AwareofAware

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

EEG surges near death prove NDEs are generated by the brain, and oily bubbles

I decided to write a very brief post on this study because it keeps popping up in the comments and people haven’t seen previous responses to it.

https://www.pnas.org/doi/10.1073/pnas.2216268120

In summary 4 people in commas had life support turned off. While their ECG was still active, but transitioning to flatline (i.e. pre-CA), two of them had EEG activity of a level and kind that is observed in consciousness (gamma waves). Since the patients never recovered, we don’t know whether they experienced awareness, or NDEs or anything. As the authors state in their discussion:

“Although the marked activation of the posterior hot zone in the dying brain is suggestive of elevated conscious processing in these patients, it does not demonstrate it.”

(There is one huge issue that they do not raise in this paper. They are saying to the family of the patients that the brain is damaged beyond repair and would not recover, and at the same time suggesting that it might have produced conscious awareness just prior to CA).

We have known now for a while that in rats there can be a burst of brain activity for about 30 seconds after CA. This study does not repeat that in humans, but shows activity once the life support is turned off and the heart is starting to pack in. In addition, if there is CPR, AWARE II has shown that EEG activity, including gamma waves can occur up to one hour later. To date no data has been presented or published that associates these bursts of EEG with conscious awareness. Therefore these studies do not prove that NDEs are generated by the brain. So what’s with the oily bubbles?

Well, I am so tired of answering question’s that arise from conflation of the two independent facts:

gamma waves are associated with consciousness + some patients have gamma waves in their EEG near (or after) death = NDEs are due to this activity,

I thought I would do something completely different and describe a conflation from the origin of life puzzle that is one of the easier ones to understand.

The conflation is this:

Under certain conditions lipids can come together and form spherical bilayers (oily bubbles) spontaneously in water + Cell membranes (or walls in plants) consist of lipid bilayers = proteins and DNA developed within spontaneously formed oily bubbles. Later on the DNA and proteins produced a cell membrane.

This is one of dozens of heinous conflations that appear in otherwise credible scientific journals to try to brush the origin of life conundrum under the rug. It is a chicken and egg question (not the biggest, which is DNA and proteins, but one of a number).

The question is this: which came first, the cell membrane that allows the cellular equipment to function, or the cellular equipment that codes for and builds the cell membrane.

The problem is this: for any primordial (pre-life, pre-evolution) system to develop, the nascent chemical systems would need to develop in enclosed structures otherwise they would just wonder off in whatever puddle they started developing in. Oily bubbles were proposed as the answer to this problem, and actually taken seriously, and still cited as a possible solution, but it is a complete nonsense for the following reasons:

1.Oily bubbles are nothing like cell membranes. Yes, cell membranes contain lipid bilayers, but these are punctured by numerous other chemical structures that allow the transport of specific chemicals in and out of the cell. Without the removal of waste or the addition of key components from outside, the machinery would die very quickly.

2. Ignoring 1, let’s say that the a system did develop, then why would it create a cell membrane? Evolution is a product of necessity, but there is an oily bubble doing the job, so you don’t need a membrane.

3.The code for a typical cell membrane is thousands of codons long, and it is assembled by specific proteins. To suggest that the code for a cell membrane, and the associated proteins spontaneously appeared in a nascent system is absurd, so no one suggests it. Moreover it is not something that could be conceived of emerging via a stepwise process. So materialist scientists who mention this in their theories hope no one notices that the oily bubble idea is totally absurd…which most people are happy to do as the moment they understand that life could not have developed by natural processes, they start to sense the presence of a rather large grey creature with a trunk in the room, or the lab. Hence my book DNA: the Elephant in the lab.

So Oily bubbles do not answer the origin of the cell membrane question, just as (currently) the reports of EEG signals in patients near death do not answer the NDE question. However, if the AWARE study shows that EEG is associated with NDE, then it is no longer conflation. It is still not proof that NDEs are the result of brain activity, but the association would strengthen the theory that they are. That is much more likely to happen than anyone squaring the oily bubble circle…or sphere.

Finally, you might be a bit peeved with me writing this, well to be honest I have been itching to write about this for a while, and the repeated raising of this conflation gave me the excuse I needed, and in truth the two are related. NDEs point to a realm beyond this life which, according to countless NDE reports, includes the presence of a Being Of Light, or God. Understanding the Origin of Life issue also points to the existence of an intelligent creator, aka God.

Rethinking Death

So I am writing this after just watching the excellent documentary made by Dr Parnia’s group at NYU Langone. Not sure when it will be availble to view on demand, but will post here once we know.

I say it was excellent because it was well produced and gave a good summary of where we are to date in terms of our understanding of death in a highly credible manner using mostly scientists or physicians as sources, other than a couple of the NDEs. The video was very well balanced, but unfortunately provided no new scientific data. The conclusion was that studies have as yet been unable to prove the “reality” of NDEs, but neither have they disproved them. There was no detail at all on the AWARE studies, which I found strange.

Despite this, it was clear that Dr Parnia, and all the other scientists shared the view that these experiences were not explained by what we understand about natural processes in the brain. There was a strong undercurrent that dualism is the likely explanation, without explicitly saying that was the case.

