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Semiology and Mechanisms of Near-Death Experiences

  • Neurotrauma (D. Sandsmark, Section Editor)
  • Published:
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Abstract

Purpose of Review

Near-death experiences (NDEs) are conscious perceptual experiences, including self-related emotional, spiritual, and mystical experiences, occurring in close encounters with death or in non-life-threatening situations. The origin of NDEs remains unknown. Here, we review recent advances in the understanding of NDE semiology and pathophysiology.

Recent Findings

Recent prospective studies confirm that NDEs reflect a spectrum of highly distinctive memories which are associated with negative or positive emotions and can be influenced by the nature of the causal event, but the temporal sequence with which these images unfold is variable. Some drugs, notably ketamine, may lead to experiences that are similar or even identical to NDEs. New models extend previous neural network theories and include aspects of evolutionary and quantum theories.

Summary

Although the factual existence of NDEs is no longer doubted and the semiology well-described, a pathophysiological model that includes all aspects of NDEs is still lacking.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Charland-Verville V, Jourdan J-P, Thonnard M, Ledoux D, Donneau A-F, Quertemont E, et al. Near-death experiences in non-life-threatening events and coma of different etiologies. Front Hum Neurosci. 2014;8:203.

  2. Martial C, Cassol H, Charland-verville V, Pallavicini C, Sanz C, Zamberlan F, et al. Neurochemical models of near-death experiences : a large-scale study based on the semantic similarity of written reports. Conscious Cogn. 2019;69:52–69. In this study, using a text mining approach, the authors compared more than 250 NDE narratives to reports from people consuming recreational drugs. Reports from ketamine and salvia divinorum users showed the highest semantic similarity to NDEs.

    Article  PubMed  Google Scholar 

  3. Kondziella D, Olsen MH. Prevalence of near-death experiences and REM sleep intrusion in 1034 adults from 35 countries. bioRxiv. 2019. https://doi.org/10.1101/532341.

  4. Ring K. Life after death: a scientific investigation of the near-death experience. New York: Coward, McCann, and Geoghegan; 1980.

    Google Scholar 

  5. Greyson B. The near-death experience scale. Construction, reliability, and validity. J Nerv Ment Dis. 1983;171:369–75. Seminal paper introducing the Greyson near-death experience scale.

    Article  CAS  PubMed  Google Scholar 

  6. Moody RA. Life after life. New York: Bantam Books; 1975.

    Google Scholar 

  7. Dieguez S. Doubles everywhere: literary contributions to the study of the bodily self. Front Neurol Neurosci. 2013;31:77–115.

    Article  PubMed  Google Scholar 

  8. French CC. Near-death experiences in cardiac arrest survivors. Prog Brain Res. 2005;150:351–67.

    Article  PubMed  Google Scholar 

  9. Braithwaite JJ. Towards a cognitive neuroscience of the dying brain. The Skeptic. 2008;21:8–16

  10. Lake J. The near-death experience: a testable neural model. Psychol Conscious Theory Res Pract. 2016;4:115–34.

    Article  Google Scholar 

  11. van Lommel P, van Wees R, Meyers V, Elfferich I, Van Lommel P, Van Wees R, et al. Near-death experience in survivors of cardiac arrest: a prospective study in the Netherlands. Lancet (London, England). 2001;358:2039–45. Landmark study on the prevalance of NDEs following cardiac arrest.

  12. Parnia S. Death and consciousness--an overview of the mental and cognitive experience of death. Ann N Y Acad Sci. 2014;1330:75–93.

    Article  PubMed  Google Scholar 

  13. Parnia S, Spearpoint K, de Vos G, et al. AWARE-AWAreness during REsuscitation-a prospective study. Resuscitation. 2014;85:1799–805. This is the first prospective multicentral study in cardiac arrest patients and NDEs.

    Article  PubMed  Google Scholar 

  14. Hausheer JR. Getting comfortable with near-death experiences. My unimaginable journey: a physician’s near-death experience. Mo Med. 2014;111:180–3.

    PubMed  PubMed Central  Google Scholar 

  15. Cicoria T, Cicoria J. Getting comfortable with near-death experiences. My near-death experience: a telephone call from god. Mo Med. 2014;111:304–7.

    PubMed  PubMed Central  Google Scholar 

  16. Alexander E. Near-death experiences. The mind-body debate & the nature of reality. Mo Med. 2015;112:17–21.

    PubMed  PubMed Central  Google Scholar 

  17. Khanna S, Moore LE, Greyson B. Full neurological recovery from Escherichia coli meningitis associated with near-death experience. J Nerv Ment Dis. 2018;206:744–7.

