AwareofAware

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

Archive for the tag “Aware study”

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.

NDE, RED, REX – is it all just a case of Timantics?

Apologies for the pun, but couldn’t help myself. As some of you may be aware one of the more valued members of this site, Tim, and I had a somewhat acrimonious discussion yesterday that became personal and resulted in Tim saying his goodbyes. Goodbyes, unlike death, can be reversible, so hopefully we will see him again and continue to learn from his outstanding knowledge of this subject.

So what was all the fuss about? For me it was a case of semantics – in this instance the meaning of the word death and its use in the term RED. The reason for us discussing what the word death means was due to this article:

Studying death and near-death experiences requires neuroscientific expertise

First of all, the title is ludicrous and based on a huge assumption. The study of NDEs only requires neuroscientific expertise if NDEs are the result of neurological processes. I have spent the past 4 years of my life working in neuroscience, and I can assure you that there is nothing in human understanding of neuroscience that could explain a genuine OBE. That has and always will be the issue, therefore the study of NDEs does not need an expertise in neuroscience. It might benefit from it to interpret various neurological measurements that are acquired during a CA, but it is not necessary, especially when it comes to any experiments that attempt to validate OBEs. If you have a scientifically validated OBE, then that cannot be explained by science. Moreover, neurologists and neuroscientists were a part of developing the consensus statement.

Obviously starting off with the assumption that an NDE is a natural neurological phenomenon means that the rest of the article is constrained by this materialist assumption and therefore many other things that are said are just incorrect. However, there are a couple of points they make that are very pertinent and worth highlighting, and one in particular that caused the spat between Tim and me. It was my suggestion that I agreed in part with their statement about the use of term RED that set things off. This is what they said:

Second, contrary to what Parnia et al. write, people who recall NDEs are therefore inherently people who have not been dead and have not met brain death criteria. Since the introduction of brain death criteria in 50 the 1960s, not a single patient properly diagnosed as brain dead has come back to life….Because of these scientific inaccuracies, the proposed term “recalled experience of death” is wrong and we firmly reject it. The authors confuse “death” with the process of dying

My initial response of agreeing in part was more a gut reaction given that I was not aware of there being specific definitions for death and therefore given this state of affairs, and given the potentially reversible nature of the condition people are in when their hearts and brains have stopped functioning, stating these people had experienced death seemed a bit of an over reach. This gut reaction is reinforced by having watched all these TV shows in which the ER physician announces “time of death” when they give up CPR…i.e. the person is beyond medical help and the process of dying has become irreversible.

As the discussion continued I started looking into definitions of the word death. Dictionaries and on line resources tend to use the word irreversible, but what really nailed it for me was the UDDA definition which is used in the US:

The Commission ultimately recommended a Uniform Determination of Death Act (UDDA) which aimed to make the total brain standard into law in the states. This recommendation has been adopted by the American Bar Association and American Medical Association, and made into law in some form in all 50 states. The UDDA simply states: ’An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead. Sarbey B. Definitions of death: brain death and what matters in a person. J Law Biosci. 2016 Nov 20;3(3):743-752. doi: 10.1093/jlb/lsw054. PMID: 28852554; PMCID: PMC5570697

In Canada: Death occurs when there is permanent loss of capacity for consciousness and loss of all brainstem functions .  This may result from permanent cessation of circulation and/or after catastrophic brain injury. In the context of death determination, permanent refers to loss of function that cannot resume spontaneously and will not be restored through intervention.

Now while this is adopted in the US and Canada, it is by no means globally adopted, and there is still uncertainty about the exact moment that the word death is appropriate, as evidenced in this NHS presentation on the subject: http://odt.nhs.uk/pdf/Diagnosis_of_death.pdf

For me the key quote in that discussion is the following:

Dying is a process; Death is a defined point in that process

This is the point that the article by Martial is making, and while it is a semantic point, it is central to the consensus paper and Martial is right to call them out for coming up with the term RED – recalled experiences of DEATH. Basically, using the dictionary, US legal, Canadian and wider medical community’s definition of death, someone who has achieved ROSC has not experienced death. Oops.

