AwareofAware

Evolving news on the science, writing and thinking about Near Death Experiences (NDEs)

Archive for the tag “AWARE II results”

AWARE II PAPER

Finally, we have a publication, albeit a preprint. Link below – it is opensource, which the final version may not be.

AWARE II PREPRINT

Thanks again to Z, always first off the mark!

Having had a very quick skim read here are my initial thoughts:

  • Nothing radically different from the presentation Parnia gave at AHA in November
  • The visual “OBE” was not verified, and would be easy for skeptics to dismiss
  • The auditory OBEs don’t sound convincing either
  • It isn’t clear whether there is any correlation (or not) between EEG signals and recalled experiences…need to read this in detail
  • A nod to the potential for better data from the COOL type study they are currently doing

I may have missed something epic, but I don’t think so. Full analysis of the details to follow below on Sunday as I am busy the rest of today. First impressions though are certainly not what we had been hoping for prior to November, but maybe what we have been expecting since then.

(FULL ANALYSIS IN NEXT POST)

Of Mice and Men (or rats and humans)

Thank you Jordan for letting me know that the Parnia lab has added a video of the AHA presentation to their YouTube channel. Here is the link below:

Audio with slides of Dr Parnia’s presentation of the AWARE II study at AHA November 2022

First of all, the slides were ever so slightly different from the ones that I posted a couple of weeks ago, but there was nothing fundamentally different in the message. The presentation was very balanced and factual in nature. He is a very good presenter and extremely credible. Key points:

  1. Around the 5 minute mark he discusses recruitment and details the huge issues they have with getting significant numbers to the interview stage. While this is frustrating for everyone who wishes to get enough data to be able to draw definitive conclusions, we must acknowledge that the Parnia lab are doing their very best to get results.
  2. At 10.20 he discusses the EEG data, and this is where the title of this post has come from. We have data from EEG in rats suggesting that there is some brain activity, and we have human data from previous case studies and now AWARE II suggesting “spikes” in EEG activity, including some gammar, which he specifically states is “usually associated with consious thought processes, recall of memory and so on…”. It is important to note that the amount of gammar is not presented.
  3. At 11.35 he makes a very intriguing comment in the discussion on implicit learning. He acknowledges that the sample size was too small and that we need larger studies to get better information on testing the implicit learning aspect, but he said this: “we had one case that worked“. Nothing more. Mmm.
  4. He spends a considerable amount of time on the fact that most patients when discussing their life review focus on morality and ethics rather than religion. He suggests this is curious and intimates that this is not something easily explained by medical or scientific understanding.

There is very little for the dualist in his presentation, but without exceptionally strong supporting evidence, I would not expect that at a scientific congress like this one. He gives lots of meat to the materialists, more so than we thought. The suggested implication that the EEG spikes are associated with consious processes and memory recall is provocative to us, especially without any specific evidence that links the two seperate observations (they may not even be in the same people). I believe he is giving attendees the opportunity to think what they want of this, and many will go down the rat route and mix dubious association with actual causation. It is unclear from this whether he believes this to be the case, but given his past statements, I suspect not.

As stated previously, in the absence of time stamped EEG data correlating with specific recollections, the EEG data is thought provoking, but does not inform us what is actually happening. I very much hope the paper will have more on this.

But what about the case “that worked”? No further details were provided, and I suspect he is saving that for the final publication. Is he referring to the 1 visual or 2 auditory recollections? Why did it “work”? Watch this space, but suffice to say, once again Parnia is leaving us in a state of expectant limbo!

Key points from AWARE II presentation at AHA 2022

Someone very kindly provided me with a copy of the slides from Sunday’s presentation. They sent them to me because I have a Ph.D. and I work in research therefore I will respect the sender’s request that they only be presented in an academic context and I will not post any of the actual slides on here, or supply copies. That being said much of the key bits of data can be found in the abstract that Z posted the following link to:

Link to AHA 2022 AWARE II abstract

Now to the presentation.

The background looks at the physiological factors around death and resuscitation, and has a slide on the pig study. It then looks at the different types of experience that are recalled, and also the psychological impact of these experiences. The historically low percentage of visual recollections is highlighted and he uses AWARE I as a source of evidence for this. He then moves on to the study itself.