    PubMed  Google Scholar 

  18. Lawrence M. Near-death and other transpersonal experiences occurring during catastrophic events. Am J Hosp Palliat Care. 2017;34:486–92.

    Article  PubMed  Google Scholar 

  19. Meoded Danon L. Between my body and my “dead body”: narratives of coma. Qual Health Res. 2015;26:227–40.

    Article  PubMed  Google Scholar 

  20. Bianco S, Sambin M, Palmieri A. Meaning making after a near-death experience: the relevance of intrapsychic and interpersonal dynamics. Death Stud. 2017;41:562–73.

    Article  PubMed  Google Scholar 

  21. Cassol H, Pétré B, Degrange S, Martial C, Charland-Verville V, Lallier F, et al. Qualitative thematic analysis of the phenomenology of near-death experiences. PLoS One. 2018;13:e0193001.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Martial C, Charland-Verville V, Cassol H, Didone V, Van Der Linden M, Laureys S. Intensity and memory characteristics of near-death experiences. Conscious Cogn. 2017;56:120–7.

    Article  PubMed  Google Scholar 

  23. Royse D, Badger K. Near-death experiences, posttraumatic growth, and life satisfaction among burn survivors. Soc Work Health Care. 2017;56:155–68.

    Article  PubMed  Google Scholar 

  24. Moore LE, Greyson B. Characteristics of memories for near-death experiences. Conscious Cogn. 2017;51:116–24. The authors show that NDEs memories are experienced as more real than imagined events and comparable to memories of real events.

    Article  PubMed  Google Scholar 

  25. Martial C, Cassol H, Antonopoulos G, Charlier T, Heros J, Donneau A-F, et al. Temporality of features in near-death experience narratives. Front Hum Neurosci. 2017. https://doi.org/10.3389/fnhum.2017.00311.

  26. Chandradasa M, Wijesinghe C, Kuruppuarachchi KALA, Perera M. Near-death experiences in a multi-religious hospital population in Sri Lanka. J Relig Health. 2018;57:1599–605. This study is one of the few analytical researches from non-Western countries. The authors investigated prevalence of NDEs and demographic data including religion in patients admitted to a general hospital in Sri Lanka.

    Article  PubMed  Google Scholar 

  27. Charland-Verville V, Lugo Z, Jourdan J-P, Donneau A-F, Laureys S. Near-death experiences in patients with locked-in syndrome: not always a blissful journey. Conscious Cogn. 2015;34:28–32.

    Article  PubMed  Google Scholar 

  28. Martial C, Cassol H, Charland-Verville V, Merckelbach H, Laureys S. Fantasy proneness correlates with the intensity of near-death experience. Front Psychiatry. 2018. https://doi.org/10.3389/fpsyt.2018.00190.

  29. Palmieri A, Calvo V, Kleinbub JR, et al. “Reality” of near-death-experience memories: evidence from a psychodynamic and electrophysiological integrated study. Front Hum Neurosci. 2014;8:1–16.

    Article  Google Scholar 

  30. Goza TH, Holden JM, Kinsey L. Combat near-death experiences: an exploratory study. Mil Med. 2014;179:1113–8.

    Article  PubMed  Google Scholar 

  31. Dakwar E, Nunes EV, Hart CL, Hu MC, Foltin RW, Levin FR. A sub-set of psychoactive effects may be critical to the behavioral impact of ketamine on cocaine use disorder: results from a randomized, controlled laboratory study. Neuropharmacology. 2018;142:270–6.

    Article  CAS  PubMed  Google Scholar 

  32. Timmermann C, Roseman L, Williams L, Erritzoe D, Martial C, Cassol H, et al. DMT models the near-death experience. Front Psychol. 2018;9:1424. In this placebo-controlled experiment, volunteers scored higer on the GNDEs when given DMT, and the content of their expereinces was very similar to NDEs. DMT in a controlled setting might be used in future studies on NDEs.

  33. Bush NE, Greyson B. Distressing near-death experiences: the basics. Mo Med. 2014;111:486–90.

    PubMed  PubMed Central  Google Scholar 

  34. Nichols DE. N,N-dimethyltryptamine and the pineal gland: Separating fact from myth. J Psychopharmacol. 2017;32:30–6.

    Article  PubMed  Google Scholar 

  35. Gaiseanu F. Quantum-assisted process of disembody under near-death conditions: an informational-field support model. NeuroQuantology. 2017;15:10–7.

