AwareofAware

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

Archive for the tag “Sam Parnia”

19 Nov 2025
40 Comments

Believe it or not.

Apologies for the delay in creating this post, but I recently moved from the UK to New Zealand, starting a new job at the same time, so I have been somewhat distracted!

As the eternal hunt for a scientifically validated OBE in an NDE continues (slowly), and the realisation dawns on researchers that it may be many years before such an event occurs, the community is required to continue to rely on human validation. This paper is an attempt to create a tool that seeks to objectively measure the reliability of these “humanly verified” NDEs. Thanks Paul for alerting us to this article

Scale Construction

The development of the vNDE evidential strength scale followed the Delphi Method using feedback from a panel of experts. The process involved circulating a draft scale among 11 experts for review and revision in two rounds, allowing time for detailed input and fostering consensus. Initially, the scale covered seven criteria; after expert discussion and consensus (80% agreement), the final version included eight well-defined criteria, each designed to rigorously assess aspects of the near-death experience and its verification.

Scale Criteria

The final scale contains eight items, covering critical aspects such as the timing of the investigation, the experiencer’s physical and medical state, the occurrence of cardiac or respiratory arrest, the degree of third-person verification, possibility of sensory explanations, the number of verified and erroneous perceptions, and the clarity of recalled perceptions. For each criterion, evaluators are required to provide both a rating and a written justification, lending qualitative depth to the scoring process.

Scale Scoring

Scores from each of the eight items are summed, resulting in a total between 0 and 32. This total score is then mapped to one of four predetermined levels of evidential strength (very low, low, moderate, or strong) aligned with the quartiles of possible scores. The highest tier, “strong,” requires not only a high total score but also a high rating in third-person verification, ensuring robust evidential support.

Scale Validation

The vNDE Scale was validated by having 13 experts and three AI language models (ChatGPT v.4, Gemini Pro, and Mistral Medium 3) independently apply it to 17 potential veridical near-death experiences (vpNDEs) detailed in nine peer-reviewed papers (most people would be familiar with these cases that have been discussed here and on the web extensively). The selection of cases was based on strict inclusion criteria, ensuring each paper provided sufficient detail and had undergone peer review. AI raters were included to assess the feasibility of automating the scale’s application and to help counterbalance possible human biases, particularly where personal beliefs could influence scoring. Out of 13 experts, 11 completed the evaluations (with two collaborating on a joint response), while the AI models followed a standardised prompt to apply the scale to each case using the relevant sections of the papers.

My thoughts

In summary the vNDE scale they created had 8 different evidential criteria, each with their own rating scale (from 1-4), which contributed to an overall score (max 32) reflecting the quality of the evidence supporting the veracity of the OBE within an NDE.

Given the baseline requirement of the cases being presented in peer reviewed journals, and also the requirement for an independent witness, the quality is already higher than many. However, this scale refines things further to determine if the sum of evidence reported and presented is strong or not in relation to the NDE being reliable evidence of an independent consciousness or not.

Below is the kind of output that was generated:

What is notable is that in the majority of cases a consensus of specific strength was not reached (e.g. strong vs moderate). However when adjacent levels were considered (e.g. strong or moderate), things improved. There was reasonable consensus within the AI models, and between AI and humans, although some wild discrepancies as well.

Given the fact that the tool failed to create consistent precise consensus between the expert assessors, it is clear that the ability to quantify the levels of strength is not quite objective enough, and allows for subjective inter-assessor interpretation. It also shows (once again) that AI while promising, cannot be fully relied upon to replace humans, even for a task that it should be ideally qualified to perform.

Having said that, in the absence of an OBE verified using electronic equipment like in AWARE II, this is about as good as it gets for now. Further refinement of this tool creating better alignment between expert assessors will no doubt lead to a fully validated tool that can be incorporated in future research.  

The other outcome of this study is the fact that AI and the expert panel agreed that the three top cases in the table above had strong evidence to support the validity of the OBEs. We should bank that for now and use these three as exemplary examples of well documented OBEs with third party witnesses. I am glad that the AWARE I OBE is in this group.

Lastly I just wanted to cover a recent poster presented by the Parnia lab at AHA recently (thanks Z). It is somewhat related to the previous article, so worth shoving in here:

Summary of Abstract:

Background: About 10% of cardiac arrest survivors experience vivid Recalled Experiences of Death (RED) marked by clear awareness and a sense of life review, which can enhance quality of life. Although often dismissed as hallucinations or dreams, this study uses Natural Language Processing (NLP) to objectively distinguish RED from dreams and drug-induced states.