Firstly he states 3 specific hypotheses related to Near Death Experiences:

  • Consciousness and awareness – with explicit and implicit learning – and cognitive experiences occur during cardiac arrest
  • Cognitive experiences may be related to the quality of brain resuscitation.
  • Experiences during states of unconsciousness may impact longer term psychological outcomes in survivors

It is important to note that while the first hypothesis refers to consciousness during CA, none of these hypotheses explicitly relate to dualism or refer to the possibility of the consciousness surviving death, which is after all what we initially believed the AWARE studies were about, and what in fact Parnia himself has stated repeatedly in public outside of the context of a clinical scientific audience – an important point. The second and third hypotheses relate more to his medical discipline as an ER doctor.

In subsequent slides he details the design of the study, and there is a new twist to this. Due to the lack of survivors from CA, a sad but inevitable problem that has plagued all his studies, he has decided to include retrospective data from reports of consciousness during CA that did not occur within the prospective AWARE II study. This was to provide qualitative information on experiences. As a researcher myself, I find the inclusion of retrospective data in a prospective study a little troublesome. I get why he might do this, but it makes the research potentially messy. However, thankfully that does not happen when it comes to the presentation of the prospective results.

After this the other techniques are discussed – brain oxymetry, EEG, headphones and a tablet generating audio and visual “clues”.

During the study memories that were reported were measured against a 32 point NDE scale, and any visual or auditory reports were collected and cross referenced with computer files listing the clues that were generated at the various timepoints.

Results:

As the abstract states 567 patients were “recruited”, but only 53 survived to discharge and of these only 28 were interviewed.

This is where I actually want to stop writing this post. It is incredibly disappointing to have such low numbers. In truth after more than 5 years they only obtained a sample of 28 subjects to glean information from. This is less than the number for AWARE I. I am not criticizing Parnia or his team – what they are aiming to do is very hard, and the fact that so few patients survive is the main reason why in my view, and I suspect the view of most who frequent this blog, the study “failed”. Given that from previous studies we know that only 2-3% of patients who experience clinical death and are resuscitated report NDEs with visual recollections, I have always said that you would need to have many hundreds, if not thousands, of interviews to stand a chance of getting a hit. The reasons for this are not just related to low percentages having visual recollections, but also to the chances of someone actually seeing and remembering the projected images if they were lucky enough to have a visual OBE. Anyway, I have flogged that horse to death many times here so back to the results.

In terms of patient characteristics, due to the low numbers of patients who were interviewed vs not interviewed, which mainly reflects survival vs non-survival, most differences do not reach statistical significance, except sex with a higher proportion of men being interviewed than women than the proportion reflected in the total study population, and age, with those being interviewed being younger. The first point is interesting since I think that historically women were more likely to report NDEs than men. Oxymetry data shows a trend of higher levels of oxygen in patients who survived. This has been observed before.

In terms of participating sites, the greatest proportion of patients came from the UK.

Now we get to some interesting tidbits…I’d love to post the graphics, but that would be disrespecting the kind chap who provided me with the slides.

There is a flow chart showing % of patients who had a tablet , oximetry and EEG installed, with the key data being for those who survived to interview (28):

  • 22 had tablets with files recording what was displayed
  • 24 had oximetry with 11 having meaningful files
  • Only 6 had EEG installed and if I am reading the flow chart correctly, only 2 of those interviewed had interpretable EEG files.

This last point is extremely important when it comes to drawing any conclusions about the relationship between reports of awareness and brain activity. You can’t.

How many reported awareness?

  • 11 of the 28 patients had memories or perceptions.
  • 6 reported transcendent experiences of death (he seems to have dropped RED in this manuscript and gone back to TED 🙂 )
  • 2 reported CIPRIC
  • 2 had memories post CPR
  • 3 had dream or dream-like experiences

This data partially verifies his first hypothesis.

The 6/28 is where Parnia get’s his 20% having NDEs (21% to be precise). Given the small sample size this is well within the bounds of error of previously reported numbers of 10%. Now for the core bits of data…the OBEs.

