AwareofAware

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 déjà 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