Hypothesis: NLP can differentiate RED accounts in cardiac arrest patients from other altered states based on thematic content, informing our understanding of consciousness during clinical death.

Methods: Researchers analyzed 3,700 anonymized first-person narratives: 1,245 RED, 1,190 dream, and 1,265 drug-induced reports, using keyword filtering and transformer-based models (Longformer for narrative classification; BERT for RED theme identification).

Results: The Longformer model achieved 98% validation F1-score and 100% holdout accuracy, accurately classifying all holdout drug narratives without needing substance names. The BERT model identified RED-specific themes with 90% validation and 87% holdout F1-scores.

Conclusion: Transformer-based NLP can effectively distinguish RED from other experiences, revealing distinct and structured patterns, and providing an objective method for analyzing survivor narratives and related psychological outcomes.

My Interpretation

Parnia’s utilisation of artificial intelligence to analyse the narrative content of two distinct types of experiences—Recalled Experiences of Death (RED) and those induced by drugs or dreams—demonstrates that AI is capable of reliably distinguishing between authentic near-death experiences and other altered states. Although the outcomes are inherently influenced by the subjective prompts provided to the AI models, the findings nonetheless reinforce the view that REDs are unique and fundamentally different in character from both “natural” and “artificial” hallucinations or experiences.

Moreover, this approach contributes to the development of more objective methodologies for differentiating between these reports. By leveraging AI as a tool for analysis, it becomes possible to more clearly separate genuine REDs from other experiences, supporting the argument that these phenomena possess distinguishing features that set them apart from ordinary dreams or drug-induced perceptions.

As always, if you haven’t already, please buy one of my books:

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29 May 2025
284 Comments

AWARE IIIa results

Firstly, thanks to Peter for bringing this to my attention. It was published a couple of days ago:

I have called this study AWARE IIIa as it is latest in a sequence of studies involving Sam Parnia (don’t think there is a formal name for this study at the moment). The first author is Joshua Ross, a resident physician at NYU Langone, and Parnia is the last-named author. First and last names on a publication are always considered the principal players in the study.

I call it IIIa because it is a pilot study looking at the feasibility of a larger potential study looking into consciousness during deep hypothermic circulatory arrest (DHCA). We have been waiting for something from this for a while now, especially as I have noted previously that recruitment started summer 2020. This paper confirms that and reports on patients recruited from 7/20 to 1/22 from 10 hospitals. It was funded by NYU and the Templeton foundation.

The idea of a study like this has been bouncing around for a while now. One of the most famous NDEs ever, Pam Reynolds, occurred during DHCA. The patient’s heart is stopped slowly under controlled conditions by cooling the body to less than 20 °C, surgery is performed, usually within 1 hour, then the body slowly warmed and the heart restarted. It is now a relatively routine procedure for types of surgery where stopping blood flow is important.

Given that the heart stops – cardiac arrest or CA – this has often been regarded as a possible model for NDEs under controlled conditions with the massive advantage that patients survive (only about 10-20% of in-hospital CAs survive to discharge). Given that patients undergoing DHCA have actually reported NDEs (or REDs), exploring this further made a lot of sense, and I was previously very excited about such a study. However, despite some early positive data from the Montreal study led by Beauregard, a more recent study showed no NDEs in a cohort of DHCA patients (HCA study from 2021). This led to me being a bit skeptical about a DHCA study producing a hit. My thinking was that maybe the patient had to be conscious prior to CA, and for the experience to be sudden for the consciousness to be “jolted out of the brain” or to allow disinhibition to occur, as Parnia would say.

Anyway, on to the study:

Design: feasibility study using similar equipment to that deployed in AWARE II – namely an ipad with images only visible from above and earbuds repeating words, as well as EEG and oximetry equipment. All of this would obviously be in place prior to CA, a huge advantage to AWARE II, as would patient consent be.

Results: Remember this is only a pilot to establish methodology, so the numbers were small:

  • 35 post procedure interviews
  • No explicit recall of images or words (3 fruits) – i.e. no one remembered seeing the images or hearing the words during the procedure
  • 1 NDE/RED experience, but without an OBE
  • 2 patients had recollections more consistent with CPRIC or ICU delirium
  • 3 patients (8.6%) were able to guess the fruits correctly – the authors suggests this may imply implicit recall (i.e. they heard it, subconsciously recorded hearing it, but don’t remember hearing), I think this is a big stretch, something they acknowledge as well, as I will explain below
  • Cerebral activity showed 70% of patient brains were isoelectric (no activity) during DHCA with about 30% having delta waves

My initial response to this was disappointment as once again we have a study without a hit, but on reflecting overnight on it, I am not so discouraged. Why is that?