  • 2 of 28 had auditory OBEs
  • 1 of 28 had a visual OBE
  • None of 28 were able to identify the correct image including the patient who had a visual recollection – big miss for us on this blog
  • 1 subject was able to identify the correct fruit from the auditory stimuli. This is the hit that was first mentioned back in 2019. It’s hard to know what to make about this without ECG and/or EEG data correlating with the time of the audio file. It could be a bona fide hit. Either way, this possibly fully verifies his first hypothesis provided the patient was proven to be in CA.

There was no statistical difference (p=0.55) in terms of oxygen levels between patients who had memories or no memories. This possibly falsifies his second hypothesis.

In terms of EEG:

•Absence of measurable cortical brain activity (47% of images)

•Normal/near-normal delta seen in 22% of recordings up to 60 minutes

•Theta activity was seen in 12% of recording up to 60 minutes

•Alpha activity was seen in 6% of recordings, up to 35 mins

However, these are not specific to patients who were interviewed, so all the talk about recollections of consciousness possibly being related to brain activity are 100% pure speculation – UNLESS the 2 EEG files he has from the interviews specifically cross reference recollections with EEG spikes from the 6 patients who had NDEs. However we aren’t told this. It is possible that this data was verbally discussed during the presentation or more likely will be presented in the final publication. It is an important piece of data, but given that there are only 2 EEG files for the 28 who survived, even if there is some correlation with one or two of the six, the numbers are way too low to draw definitive conclusions and so I am of the view that Parnia’s reference to these recollections of Awareness being related to these is at best speculative.

The last section of the presentation refers to the retrospective study and repeats much of what has been said in the consensus statement and distinguishes REDs (yes, he uses RED here rather than TED) from other CPR related experiences such as CIPRIC.

In summary, in the absence of scientifically verified OBE or EEG data correlating specifically with strong NDEs, or an OBE, we are unable to verify or falsify the hypothesis that the consciousness is not a product of the brain. This is entirely attributable to the low numbers recruited in the study. From the PowerPoint presentation that I have, no hypothesis, either his, or ours, relating to the nature or origin of conscious awareness during CA has been validated or falsified. Given how much hope I once had for this study, I am of course very disappointed, but such is life. On a research front though, the collection of so much EEG data from patients who are in CA and having CPR is truly groundbreaking, it is just a shame that without more information we are unable to draw conclusions on the meaning of this data.

I anticipate lots of questions and a lively discussion!!

Lastly I would like to thank the lab for providing the slides for me to look at and pay my respects to the Parnia lab team, all the research sites, and the patients who took part in this study. It is no one’s fault that this study does not satisfy our desire for a “hit”, it was an epic effort and the nature of the population always made this outcome more likely than not. Also, there is another study that we still have to hear about…another day. I live in hope!!

What are the chances?

This article was posted by Maria in the comments of my last post. Thank you.

Link to article on how to capture visual OBEs

The original article is over 30 years old, and this fact alone highlights just how long we have been waiting for a scientifically verified visual OBE in a research setting. When I say scientifically verified, I mean that a hypothesis is generated, an experiment devised to test that hypothesis, and a positive result recorded within that context. I have taken great pains over the years to point out that adherence to the scientific method is central to insuring the credibility of any results that emerge from a study seeking to verify OBEs or NDEs.

The hypothesis would go something like this:

The consciousness is able to persist and separate from the physical body once the heart has stopped beating and brain stopped working, and observe events externally from the body.

The experiment would then test this hypothesis by creating a method by which the ability to observe events during this state is assessed. This paper describes the type of visual stimuli and location that would be best, based on interviews of people who reported OBEs during their NDEs. Presumably Sam Parnia read this article as a reference for designing this aspect of the AWARE study. He placed cards on shelves near the ceiling in various ICU wards in different hospitals. Despite there being a total of thousands of these cards dotted around hospitals all over the world, none of the reported NDEs from AWARE 1 occurred in a room with a card. The reasons for this have been discussed multiple times before. While reports of NDEs are very common, deliberately setting out to prospectively observe patients who have a CA with an NDE and an OBE and who then survive long enough to be interviewed is extremely difficult. Reports of murders are common, but if you set up an experiment to try to witness a murder, it would be very hard. Maybe a clumsy analogy, but my point is that while a random event may occur commonly, being able to deliberately observe that event may not be straight forward.