    Article  Google Scholar 

  36. Lake J. The near-death experience (NDE) as an inherited predisposition: possible genetic, epigenetic, neural and symbolic mechanisms. Med Hypotheses. 2019;126:135–48. The author provides a comprehensive analysis of evolutionary scenarios that might have led to the origin and transmission of a NDE predisposition.

    Article  PubMed  Google Scholar 

  37. Nelson KR. Near-death experience: arising from the borderlands of consciousness in crisis. Ann N Y Acad Sci. 2014;1330:111–9.

    Article  PubMed  Google Scholar 

  38. Radin D. Getting comfortable with near death experiences. Out of one’s mind or beyond the brain? The challenge of interpreting near-death experiences. Mo Med. 2014;111:24–8.

    PubMed  PubMed Central  Google Scholar 

  39. Shan L. Consciousness is an entity with entangled states: correlating the measurement problem with non-local consciousness. NeuroQuantology. 2018;16:70–8.

    Google Scholar 

  40. Brabant O. More than meets the eye: toward a post-materialist model of consciousness. Explor J Sci Heal. 2016;12:347–54.

    Google Scholar 

  41. Evrard R, Toutain C, Glazier JW, Le Maléfan P. The energy of despair: do near-death experiences have an evolutionary value? Psychol Conscious Theory Res Pract. 2018;6:184–99. https://doi.org/10.1037/cns0000166.

    Article  Google Scholar 

  42. Martial C, Charland-Verville V, Dehon H, Laureys S. False memory susceptibility in coma survivors with and without a near-death experience. Psychol Res. 2018;82:806–18.

    Article  PubMed  Google Scholar 

  43. Long J. Near-death experience. Evidence for their reality. Mo Med. 2014;111:372–80.

    PubMed  PubMed Central  Google Scholar 

  44. Nelson K. Near-death experiences--neuroscience perspectives on near-death experiences. Mo Med. 2015;112:92–8.

    PubMed  PubMed Central  Google Scholar 

  45. Parnia S. Understanding the cognitive experience of death and the near-death experience. QJM. 2016;110:67–9.

    Google Scholar 

  46. Greyson B, Bush NE. Distressing near-death experiences. Psychiatry. 1992;55:95–110.

    Article  CAS  PubMed  Google Scholar 

  47. Bush NE. Afterward: making meaning after a frightening near-death experience. J Near-Death Stud. 2002;21:99–133.

    Article  Google Scholar 

  48. Charland-Verville V, Martial C, Cassol H, Laureys S. Near-death experiences: actual considerations. Coma Disord Conscious Second Ed. 2017. https://doi.org/10.1007/978-3-319-55964-3_14.

    Google Scholar 

  49. Greyson B. Incidence and correlates of near-death experiences in a cardiac care unit. Gen Hosp Psychiatry. 2003;25:269–76.

    Article  PubMed  Google Scholar 

  50. Parnia S, Waller DG, Yeates R, Fenwick P. A qualitative and quantitative study of the incidence, features and aetiology of near death experiences in cardiac arrest survivors. Resuscitation. 2001;48:149–56.

    Article  CAS  PubMed  Google Scholar 

  51. Schwaninger J, Eisenberg PR, Schechtman KB, Weiss AN. A prospective analysis of near-death experiences in cardiac arrest patients. J Near-Death Stud. 2016;20:215–32.

    Article  Google Scholar 

  52. Klemenc-Ketis Z, Kersnik J, Grmec S. The effect of carbon dioxide on near-death experiences in out-of-hospital cardiac arrest survivors: a prospective observational study. Crit Care. 2010;14:R56.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Morse M, Castillo P, Venecia D, Milstein J, Tyler DC. Childhood near-death experiences. Am J Dis Child. 1986;140:1110–4.

    CAS  PubMed  Google Scholar 

  54. French CC. Dying to know the truth: visions of a dying brain, or false memories? Lancet. 2001;358:2010–1.

    Article  CAS  PubMed  Google Scholar 

  55. Facco E, Agrillo C, Greyson B. Epistemological implications of near-death experiences and other non-ordinary mental expressions: moving beyond the concept of altered state of consciousness. Med Hypotheses. 2015;85:85–93.

    Article  PubMed  Google Scholar 

  56. Facco E, Agrillo C. Near-death experiences between science and prejudice. Front Hum Neurosci. 2012. https://doi.org/10.3389/fnhum.2012.00209.

  57. Blanke O, Ortigue S, Landis T, Seeck M. Stimulating illusory own-body perceptions. Nature. 2002;419:269–70.

    Article  CAS  PubMed  Google Scholar 

  58. Blanke O, Mohr C. Out-of-body experience, heautoscopy, and autoscopic hallucination of neurological origin implications for neurocognitive mechanisms of corporeal awareness and self-consciousness. Brain Res Brain Res Rev. 2005;50:184–99.