Once again the numbers were small. Only 35 were interviewed. Now if these were CAs that occurred in an ICU or ER and were sudden as with most NDEs, you would expect 3-6 NDE/RED reports, but there is only one. If my thinking outlined above is correct – namely that a sudden/unexpected cessation of heartbeat while conscious is normally required for the consciousness to “untether” then you would either expect no NDEs from a DHCA study, or a much lower incidence. That may be why we only see one RED (although that is one more than was seen in the 2021 study).

Given that that there was only one reported RED (i.e. an experience meeting the stricter criteria outlined in the 2022 consensus statement – something I am leaning to much more given some of the physicalist’s adoption of the term NDE to describe all kinds of non-classical NDE events) and that normally only 20-25% of people who have a RED report an OBE (in this dimension at least), then you would not expect an OBE, especially one that noticed the screen.

As for guessing the fruits – banana, apple, pear – I suspect that if you asked 100 people to randomly name the first 3 fruits that came into their heads maybe 5-10% would come up with this combination. If it had been Apple, Banana orange it would probably be 30%. Anyway, the authors acknowledge that not too much should be made of this finding as chance may play a part. (they need to change the words and images for future studies as people familiar with these studies may taint the results)

Sceptics may argue that I am clutching at straws by remaining positive here, and they may be right, but if this had been a study with 10 times the number of patients, and there had been no NDEs with OBEs, then I might agree. As it is, I think my position is rational, if on the optimistic side.

In conclusion (from our perspective), while there was no OBE with explicit recall of images, given the 1 RED, this DHCA pilot study hints at the possibility of using DHCAs as a better method for exploring consciousness during CA, and specifically REDs. However, accounting for the possibility of a lower prevalence of REDs from this procedure than that seen in the unplanned CA population, much larger numbers may be needed. Hopefully they carried on with collecting data after January 2022 and we won’t have to wait another 5 years! Moreover, I hope they are continuing collecting data for AWARE II since it is still possible DHCAs may prove a dead end.

Parnia continues to lead the way in research into consciousness during CA. He is genuinely an outstanding researcher in this field and I hope that one day his labor and perseverance will be rewarded. All power to Parnia!

Finally, if you haven’t already, please visit this site which has my books on NDEs etc and feel free to buy one! If you read a book, liked it but not yet reviewed/rated it, then please do so. Finally I am in process of creating audiobook versions of some of the books which will be available later in June.

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19 Aug 2024
59 Comments

Review of Parnia’s Lucid Dying

Should be a part of any NDE-nerds library:

I have given this five stars on Amazon as I know that anything less is regarded as average. Here, I would say 4.5/5. In summary an excellent detailed resource on NDEs from a rational scientific and philosophical perspective, but at times there is a bit too much detail for my liking, but I am still glad I bought it and would recommend to all who come here.

After an initial introduction he goes into a detailed overview of the pig brain studies, and other data that shows that the brain is viable for much longer than we think after death. If you are into science (as I am) and a story of how a great discovery was made, then worth sticking with it. There are some super interesting insights that you can glean from Parnia’s commentary of the whole Pig Brain episode, and how the full meaning of the results was deliberately conveyed in a confusing way. We on here however have understood the potential consequences – namely that a brain does not immediately die or decay within minutes or even hours, and if preserved in the correct manner that stopped any tissue degradation, and was reperfused in a way that avoided cellular damage due to reperfusion injury, could potentially be restored to full function, possibly many years later. This is all hypothetical as they haven’t yet presented data on allowing the pigs the possibility to function normally. This obviously has implications as to what happens to the consciousness in the intervening period.

He spends a lot of time discussing the terminology of death and how the use of the term “clinically dead” is unsatisfactory and meaningless but doesn’t really propose an alternative. I will stick with it for now!