This problem has also plagued AWARE II despite its updated methodology and slightly tighter inclusion criteria, and based on the preliminary data presented at AHA in December 2019, it seems unlikely that when the final results are published that there will be a verified visual hit. This quote from the article’s conclusion predicts our torture all the way back in 1988:

the process of accumulating sufficient data in hospital veridicality research may be protracted

No kidding!

There is another problem with the AWARE studies. The above hypothesis that I state is not specifically included in the study, and the studies are not designed with the specific intent of testing this hypothesis. Testing this kind of hypothesis may have been Parnia’s original intent when he started out, but possibly for credibility reasons, he has not been able to explicitly state this in the study designs. The studies have therefore been hampered in their ability to achieve the outcome of proving this hypothesis as a result. If there is a scientifically verified OBE it will be a byproduct of the research in that the stated aim of the visual and auditory experiments is to better understand the nature of reports of conscious awareness rather than prove the above hypothesis.

Finally, any publication that Parnia submits will need to be peer reviewed. Peer review is far from a flawless process and is subject to the personal biases of the reviewers. Given the hostility in the materialistic scientific community to research that might challenge the prevailing materialistic orthodoxy, any evidence that Parnia presents to support this hypothesis will scrutinised very closely and potentially arbitrarily dismissed by reviewers. We only need to look at the COVID lab leak vs natural emergence fiasco to know without doubt that the scientific community is capable of subverting the truth if the truth challenges their preferred narrative.

Given all of this, I am becoming quite gloomy about the prospect of the paper that presents results from AWARE II including any scientifically verified OBE. It is due in the next few months, so we should know one way or the other.

AWARE II: 15% of people had REDs

This is the first time I think that Dr. Parnia has mentioned any specific numbers from the forthcoming and much anticipated publication of data from AWARE II. A nice teaser quote from the UK Telegraph this weekend:

“Dr Parnia said soon-to-be published research will show that around 15 per cent of people who have been resuscitated from a coma after cardiac arrest have a Recalled Experience of Death.”

Daily Telegraph, 7th May 2022. Sarah Knapton, Science Editor

Link to latest AWARE II teaser

(it is behind a paywall, and given it is mostly a summary of the consensus statement and the state of the field, useful and informative to the wider public, but won’t be news to most here – except for the quote I have given)

Of course it is possible that this could be from his other research which from my understanding is a retrospective database analysis of reports they have collected from NYU and other establishments over the years, but I don’t think he would necessarily be able to state such a well defined number since, unlike AWARE II, that work is not a prospective study that looks at incidence of NDE among all those who survive a CA. Moreover, the fact that he has been trailing the publication of AWARE II for months now, would suggest it is from this study.

I think this is very important as I assume that he will be using the new criteria for REDs to differentiate from other experiences. It also significantly increases the chances of a “HIT”…by about 50% in fact. Given the rigour with which his team at NYU are conducting this research, I think that 15% will become the established number…provided the wider survivor cohort is sufficiently large.

I also think it is really important to consider that OBEs have largely been redefined as EVAs (external visual awareness), which by their very definition require VISUAL recollections. For a long time here we have been discussing the possibility of auditory OBEs , but in the consensus paper these are only mentioned in the context of accompanying an EVA and not a significant phenomenon in its own right.

There are some good NDEs in the comments section of the telegraph article, including one from a chap who had 3 CAs but only produced a single RED. This has been reported before on numerous occasions and points to Dr Parnia’s assertion that most, if not all, people who die and are resuscitated have an NDE (not a RED), but most can’t recall them due to physiological and/or biochemical reasons (which is why they aren’t REDs). This undermines one of the theories I state in my book, which I would be very happy to see undermined as it is not all that pleasant!!

Reminder in the link of my book which I recently updated (available amazon globally). I will be writing another update post AWARE II publication which, in addition to analysis of the new data, will include adjustments and additions to the possible theories as to why 80-90% can’t recall their NDE. This will reflect some of the excellent analysis provided on this topic in the consensus paper.