    Article  PubMed  Google Scholar 

  59. De Ridder D, Van Laere K, Dupont P, Menovsky T, Van de Heyning P. Visualizing out-of-body experience in the brain. N Engl J Med. 2007;357:1829–33.

    Article  PubMed  Google Scholar 

  60. Britton WB, Bootzin RR. Near-death experiences and the temporal lobe. Psychol Sci. 2004;15:254–8.

    Article  PubMed  Google Scholar 

  61. Alexander E 3rd. Near-death experiences: the last word. Mo Med. 2015;112:275–82.

    PubMed  PubMed Central  Google Scholar 

  62. Nelson KR, Mattingly M, Lee SA, Schmitt FA. Does the arousal system contribute to near death experience? Neurology. 2006;66:1003–9. The authors report a significant association of NDEs with REM sleep intrusion.

    Article  PubMed  Google Scholar 

  63. Blackmore SJ. Near-death experiences. J R Soc Med. 1996;89:73–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Meduna LJ. Carbon dioxide therapy: a neurophysiological treatment of nervous disorders. Doi. 1950. https://doi.org/10.1037/13238-000.

    Book  Google Scholar 

  65. Whinnery JE. Psychophysiologic correlates of unconsciousness and near-death experiences. J Near-Death Stud. 2016;15:231–58.

    Google Scholar 

  66. Greyson B. Hypercapnia and hypokalemia in near-death experiences. Crit Care. 2010;14:420; author reply 420-1–420; author reply 421.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Morse ML, Venecia D, Milstein J. Near-death experiences: a neurophysiologic explanatory model. J Near-Death Stud. 1989;8:45–53.

    Article  Google Scholar 

  68. Carr DB., Prendergast Michael. Endorphines at the approach of death. Lancet. 1982;317:390.

  69. Strassman R. DMT: the spirit molecule: a doctor’s revolutionary research into the biology of near-death and mystical experiences. Rochester: Park Street Press; 2001.

    Google Scholar 

  70. Corazza O, Schifano F. Near-death states reported in a sample of 50 misusers. Subst Use Misuse. 2010;45:916–24.

    Article  PubMed  Google Scholar 

  71. Szabo A, Kovacs A, Riba J, Djurovic S, Rajnavolgyi E, Frecska E. The endogenous hallucinogen and trace amine N,N-dimethyltryptamine (DMT) displays potent protective effects against hypoxia via sigma-1 receptor activation in human primary iPSC-derived cortical neurons and microglia-like immune cells. Front Neurosci. 2016;10:1–11.

    Google Scholar 

  72. Jansen K. Near death experience and the NMDA receptor. BMJ. 1989;298:1708.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Jansen KLR. The ketamine model of the near-death experience: a central role for the N-methyl-D-aspartate receptor. J Near-Death Stud. 1997;16:5–26.

    Article  Google Scholar 

  74. Greyson B. Biological aspects of near-death experiences. Perspect Biol Med. 1998;42:14–32.

    Article  CAS  PubMed  Google Scholar 

  75. Strubelt SS, Maas U. The near-death experience: a cerebellar method to protect body and soul-lessons from the iboga healing ceremony in Gabon. Altern Ther Health Med. 2008;14:30–4.

    PubMed  Google Scholar 

  76. Saavedra-Aguilar JC, Gómez-Jeria JS. A neurobiological model for near-death experiences. J Near-Death Stud. 1989;7:205–22.

    Article  Google Scholar 

  77. Pana R, Hornby L, Shemie SD, Dhanani S, Teitelbaum J. Time to loss of brain function and activity during circulatory arrest. J Crit Care. 2016;34:77–83.

    Article  CAS  PubMed  Google Scholar 

  78. Sekhon MS, Ainslie PN, Griesdale DE. Clinical pathophysiology of hypoxic ischemic brain injury after cardiac arrest: a “two-hit” model. Crit Care. 2017;21:1–10.

    Article  Google Scholar 

  79. Sabom M. Light and death: one Doctor’s fascinating account of near-death experiences. Gran Rapids: Zondervan; 1998.

    Google Scholar 

  80. Tao JX, Ray A, Hawes-ebersole S, Ebersole JS. Intracranial EEG Substrates of Scalp EEG Interictal Spike Potentials. Epilepsia. 2005;46:669–76.

    Article  PubMed  Google Scholar 

  81. Kobayashi E, Hawco CS, Grova C, Dubeau F, Gotman J. Widespread and intense BOLD changes during brief focal electrographic seizures. Neurology. 2006;66:1049–55.