Then he cites Bjorgin’s studies…oh dear. He has completely missed the fact that she claims the EEG signals happened during CA in the coma patients, but in fact happened before CA. It is somewhat concerning that he has fallen for it when others like Van Lommel have not. He does the same with Chawla’s data from 2009. My gut feeling is that her data feeds into his own personal pet theory of disinhibition as he goes on to weave the data of EEG signals around the time of death with AWARE II. If I am honest, much of it is a little misleading, and unless you are familiar with the studies he is talking about you will walk away with the conclusion that there is a lot of brain activity during early death and that it is definitely related to the experiences people report when they achieve ROSC and survive long enough to be interviewed. He thus overstates the importance of AWARE II. I’d probably do the same if I had spent years working on it!

On Page 74 of the Kindle version he alludes to the fact that the whole subject area is Taboo in science and medicine, and this may affect his approach and his desire to wed scientific observations with his personal dualistic understanding, but it doesn’t wash. As I have said so many times before, the observations of EEG activity before and up to 30 seconds post CA (in rats) without external assistance, or up to 60 minutes with CPR, have never been tied to actual conscious recollections, so all hypotheses proposed to explain this are purely speculative, and all evidence circumstantial.

He explains very well how the AWARE II study differentiated from other experiences such as psychedelic experiences (but only by including interviews from subjects who had reported NDEs outside of the study).

I must admit, since he hadn’t fully explained his theory of disinhibition before, I had made some assumptions about what he had previously said. He now focuses quite a lot on the disinhibition of natural processes that are normally inhibited (regulated) and mean we can cope with the vast amount of complex information in a sensible and coherent manner, and that when disinhibition occurs, the brain releases all kinds of hormones to kick the body back into life that would normally be inhibited. He also talks about accessing new dimensions of reality. However, he very much grounds this initial treatment of disinhibition into a physicalist explanation as “a unique state of hyperconsiousness”. Having done this he then moves into true NDE territory…the next phase of death…lucid death.

Page 104 (my Kindle version) is perhaps the most important quote regarding his absolute position on the subject:

“We agree that they experience a new dimension of reality in death. We also do not think the finding of brain electrical markers of hyperconsciousness means the brain is producing the experience. On the contrary, it means the mind and consciousness, tethered to the brain in death, are interacting with and modulating the brain. Of course, this discussion goes to the heart of the ancient mind-body problem, also referred to as “the problem of consciousness” by scientists and philosophers today.”

He is inferring this implies dualism. He may be right about dualism, and he may right about these neurological markers being that, but the EEG data itself is not direct evidence that supports that assertion…it merely allows speculation.

He then goes on to discuss NDEs of various people and the different aspects of them. He goes through each of the 50 different facets of the narrative arc he describes in the 2022 consensus statement. It is an expanded version of the original core elements and contains more detail and specifics. It is a particularly good reference and contains lots of excellent examples.

He then talks about the nature of consciousness, with a very detailed summary of the different theories of consciousness and how ultimately a brain-based understanding is not supported by the evidence. He cites Eccles and Hoffman a lot who have left behind physicalist or reductionist viewpoints.

He then looks at Olaf Blanke’s use of autoscopy to mischaracterise OBEs and says it is like putting lipstick on a pig. He is almost as outspoken about this and Timmerman’s work on psychedelics as I am about Borjigin’s claims. The gloves definitely come off!

Last section he goes into what it all means for us from a philosophical perspective. I agree with some of what he says, but disagree sharply on other stuff, but will leave that to the book that I am currently in the process of finishing and that will be available in the Fall. He talks about confirmation bias and cognitive dissonance…I recognise that I am possibly guilty of this at times but I think he has a blind spot towards his own failings in this area and regards himself as an impartial judge…but I will save that for my book.

One thing that comes out of the book is my sense that he has all but given up on a scientific verification of OBEs. I may be wrong, but he seems to have come a point where he regards the difficulties of gathering enough interviews of survivors as to be so overwhelming that he may have abandoned the effort of doing it. Hard to say. I hope not.

Anyway, I would recommend all NDE nerds buy the book. The first section is hardgoing, which his publishers should have helped him with, but it is worth sticking with it as you will really have a full and complete picture of the subject after finishing.

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14 Dec 2023
121 Comments

I am in good company!

It appears that I am not the only one who finds Parnia’s disinhibition assertions disconcerting (try saying that fast after a couple of glasses of wine!).