Now I understand why Parnia et al came up with the term, and I somewhat agreed with it in principal at the time, but my view has now changed, and I think theirs should too…although that is harder as they might need to retract their paper which is a pretty hideous thing to do from a researcher perspective. NDE is actually the most accurate term, and while it has been abused by people broadening its application from the one originally intended, it would be better to apply clarifications such as authentic, or classical, rather than completely discard it. In fact their recent attempt to completely change the meaning of the term NDE to not include REDs was something that I really objected to.

But it is all just semantics. Fundamentally, while the term RED is technically wrong, we know exactly what condition they are describing: it is a condition in which the body is completely incapable of consciousness and in which the brain is incapable of producing or storing conscious recollections, and yet people report experiences occurring and have been able to “prove” these through human verification. This is why I say I partly agree with Martial et al say, because otherwise much of way they say is complete hogwash. For instance:

There is hence no “recalled experience of death”; if anything, it should be ‘recalled experience of what might have been the start of the dying process just before consciousness was lost’.

Technically they might right in saying that it could be the start of the dying process, but by adding “just before consciousness was lost” they are betraying their materialist bias. That is an assumption, and the whole point of doing these studies. While they have a point in saying that studies have failed to empirically prove [beyond any doubt] that “people are able to report actual (real-life) events and details happening during e.g., cardiopulmonary resuscitation” neither do these studies, or any others disprove it. Moreover studies such as AWARE I and others, while not providing slam dunk proof, provide very strong evidence supporting the thousands of reports by very credible people, including Health Care Professionals, outside of the context of a clinical study.

Their third point is another tricky one and I find myself agreeing with a part of it:

“Third, the authors write that NDEs in post-cardiac arrest patients fundamentally differ from NDEs made in other life-threatening or non-life-threatening situations, and that the latter experiences are “mislabeled”. Again, the reasoning is flawed. There are no empirical data so far to indicate that the phenomenology of NDE differs in situations that are (a) associated with a threat to life and impaired brain physiology such as  a cardiac arrest, (b) associated with a threat to life but unimpaired brain physiology such as a near-miss traffic accident, and (c) associated with non-life-threatening situations such as drug consumption or  meditation. To the contrary, the data that do exist indicate that all these experiences are phenomenologically  similar (e.g.,12-16). In other words, from the phenomenology of the experience one cannot tell if what happened was a cardiac arrest or e.g., use of a psychedelic drug. Contrary to what the authors state, this similarity suggests that the brain mechanisms behind these experiences are probably also similar, if not identical.”

I agree somewhat with their stating that some aspects of NDEs overlap with other experiences reported in different states. However, there are two ways of looking at this. The first, and one they cite, is that these experiences are the result of similar neurological processes, and the second that these experiences are possible in a variety of states and speak to the ability of the human consciousness to momentarily detach from the physical body. Both, in the absence of scientific, or empirical evidence, are possible explanations, but Martial et al only countenance one, and this is neither objective nor scientific. Moreover, the different conditions they cite are unlikely to produce similar neurological states and therefore it is unlikely they would produce similar psychological outcomes or recollections.

They make a few other statements based on their assumption that NDEs are the result of physiological process, which must be viewed in the light of this unscientific bias. However there is one statement they make that I absolutely 100% agree with, and which has troubled me enormously, and which I have commented on myself previously in this blog.

“Although Parnia et al. question the existence of distressing NDEs which they consider “related to [intensive care unit] delirium, delusions, and dreams in response to toxic metabolic states and withdrawal states (e.g., alcohol withdrawal)” (p. 17 of 127 File S2 from1), the latter claim is not empirically supported.”

The paper that Parnia cites to make this assertion actually suggests the complete opposite. I think this comes from a fundamental flaw in Parnia’s character…he is too nice! He doesn’t even want to consider the idea that people suffer after they die. I get that, but I do not believe that his position is the right one, and explain why in my book.

As for the conclusion of the article:

“Although (near-)death research certainly merits a framework directive, the paper by Parnia et al. is subject to a surprising lack of neuroscientific understanding. It reflects the fact that the field of NDE research (at least in parts) is biased by a widely held belief that there is something fundamentally special, if not supernatural, about NDEs, such as the notion that humans can have conscious experiences in the absence of a functioning brain.”

Yep, that’s the whole point isn’t it, and in the absence of scientific proof that consciousness in the absence of a functioning brain is not present, it should not be discounted as a possibility, and to do so is unscientific. The above statement displays a whopping lack of self-awareness when it comes to understanding their own lack of objectivity.

