other imponderables. They usually die of respiratory or urinary infections. Longer survivals have been described, but are exceptional."
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