It is fine theorising that this may be what is going on, but the fact is some of his comments regarding the factuality of his hypothesis to the media (the Guardian and BBC in particular) seem to move beyond the word “may” to “is”. I have provided examples of this in previous posts, and it seems that two of the most respected researchers in this field have made some comments, to which Parnia has decided to reply in the journal (click on the pic for full article):

Now I can’t find the original comments, but it seems they stated that the subjects were not conscious. The fact is we do not know what was going on, so it is wrong to assert that there is or is not activity of any kind that is truly conscious. Since the vast majority of examples of EEG activity were in patients who sadly died, we do not know whether they had conscious experiences. Personally I believe the patients with EEG activity may have had some sort of CPRIC episode if anything, but I do not know that, no more than Parnia knows whether they had a disinhibition episode.

The fact is that only 2 of the 28 patients who were interviewed had interpretable EEG data. It is not mentioned whether there was activity or not, but either way these patients were not in the 11 who had recollections from their time during CA. If anything this would provide evidence against Parnia’s hypothesis.

I think that it is OK hypothesising as he does in the paper, but some of his recent media noise has gone beyond this, and I suspect that is why these two great men have given their esteemed colleague an academic poke. A part of me wonders if he is playing a much deeper game here, but I will keep my thoughts on that to myself.

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15 Sep 2023
81 Comments

“News” about AWARE II publication! (and a comment about “news”)

Yesterday I had a long journey back from vacation, and didn’t arrive home till 3:00am. So firstly apologies for not commenting on all the excitement that Mary and David mentioned in the previous post around the “publication” of Parnia’s AWARE II study yesterday. Secondly, after having my very tired brain shocked into activity by reading those comments, and frantically following up on this “news” I really feel like I could go back to bed…but I won’t. I have another flight on Monday, this time for work, and need to adjust my brain to yet another time zone.

The AWARE II study was not published yesterday, it was published in July. However, it became freely available on the on line version of Resuscitation yesterday and I encourage you to download the PDF and read it:

Link to full AWARE study publication

This is identical to the paper that I discussed back in July . If you recall I focused on the one key piece of data that we had been asking for since December 2019 and had finally been revealed, namely whether there was any EEG data for patients who reported an NDE or RED. This key piece of information was buried in the footnotes of Figure 2:

Two of 28 interviewed subjects had EEG data, but, weren’t among those with explicit cognitive recall.

https://doi.org/10.1016/j.resuscitation.2023.109903

To be fair to CNN they do include an excellent rebuttal to the inference of their own title provided by Bruce Greyson, who presumably also read the small print under figure 2:

“This latest report of persistent brain waves after cardiac arrest has been blown out of proportion by the media. In fact, his team did not show any association between these brain waves and conscious activity,” said Dr. Bruce Greyson, Carlson Professor Emeritus of Psychiatry and Neurobehavioral Sciences at the University of Virginia School of Medicine in Charlottesville.
“That is, those patients who had near-death experiences did not show the reported brain waves, and those who did show the reported brain waves did not report near-death experiences,” Greyson told CNN via email.

CNN article

Thank you Dr Greyson for putting it so perfectly. THERE IS NO ASSOCIATION, OR “TIES” in this study. So CNN are misrepresenting the studies core findings, but what is new about that? Organizations like CNN have been misrepresenting the “news” for decades now. However, I am a little concerned that it is not just CNN, but an organization that should know better:

Up to an hour after their hearts had stopped, some patients revived by cardiopulmonary resuscitation (CPR) had clear memories afterward of experiencing death and while unconscious had brain patterns linked to thought and memory.

https://nyulangone.org/news/patients-recall-death-experiences-after-cardiac-arrest

This is from the NYU News Hub, and is possibly even more misleading than the CNN headline. By joining the two separate findings of 1. “patients experiencing clear memories of death” and 2. “while unconscious had brain patterns linked to thought and memory” with an “and” in the same sentence, they are guilty of egregious conflation to infer a conclusion that these memories were a result of brain patterns. This is pretty shameful for a reputable medical scientific organization to do . Was this Parnia’s doing, or the work of others who are opposed to the potential for his work to prove the fact that the soul persists after death? Something fishy is going on.

Then David mentioned this interview with Sam Parnia yesterday which was presented on NBC:

More balanced NBC article with interview with Sam Parnia

The written article does not misrepresent the data in the way that CNN does, or NYU, although some dodgy editing of the interview perhaps leads one to conclude the EEG data may be linked. Parnia talks about a book that he is co-authoring with Mary Curran-Hackett who had an OBE. I look forward to that book.