In summary, I think Parnia et al may need to rethink the use of the term RED. They also need to be aware of their own potential bias, such as on the subject of negative NDEs, and be open to outcomes that might be unappealing, but are nonetheless possible.

You say tomat[e]o, I say toma[re]to – NDE/RED/CPRIC

Thanks again to the eternally vigilant “Z” for spotting this paper which begs the oft repeated question – are NDEs/REDs just another form of CPRIC (CPR induced consciousness)? It is a question that we have answered at length in many past posts but it is important to revisit this due to the context in which it is raised.

While Parnia is not the main author, his influence on it is present, and his work is mentioned and forms part of the analysis. The other authors are from Southmead in Bristol UK, Toronto and Cologne, Germany. Southmead Hospital has a neurology research centre associated with the University of Bristol, and I have been there a fair bit in recent years due to my work in sleep medicine and Alzheimer’s disease (work that has suddenly come to an abrupt end unfortunately due to the vagaries of government regulatory and reimbursement bodies)

https://www.sciencedirect.com/science/article/pii/S2666520422000418

Title of the paper: CPR-related cognitive activity, consciousness, awareness and recall, and its management: A scoping review

At first it seems that they are lumping NDEs/REDs in with CPR induced consciousness. From the intro:

“Two types of cognitive activity and awareness were identified [during CPR]. The first includes visible signs of consciousness such as combativeness, groaning, and eye opening and was referred to as CPR induced consciousness. The second, a perception of lucidity with visual and auditory awareness and recall without external signs of consciousness.”

This is then clarified further in the discussion:

“It could be assumed that pain and distress would be expected in patients showing overt physical signs of con- sciousness through CPR. On the other hand, there have also been cases documented where survivors experiencing more transcendental post cardiac arrest experiences whilst not showing signs of pain or distress have benefited from the experience with it having a positive impact on the patient’s life. When considering treatment options, it may be beneficial to consider these two experiences as two separate entities.”

You reckon!? I suspect that the last sentence was most likely due to Parnia’s influence as a co-author.

All of the key pieces of AWARE data published and presented to date, from I (2014) and II (2019), is included in this review, and therefore, in this paper at least, NDEs are lumped in with CPRIC as events of consciousness that occur DURING CPR – related to CPR. This last point is the most important. Association and causation are two different things, and while the first type of experience, where there are physical signs of consciousness, are undoubtedly caused by CPR, the second, RED/NDE type, is only associated in these cases with CPR. The fact that NDEs have been reported outside of the context of CPR further differentiates them from CPRIC, but this is not discussed in the paper, and these types of experience seem to have been put aside for now by Sam Parnia, most likely for very good reasons, possibly to narrow the field of research to experiences that occur in strictly defined situations with scientifically measurable outcomes.

However, despite the fact that the paper does concede that NDE type events are only associated with periods during which CPR is being conducted, you can guarantee skeptics will cite this paper as further evidence that REDs are due to physiological reasons, and nothing else.

As an aside, having lived on both sides of the pond, I can attest to the fact that you really do need to get your pronunciation of the word describing the small round red vegetable correct to be understood. I remember asking a stewardess on a flight to Ottawa for a can of tomato juice, and being a recent arrival to North America, I was still saying Toma[re]to…and despite repeating it 3 times she had no idea what I was saying. It was very strange indeed, I might as well have been asking for a football, it seemed impossible for her to make the connection between the word I was saying and the numerous cans of the substance she had right in front of her on her trolley. It was only when I said Tomat[e]o that she understood. From that point on I reluctantly adopted the local dialect when it came to certain words, particularly important due to the fact that at the time I was smoking and working in HIV (English smokers will know exactly what I am referring to!) Having returned to the UK I have managed to revert back to the mother tongue, except for the word loo…just can’t use it any more, so I still find myself saying washroom! My wife laughs at me for not returning to the British vernacular for the word toilet, despite the fact that she is a Kiwi and therefore has to juggle 3 forms of English in her head. The only concession I make on this is to use the word “bog”, which is another English word to describe toilet, but I generally do not use it other than when I am in a pub with a group of mates, since this word is not deemed polite.

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.