Link to my book on the AWARE studies

Really good to see the MSM, particularly a respected broadsheet like The Telegraph, take this seriously and report it in a balanced objective manner.

Answer to Oxygen levels and OBE report question – sort of

The second video on the page in the link below is a recording of Grand Rounds from March 2020, which for some reason, I had missed until recently.

Link to videos from Parnia lab

This video should be compulsory viewing for anyone who is interested in a scientific overview of NDEs, the AWARE studies and the work of the Parnia lab. It really highlights to me how amazing Sam Parnia is in terms of his persistence, his thoroughness, his balance, and his humanity in his approach to this subject. Lot’s of amazing tidbits in this video, including anecdotal accounts of NDEs, some discussion around explanations (or lack of) for consciousness and the philosophy of it all. Remember, this is in the context of Grand Rounds at one of the world’s leading hospitals…not a meeting of your local chapter of IANDS. This is one of the world’s leading scientists on the science of consciousness during “death” speaking to fellow physicians and scientists.

Anyway, the reason I made a post about it is that I get an answer to a question that has been bugging me for ages, namely the link between R02 (blood oxygen in the brain as measured by brain oximetry) and episodes of conscious recollection. I have repeatedly tried to get some comment from Dr Parnia or one of his research colleagues on whether any of the reports of sufficient oxygen levels to potentially experience consciousness were correlated with reports of auditory OBEs or other conscious recollections, or not. In this video, at about 50 mins, one of the attendees at rounds asks a similar question, and Dr Parnia replies that there is currently insufficient data to comment on that. That’s why it is only sort of an answer.

This was a year ago. It’s hard to assess how much impact COVID has had on AWARE II, but if they were going by their original study plan, they would have completed recruitment by now and be writing it up. Hopefully we won’t have too long to wait before we receive a full read out from this study.

NYU Livestream chat and thoughts

Just thought I’d open a new thread so we can post our “live” thoughts here. I notice there are 32 other people watching…hoping some of them are people from here.

The link in case you don’t have it

livestream link

You will be able to ask questions in the chat section

Brain Activity During CPR in AWARE II

More data from AWARE II. Eduardo picked this one up. This is also being presented at the AHA meeting this weekend, and while not as exciting from the NDE side of things, is very important because it appears to slay one of our holy cows…people cannot be conscious if they have had a CA.

Abstract 287: Bimodal Brain Monitoring Using Portable EEG and Cerebral Oximetry During Cardiopulmonary Resuscitation (CPR): A Pilot Study

As with abstract 387, the significance of this abstract needs teasing out (and after my last effort, please let me know if I have misunderstood it again!). It has to be said that this one is written using even more jargon. In this “experiment” 38 patients from AWARE II had simultaneous measurement of EEG and brain oxygenation during CPR. CPR lasted for between 10-60 minutes, and the correlation between brain oxygen levels and EEG was established. Various levels of brain activity were defined: normal/near normal, seizures, coma, absence of cortical activity, as determined by EEG. rSO2 (cerebral oximetry  levels) of 60-80% are normally required for normal brain function, including consciousness. However, this study suggests that levels as low as 30% are sufficient to produce cortical activity and that these levels are achieved at various points during CPR. From the conclusions:

…real-time bimodal brain monitoring provides insights regarding brain resuscitation and its dynamic interaction with patient factors. While ischemia may cause epileptogenic activity, there are periods of normal/near-normal cortical activity despite prolonged CPR >45-60 mins. A minimal threshold of brain oxygen delivery (rSO2>30%) may be required for cortical activity. These data raise questions regarding assumptions of irreversible brain damage with prolonged CPR, as well as the possibility of consciousness and cognitive activity during CPR

This, to me, at least suggests that periods of consciousness are possible during CPR after a CA and before full ROSC (return of spontaneous circulation) is achieved. This is food for skeptics who will now claim that NDEs are a result of these kinds of brain activity. However, unless one of the NDEs in abstract 287 is directly correlated with rSO2 levels>30%, then these findings are irrelevant to NDEs. There is no mention of matching the patients in the two posters. What I would hope would be to see the subject who heard the noise from the headphones have an rSO2 of >30%, but the other 4 below those levels.