Finally, as promised my comment on the media. In an ideal world the media would report the facts as they appear with balanced commentary, but they do not…they report stories that often support specific preferred narratives based on facts that they often twist. This is most obvious in politics where an event involving either Biden or Trump, will be reported in completely differently ways by Fox and CNN. That’s bad enough, but when it comes to scientific data that has implications on how we view the very essence of our existence, then it is utterly despicable. In fact I would go so far as to say it is evil. I have seen it in the field of origin of life research, and I spent a chapter in my book about the origin of life, DNA: The Elephant In The Lab venting on the issue of media misrepresentation of the science, and that includes scientific media, such as Science magazine, or NewScientist. Here we have something that is my view even worse. Not only is CNN guilty of misrepresentation of facts, but the NYU news hub, the very institution that generated those facts.

You have to ask yourself why do they do this? Why are they so determined to suppress all discussion or science that may point to a non-materialist understanding of our existence, and change the way that man behaves.

I look forward to your comments.

Finally, thank you to those who have bought me a coffee. If you appreciate my writing, then please feel free to buy me a coffee now (or more than 1 as some very generous people have done!)

https://www.buymeacoffee.com/orsonw23W

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11 Jul 2023
113 Comments

AWARE II Final Publication – speculation does not imply association

[and finally the answer to my 3.5 year old vital question!]

Firstly, congratulations to Dr Sam Parnia and the team of researchers who conducted this awesome study which is the first study ever to find biomarkers of consciousness during CPR in the absence of heartbeat. Let me repeat that because it is a huge achievement. This is the first study to ever find markers of consciousness during CPR. I can just see the materialists entering a wild feeding frenzy, their eyes rolling back in ecstasy as they chew on this headline, but what they might think is raw fillet may turn out to be TOFU (no offence to vegans – just a matophor).

This is a pre-proof, rather than a pre-print (which was put out there earlier in the year). That means it is only a proofread away from full publication rather than a serious review and edit. This is for all intents and purposes the final publication that will appear in Resuscitation. The link is below:

AWARE II final paper link

Essentially the results are not much different from those presented at AHA last November, and in the pre-print mentioned above and found in my summary in the following link, WITH ONE VERY BIG EXCEPTION.

AWARE II preprint analysis

Before I draw your attention to the exception which answers the question I sent to the Parnia lab in January 2020, I will just remind you all of the key findings:

  • The study finished recruiting from 25 sites, predominantly located in the UK or US, in March 2020 (at least for this analysis – is it the final analysis? They are still recruiting according to NYU website).
  • The key findings are summarized as follows and all the quotations are from the citation beneath:

Of 567 IHCA, 53(9.3%) survived, 28 of these (52.8%) completed interviews, and 11(39.3%) reported CA memories/perceptions suggestive of consciousness. Four categories of experiences emerged: 1) emergence from coma during CPR (CPR-induced consciousness [CPRIC]) 2/28(7.1%), or 2) in the post-resuscitation period 2/28(7.1%), 3) dream-like experiences 3/28(10.7%), 4) transcendent recalled experience of death (RED 6/28(21.4%)…. Low survival limited the ability to examine for implicit learning. Nobody identified the visual image, 1/28(3.5%) identified the auditory stimulus. Despite marked cerebral ischemia (Mean rSO2=43%) normal EEG activity (delta, theta and alpha) consistent with consciousness emerged as long as 35-60 minutes into CPR.

S. Parnia, T. Keshavarz Shirazi, J. Patel, L. Tran, N. Sinha, C. O’Neill, E. Roellke, A. Mengotto, S. Findlay, M. McBrine, R. Spiegel, T. Tarpey, E. Huppert, I. Jaffe, A.M. Gonzales, J. Xu, E. Koopman, G.D. Perkins, A. Vuylsteke, B.M. Bloom, H. Jarman, H. Nam Tong, L. Chan, M. Lyaker, M. Thomas, V. Velchev, C.B. Cairns, R. Sharm, E. Kulstad, E. Scherer, T. O’Keeffe, M. Foroozesh, O. Abe, C. Ogedegbe, A.Girgis, D. Pradhan, C.D. Deakin, AWAreness during REsuscitation – II: A Multi-Center Study of Consciousnessand Awareness in Cardiac Arrest, Resuscitation (2023), doi: https://doi.org/10.1016/j.resuscitation.2023.109903
  • Key points on the target methodology:

The headphones were placed over the ears during CPR. One minute after being switched on, the tablet randomly projected one of 10 stored images onto its screen, and after five minutes (derived from implicit learning protocols during anesthesia) 6-10 audio cues (three fruits: apple-pear banana) were delivered to the headphones every minute for five minutes.