    Article  CAS  PubMed  Google Scholar 

  82. Borjigin J, Lee U, Liu T, Pal D, Huff S, Klarr D, et al. Surge of neurophysiological coherence and connectivity in the dying brain. Proc Natl Acad Sci. 2013;110:14432–7.

    Article  CAS  Google Scholar 

  83. Lee DE, Lee LG, Siu D, Bazrafkan AK, Farahabadi MH, DinhTJ , Orellana J, Xiong W, Lopour BA, Akbari Y. Neural correlates of consicousness at near-electrocerebral silence in an asphyxial cardiac arrest model. Brain Connectivity. 2017;7:17–181. This paper showed distinctive brain activity at near-electrocerebral silence in rats with asphyxial cardiac arrest suggesting brain function immediately prior to death.

    Article  PubMed  PubMed Central  Google Scholar 

  84. Chawla LS, Akst S, Junker C, Jacobs B, Seneff MG. Surges of electroencephalogram activity at the time of death: a case series. J Palliat Med. 2009;12:1095–100.

    Article  PubMed  Google Scholar 

  85. Hou Y, Huang Q, Prakash R, Chaudhury S. Infrequent near death experiences in severe brain injury survivors - a quantitative and qualitative study. Ann Indian Acad Neurol. 2013;16:75–81.

    Article  PubMed  PubMed Central  Google Scholar 

  86. Hameroff S, Chopra D. The "quantum soul": a scientific hypothesis. Explor. Front Mind-Brain Relatsh. Springer, New York NY: Moreira-Almeida A., Santana Santos F (eds) 2012;79–93.

  87. Barberia I, Oliva R, Bourdin P, Slater M. Virtual mortality and near-death experience after a prolonged exposure in a shared virtual reality may lead to positive life-attitude changes. PLoS One. 2018;13:e0203358.

    Article  PubMed  PubMed Central  Google Scholar 

  88. Dreier JP, Major S, Foreman B, Winkler MKL, Kang EJ, Milakara D, et al. Terminal spreading depolarization and electrical silence in death of human cerebral cortex. Ann Neurol. 2018;83:295–310.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Carlson AP, Shuttleworth CW, Major S, Lemale CL, Dreier JP, Hartings JA. Terminal spreading depolarizations causing electrocortical silencing prior to clinical brain death: case report. J Neurosurg 2018;1–7.

  90. Dreier JP, Major S, Lemale CL, Kola V, Reiffurth C, Schoknecht K, et al. Correlates of spreading depolarization, spreading depression, and negative ultraslow potential in epidural versus subdural Electrocorticography. Front Neurosci. 2019;13:373.

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Acknowledgements

Supported by DFG DR 323/5-1, DFG DR 323/10-1, FP7 no 602150 CENTER-TBI.

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Authors and Affiliations

  1. Department of Neurology, Rigshospitalet, Copenhagen University Hospital, 2100, Copenhagen, Denmark

    Costanza Peinkhofer & Daniel Kondziella

  2. Medical Faculty, University of Trieste, Trieste, Italy

    Costanza Peinkhofer

  3. Center for Stroke Research Berlin, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

    Jens P. Dreier

  4. Department of Neurology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

    Jens P. Dreier

  5. Department of Experimental Neurology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

    Jens P. Dreier

  6. Bernstein Center for Computational Neuroscience Berlin, Berlin, Germany

    Jens P. Dreier

  7. Einstein Center for Neurosciences Berlin, Berlin, Germany

    Jens P. Dreier

  8. Department of Neuroscience, Norwegian University of Technology and Science, Trondheim, Norway

    Daniel Kondziella

  9. Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark

    Daniel Kondziella

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  1. Costanza Peinkhofer
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Contributions

CP: acquisition of data, analysis and interpretation, writing of the manuscript, critical revision for important intellectual content, approval of final manuscript; JPD: analysis and interpretation, critical revision for important intellectual content, approval of final manuscript; DK: study concept and design, acquisition of data, analysis and interpretation, writing of the manuscript, critical revision for important intellectual content, approval of final manuscript.

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Correspondence to Daniel Kondziella.

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Costanza Peinkhofer, Jens P. Dreier and Daniel Kondziella each declare no potential conflicts of interest.

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Peinkhofer, C., Dreier, J.P. & Kondziella, D. Semiology and Mechanisms of Near-Death Experiences. Curr Neurol Neurosci Rep 19, 62 (2019). https://doi.org/10.1007/s11910-019-0983-2

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