“This time next year Rodney”

We come to that time of the year again when we look back at the past year and rue the lack of new data, and look forward hoping that this year will be different. We are like the characters in the 1980s UK hit TV show, Only Fools and Horses featuring Del Boy and Rodney Trotter, who lived in a state apartment in a poor part of London and were always coming up with schemes to make themselves rich, but never succeeding. “This time next year Rodney,” Del boy would say to his younger brother, “we’ll be millionaires.” It was either this analogy I was going to use, or Groundhog Day…both fit the feeling I have about the AWARE II study despite the promising Tweet made just after New Years which stated:

“We hope to see you in 2022 as we ring in the New Year with exciting news, including updates on the AWARE II study!

This has been followed more recently by some Tweets on the study that looks into paradoxical terminal lucidity in patients with Dementia. I currently work in Dementia as a medical scientist for a Biotech with “skin in the game” so to speak. Also, I watched my father die from Dementia, so I am very interested in this study. I have spoken about this in previous posts, so won’t say any more for now.

On the promise of “updates on the AWARE II study” I am now very cautious about raising my hopes too much having experienced so much disappointment over the years. My expectations range from a statement saying they have more hospitals recruiting patients, to a paper, or conference abstract that provides more details on the different auditory experiences they reported at AHA 2019. The latter has the potential to be extremely important, although I doubt the media or wider scientific community will regard it in such a light. It is clear that Parnia does not believe that CPRIC (CPR induced consciousness) or blood flow from CPR could produce NDEs. I was not certain of this until I read the essay that he submitted to the Bigelow competition (more on that in a moment). It is possible that the update from the AWARE II study includes data from EEG and ECG matched against one or more of the reported auditory OBEs. This could be the smoking gun. Like I said, the scientific community may not accept it as such without a lot of persuasion.

The Tweet trailing “exciting news” was not just confined to the AWARE II study though. It is possible that data may be presented from AWARE III, the study looking into OBEs reported during hypothermic surgery. They recruited their first patient in August 2020, and it is possible that they have been recruiting a number each month, and if that were the case, I would fully expect to have a hit by now.

Who knows, but watch this space, or sign up directly to their Twitter feed.

On another note, I was able to read Sam Parnia’s essay over the Christmas holidays. It was a robust defense of the argument supporting NDEs and as well as going over a lot of old ground, I feel he made a lot more of the hit from AWARE I than he previously has, specifically stating that this is the only time in a clinical study that recollections from an NDE have been corroborated by attending HCPs AND that these recollections were time stamped to prove that they were from a time that the patient had no heartbeat. In some ways this made me feel a little concerned that this would be his “forever hit”, and that from his standpoint no more evidence is needed. From a proof standpoint, I somewhat agree, but then I would, it’s the wider scientific community that demands more.

He also provided a very good argument, supported by data, that CPR could not produce the lucid kind of experiences described in NDEs as CPR does not produce sufficient blood flow, and the EEG patterns associated with CPR do not correspond to consciousness. As others have noted in previous discussions, this puts to bed any doubts around CPR causing the auditory OBEs in AWARE II despite this going against the line that he put in his AHA abstract, so I look forward to any publication that goes into this further. He also discussed CPRIC which is a completely different phenomenon, and is when the patient achieves consciousness during CPR, normally as a result of brief restoration of heart beat. This kind of event is always associated with confusion and distress, and completely different from the kind of recollections that feature in an NDE.

Anyway, I will once again draw deep on my reserves of hope that we will learn of that illusive hit before too long. To me it is inevitable, and judging by the Tweets, the Parnia team also believe it is inevitable, otherwise why would they be so assertive in claiming that CA survivors can recall details from the time they were beyond the threshold of death?

The longer you live, the less likely your soul will survive death: discuss [ideas posted may be included in next version of book]

A 10 min video summarizing what I say in my book. WARNING – those who are sensitive about any reference to Christian teaching, the last two minutes may be worth skipping!

Let me know your thoughts and alternative theories explaining why it is that only 10-20% of elderly adults reports NDEs, whereas 80-90% of kids who die and are resuscitated report NDEs. As a reminder if you read my book, changes in memory function with age do not account for the difference.

I will start with one alternative my wife came up with:

Those who are older, and who come to the boundary, are much more likely to cross the boundary, therefore a much higher proportion of the elderly may in fact have souls that survive death, but we don’t know about it because they don’t come back to tell us.

I know in my previous post others had other ideas…please repeat them here.

Also, any good ideas that either resonate with NDE observations or have supporting evidence, I will probably include in any updates of my book in the future.