Parnia et al Resuscitation (2023)
  • One person identified the fruit (audio recall). Another had visual recollections of the ER scene, but could also feel things, so possibly CPRIC.

Key comment from discussion:

This is the first report of biomarkers of consciousness during CA/CPR.

Parnia et al Resuscitation (2023)

And:

Recent reports of a surge of gamma and other physiological electrical activity (ordinarily seen with lucid consciousness) during and after cardiac standstill and death, led to speculation that biomarker(s) of lucidity at death may exist [rat study and coma patients], which our findings support. Taken together, these studies and ours provide a novel understanding of how lucid experiences in relation to cardiac standstill/death may arise […] However, the paradoxical finding of lucidity and heightened reality when brain function is severely disordered, or has ceased raises the need to consider alternatives to the epiphenomenon theory [materialist].

Parnia et al Resuscitation (2023)

I don’t include anything from the data collected from subjects who were not part of the AWARE II clinical protocol, and who sent their subjective reports of NDEs to the lab. I don’t believe it belongs in this paper and potentially dilutes its very real scientific merit and is ultimately largely irrelevant to the key findings. [If anyone from the lab is reading this, I know that sounds snotty, it is just my subjective view, not intended as a criticism]

So there we have it, in conclusion:

  • Due to the difficulties in recruiting only 28 patients were interviewed
  • Of these 6 had NDEs (or REDs)
  • The study didn’t have any visual hits (unsurprising given only 6 had NDEs)
  • The audio hit was inconclusive
  • EEG data “consistent with consciousness” was recorded in patients up to 60 minutes after CA began (although the majority of this EEG activity would not in fact be consistent with lucid consciousness)

So now for the big piece of news, probably the most important piece of data (for us here at least) that he presents, which is buried in the text underneath Figure 1 and the answer to the question I have been asking for 3.5 years and is the most relevant to this study – namely, did any of the patients who had NDEs/REDs have EEG data consistent with consciousness?

I had already guessed that there would be no data due to the difficulty in getting in interpretable EEG results, and I was right:

“Two of 28 interviewed subjects had EEG data, but weren’t among those with explicit cognitive recall”

Parnia et al Resuscitation (2023)

This is the money line. This is the one that shoots down any materialist attempts to use this study to say that NDEs are proven to be a result of brain activity (and there will be lots of attempts).

This is also where I dispute some elements of the discussion, particularly the “as an association doesn’t imply causation” statement, which I would normally agree with, but in this instance THERE IS NO ASSOCIATION. NONE. NADA. ZERO.

None of the subjects who reported conscious recollections, including the 6 who had NDEs had any EEG data, let alone EEG data that showed markers of consciousness. Let me repeat, because of this it is entirely false to say there is an association of brain activity with NDEs. This is no different from the findings from the rat studies or the coma patient studies. Speculation does not imply association!

FROM THIS STUDY AND ALL PREVIOUS STUDIES THERE ARE NO REPORTED NDEs THAT HAVE ANY EEG DATA, LET ALONE DATA SHOWING BRAIN ACTIVITY, ASSOCIATED WITH THESE REPORTS.

This means that we are back to square one. Despite the valiant efforts of Parnia and his team, we are no closer to having scientific evidence supporting any understanding of the cause of NDEs or the nature of consciousness. To say otherwise, especially without association, is pure speculation.

Look forward to the discussion, make sure you come back and check the comments.

Finally, I have had to pay for this paper and the upkeep of this blog, so would appreciate a tip if you have benefitted from reading this and not tipped before (or feel free to tip again if you are rich/and or generous 😊 )

https://www.buymeacoffee.com/orsonw23W

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25 Apr 2023
40 Comments

Not Near-Death NDEs

Incidence of near-death experiences in patients surviving a prolonged critical illness and their long-term impact: a prospective observational study

This study was recently published in the journal called critical care. Here is a summary of the key methodological details and findings:

  • Prospective study designed to assess the incidence and patient characteristics of NDEs during stays in the ICU.
  • Pts who had ICU stays >7 days were interviewed within 7 days, 1 month and 1 yr following discharge from the ICU.
  • 126 patients were included with 19 (15%) reporting NDEs (score of ≥7 on the Greyson scale).
  • Cognitive and spiritual factors outweighed medical parameters as predictors of the emergence of NDE.