It would be good to have the whole poster or presentations for these. they may be available after they have been presented.

AWARE II – preliminary results

Once again thanks to Samwise for posting these in the comments section (I’m starting to have  suspicions about who he really is!). The link below is to the abstract from a poster by Sam Parnia that was – correction – will be presented at a meeting of the AHA in a few days ago time which focuses on resuscitation. The abstract has been posted on line in advance of the meeting, so this really is hot of the press.

Link to AWARE II poster abstract

On first analysis, the news is not brilliant in  terms of conclusive proof that NDEs are proven to be real, or at least not what we might be hoping for (edited to add: I may have got this completely wrong in my haste to post – please read the fantastic analysis by Tim in the comments section – if he is right then this data is very significant and is the first scientific evidence of auditory OBEs). However, on closer inspection, there is a small ray of light and also it is important to note that the numbers of this sample from the study are extremely small, and the study is still ongoing.

So, to the results (most of us know the methods – people who have had a CA are exposed to various stimuli, including the upturned ipad, during CPR, to understand consciousness while the brain is effectively “dead”):

Results: Among 465 in-hospital CA lasting >5 min, 44 (9%) survived and 21 were interviewed. Of these, 4 (19%) reported explicit memories, including (internal) cognitive processes such as feeling peace, joy, and a perception of seeing relatives, while other memories were suggestive of (external) awareness e.g. hearing people talking, drugs given. One of 19 correctly recalled the audio stimuli given during CPR, but none identified the visual test. In this limited sample, there were no signs of implicit learning. We then compared these to 22 self-reported memories from a registry of CA survivors, Additional themes emerged as follows: 1) a sense of joy and peace (95%), perception of a light (86%), a tunnel (59%), a review and judgment of major life events including a person’s own actions and intentions (54%), and an overall feeling of positive transformation after the event (95%).

Key points to take away:

  • No iPad visual hits – no smoking gun that we have all been waiting for
  • 1 audio hit – a slightly warm gun?
  • There were only 21 interviews, and only 4 who could recall any memories from the time during CPR – this is an extremely small sample

So there we have it, once again Dr Parnia used an AHA meeting to announce some preliminary results from one of his AWARE studies. The last one was in 2014 if I recall. There is a sense of dĂ©jĂ  vu in more ways than one though. We don’t have an iPad (visual) hit, but at the same time the numbers involved were so small that it would be extremely unlikely for there to be a visual hit. Remember, about 10% of CA survivors have NDEs and about 25% of those have an OBE of some sort. In this sample size there were 21 interviews, 4 of whom had memories (how many of these were NDEs by the Greyson scale is not mentioned). Assuming 2 were NDEs, there was a 50% chance of an OBE. From this brief abstract, it appears no one claimed to have an OBE, which would be consistent with expectations.

The audio hit is interesting, but I know the skeptics will discount this out of hand. However, if the EEG was flat-lining, and there was no heartbeat at the time-point the audio was played, then this does provide the first true “scientific” evidence that NDEs are real. But it won’t be received that way.

The conclusion section closes with this comment:

In this context, in place of NDE a more appropriate term might be transformative experience of death (TED)

Well I’m not sure what to make of this. AWARE II is still ongoing, and I know many of us here were convinced that he may have had some positive iPad hits by the way he has been discussing the whole “nature of consciousness being a separate entity to the brain” in public, but there is nothing in these results to give rise to such confidence. Also…what’s with TED?

I suspect there will be lots of discussion! Remember, he is presenting next Monday at NYU and a live-stream is available. I’m sure he will elaborate further then.

(NB. I MAY HAVE MISINTERPRETED THE RESULTS REGARDING AUDIO MEMORIES. PLEASE READ THE GREAT ANALYSIS BY TIM IN THE COMMENTS SECTION. HOPEFULLY DR PARNIA WILL ELABORATE MORE ON MONDAY WHEN I WILL CREATE A NEW POST WHICH DELVES INTO THE SIGNIFICANCE OF 4 PEOPLE HEARING CONVERSATIONS WHEN THEY HAD HEADPHONES ON)

Link to NYU event

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