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.

Terminal/paradoxical lucidity. Overlap with NDEs?

The change in Brain structure due to Alzheimer’s disease (from John Hopkins)

I was going to write this at some point after Alan put a link to the below Guardian article in the last post discussion, but someone else has asked me to post on it, so here we go.

Guardian article on Terminal Lucidity.

I recently started work in Alzheimer’s for a Biotech that has a program in developing treatments for Alzheimer’s Disease (AD). As with all my work over the years in different diseases, I collaborate with leading academics and physicians in the disease area to develop research ideas – our own and theirs; discuss and disseminate latest research information and help facilitate the implementation of improved diagnostics and treatment pathways. I love what I do, whether it is in HIV, which I spent many years working in, or AD, which I have a particular passion for due to watching my father succumb to this hideous disease. The idea that I may be a part of helping deliver the first wave of potentially disease modifying therapies that slow the progress of this monstrous disease is hugely exciting.

Above is a picture of a normal brain and a brain that has been severely damaged due to AD . The brain of someone who dies with AD can weigh as much as 30% less than a normal brain at death. AD destroys the brain through a pathway that is widely understood to involve the deposition of Beta-Amyloid plaques in the neurons of the brain, which then through an immune response causes another protein called Tau, which has structural and metabolic roles in the neuron, to become dissociated with the neuron and eventually form clumps and neuronal death. This is the Amyloid cascade pathway that most scientists believe is the primary mechanism by which AD occurs. The process can start up to 20 years before symptoms appear, and once symptoms appear will usually kill the patient within 6-15 years. It is a terminal disease.

As the disease progresses patients go from experiencing mild cognitive impairment (MCI) which usually involves short term memory issues, to mild dementia which may affect one’s ability to do complex tasks, through to severe or advanced dementia where the patient is normally incapable of the most basic of tasks, becomes completely incontinent, and has lost all memory function or ability to speak. They are barely conscious as we understand consciousness. The final stage is death when the part of the brain that controls vital functions such as metabolism or heart rate etc becomes affected. Often dementia patients will die of chest infections as they lose their cough reflex and they literally drown in the fluid accumulating in their lungs. Often they will have pneumonia on their death certificates, but ultimately it is AD that killed them. In the UK it is now acknowledged as the biggest killer (over 20% of “with COVID” deaths are dementia patients). Suffice to say, at this stage the brain should not be functionally capable of lucidity.

Terminal, or paradoxical lucidity, is the phenomenon in which patients who have advanced AD and who have been in a state of cognitive non existence for months suddenly appear completely lucid or “their old selves again”. This usually occurs shortly before their deaths. It is not unique to AD patients, but from a scientific and philosophical perspective it is this group of patients that are most interesting and where those who have an interest in NDEs become excited.

Ultimately, terminal or paradoxical lucidity is not understood from a scientific perspective. A brain that has lost so much of its physical structure that the patient long ago lost cognitive function, and can no longer perform basic physiological functions like bladder control, should not be capable of “producing” high level conscious activity. It is a paradox, hence the alternative nomenclature. The overlap with NDEs, and hence the reason that Sam Parnia has become involved in this work, is obvious: people who report NDEs are reporting consciousness when the brain is completely incapable of consciousness from a scientific perspective because it is completely inactive.

The justification for research into this area is that maybe by understanding what activity we observe on an EEG during one of these terminal lucidity episodes, we may be able to develop technology that generates sufficient targeted stimulation to cause patients with AD to recover some of their function. There is a precedent for this. Currently available symptomatic treatments of AD, such as Donepezil, which slow the breakdown of the neurotransmitter acetyl choline, have been shown to improve cognitive function in some patients with AD, especially when used early. However these drugs do not alter the underlying disease process, they just “make better use of” the undamaged part of the brain; the patient will die at the same point with or without treatment. It is just a brain booster (student doctors have used it in medical exams to enhance their performance!). Arguably, if we can understand the physiological processes that are occurring during terminal lucidity, maybe we can devise technology that creates the same effect. That at least is the materialistic justification for this research.

Non-materialists, or “Nutters”, like me have a different explanation. The long established guest of the brain (the consciousness) has returned and somehow is able sequester the remnants of its dying host to experience and communicate with this realm one last time. It is a “paranormal” or “supernatural” phenomenon.

Discuss!

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