My comments on this study:

What immediately makes it interesting is that these were patients who were in the ICU, NOT the ER. These patients were not in CA if they reported an NDE, hence the name of this post. Yet 15% of patients who stayed in the ICU had an NDE. These would not be classified as REDs using the criteria published last year, and yet if they are authentic NDEs, which the Greyson scoring suggest they were, then they occurred in a situation where the patients may have died without the intense medical interventions that were being applied in the ICU. This raises questions about the mechanisms of triggering an NDE, as well as the authenticity of them…the latter is perhaps what the authors are hinting at. This is what the authors say about NDE induction:

“Patients in ICU may face potentially physical stressors, such as inflammation, high catecholamine levels, independently of the primary organ failure triggering ICU admission [4]. These are all potential inducers of NDE [5]. Next to these (neuro)physiological factors, some cognitive processes have also been proposed to trigger NDE, such as the tendency for dissociation.”

As for the key findings that the authors highlight, much of it comes from this finding:

“…DES [a questionnaire that assessed the presence of dissociative states] and the WHOQOLSRPB [a WHO questionnaire that assesses a propensity to religious or spiritual beliefs] as the strongest predictors for the emergence of NDE…”

In the discussion they flesh out their thinking on these findings:

“a higher frequency of dissociative symptoms and a greater spiritual and personal well-being were the strongest predictors for the recall of NDE using multivariate analysis (Fig. 1). It is then reasonable to hypothesize that a propensity to dissociative states and to spiritual beliefs and practices make people more likely to report NDEs when exposed to certain physiological conditions.”

My big issue with this conclusion is that all the data relating to dissociative states and religious propensity was gathered after the ICU stay, and therefore after any potential NDE. The question must therefore be asked as to whether or not this propensity to dissociative states and to spiritual beliefs and practices was pre-existing or heightened or even induced by the NDE. It is hard to see how the questionnaires would explicitly be able to identify these traits as underlying and pre-existing, so the hypothesis is based on somewhat shaky ground. Moreover, even if the hypothesis is correct, it says nothing about the validity of NDEs being a manifestation of the dualist relationship of human consciousness with the brain. I state in my book on NDEs that it is possible, even likely, that some people are more prone to being spiritual, and that there are genetic links to this. This could mean that some people are physiologically more prone to NDEs…their consciousness may be less “tightly tethered” to their brains, for want of a better expression.

I do give credit to the authors here for not drawing any conclusions that do not belong outside of the parameters of the area of study, and to the potential nature of NDEs, although they do give a nod to some of the previous attempts to explain NDEs through neurological processes. Despite the latter, I don’t really know where the authors stand on the issue, and that is a very good thing because it suggests that their bias didn’t influence their research.

Returning to their discussions, the problem associated with only having data post ICU stay also applies to one of the key overall conclusions of the study, specifically that NDEs do not alter quality of life. Due to the small sample size, and the fact that we do not have QOL data from before the ICU stay, it is not really possible to say with certainty that NDEs have any effect on QOL. Moreover, the type of questionnaire used focuses on physical outcomes, and since these people all suffered conditions that required intensive care, and NDEs are largely understood in a spiritual context, then it would be highly unlikely that there would be much difference in physical outcomes. In fact, I think I once heard that people who have had NDEs were more likely to die in subsequent years than those who hadn’t, but I can’t remember the source.

My biggest gripe with this publication is that details from the NDE interviews are not revealed. There were 19 in total, it is therefore highly likely if ICU NDEs followed similar patterns to CA-induced NDEs that there would 2-4 OBEs. This is not mentioned or discussed, nor are the breakdowns of the Greyson scores. Given that this is the first study to prospectively look at NDEs in an ICU, I feel this was a bad omission since they could have determined if there might have been differences between the NDEs from ICU and CA. Also, were they hiding something? Were they discouraged or prohibited from sharing “subjective” OBEs by the reviewers?

Other than this, the study was well conducted and the findings neutral. Most of all, for us they highlight the fact that NDEs occur in instances beyond just cardiac arrest, and that they may be much more common as a result. The downside of this is that in the absence of scientifically validated OBEs, these types of NDE are much more open to mundane physiological explanations touted by neurologists.

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14 Jan 2023
25 Comments

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)

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22 Nov 2022
258 Comments

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!

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08 Nov 2022
156 Comments

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!!

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