I have a lot of respect for Parnia and everyone else involved in this, but I find it extremely frustrating that there is data from AWARE II that shows EEG activity consistent with consciousness during CA and CPR after up to an hour (something he alluded to in the panel discussion), and yet they have never stated whether or not any of these EEG events were in patients who reported NDEs. They know, they have the data, so why not share that? I suspect that they have no EEG data at all in those patients as only a small percentage of the entire cohort had EEG data, and most of those sadly did not survive. Why not say that?

Like I said, frustrating. Maybe the final peer reviewed paper will provide that data, although he closed the discussion by saying “this is a long process, maybe come back in 5 years and we will have something for you!”

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.

The Good, the Bad and the Ugly study

Thanks to Z who has once again done my job and kept a close eye on the literature, and alerted us to this study which was published at the end of last week:

Lapses of the Heart: Frequency and Subjective Salience of Impressions Reported by Patients after Cardiac Arrest

The Good:

This study is possibly the best designed NDE study I have come across. The site in Vienna started out as a site in the AWARE study, they then extended the protocol beyond AWARE creating their own method for validating…or otherwise, OBEs. It is like they read what we suggested as a well designed experiment, ensuring full blinding until the close of the study, and implemented it:

Hidden Images

At an elevated position above one emergency bed (2 m above ground), a notebook PC was fixed facing the ceiling and displaying images selected at random from a pool of 29, switching from the actual to any in the pool every few hours (the number of hours was unpredictable). These images were not disclosed to the public and were not even known to all of us (in particular not to the main interviewer M.L.B.). The presentation history was stored on the PC, and any readout of this history, be it authorized or not, left its trace.

Well done to this team for getting this right.

They also extended the inclusion criteria for possible experiences, allowing for patients who had Greyson scales <7 to be included in the results if they had recollections around the time of CA. This was smart, and I will come back to this in a moment.

So that’s the good.

The Bad:

The results are disappointing. Yet again a low percentage of NDEs, especially using the Greyson scale:

Only 5 of 126 (4%) scored at least 7 points, the criterion to pass as NDE in the strict sense. Under the impression that this instrument may not be sensitive enough to detect experiences associated with a transient shortage of brain oxygen during CA, we included 15 more with detailed recollections from a period near to their CA.

I would say that another 6 (cases E,G,I,K,M and P) had elements of NDEs that we are familiar with, so if you included these 6, you have 11 NDEs from 126 CA survivors, which is very similar to other NDE studies.

There is one OBE, but the subject reported standing next to their body, rather than being above it, and were unable to report the memory of what they saw with any accuracy. There were a couple of other OBE like reports, but were more likely visual distortions etc due to erratic brain activity.

Subject K is highlighted as someone who got them excited:

“She had seen a field with beautiful pink flowers resembling water lilies, all of similar size. In her words, this was the first impression “during waking up” and she added: “It was great that the medical staff was capable to display it for me”. When she saw these flowers, she was sure that she would “return”. For the first (and only) time, we had the suspicion that a patient made reference to one of our hidden images.”

In 2021 when they reviewed the data from the laptop which reported exactly what images were presented at what time, the images that were displayed when she was in CA were nothing like what she described. Some key points here:

  • She had a Greyson score of 1, and most importantly
  • she did not report an OBE.

I will come back to this, since it central to what makes some of their conclusions and discussions downright:

The Ugly:

The paper was authored by Michael L. Berger and Roland Beisteiner. Both are involved in neuroscience research and neurology. While attempting to create a veneer of impartiality they quickly betray their underlying, subjective, predetermined view of OBEs in the introduction:

It may be objected that an experimental approach testing for visual awareness from a point outside the body was futile and misplaced in a serious scientific study, neglecting the generally accepted view that ‘even the most complex psychological processes derive from operations in the brain’ [11]. On the other hand, our certainty about the biological basis of awareness (as about any scientific ‘fact’) is the result of well-controlled experiments and observation, but can never be final and absolute. It has always been the noble privilege of experimental research to put to the test even the most solid dogma, provided the chosen approach was sufficiently well controlled against error and fraud.

In other words they are saying “we know that NDEs and OBEs are caused by neuronal activity, but we are going to do this experiment anyway because this position has not been absolutely and finally proven…although we actually think it has.”

They cite some of the studies we are familiar with, and have debunked here, as evidence for their position. Anyway, given this, you know from the outset they are not going to be objective. It feels very much like they have taken part in this study, are a bit embarrassed about it so put lots of caveats up front, and then completely abandon all objectivity when it comes to their conclusions so their colleagues won’t laugh at them. Shame on them, it is truly fugly.

This is the offensive line referring to subject K:

The image shown during the acute period (CA and post CA, Figure 2) had not the slightest resemblance to the scenery described by the patient. This may be seen as a negative result, but in fact it vindicated the generally accepted view that consciousness depends solely upon brain function.

The hell it does!

Sorry, I know some people don’t like the H word (esepcially Sam Parnia!), but I cannot think of saying this more politely. It is an obscene conflation. To understand why this is the case, you need to read the interview report of subject K:

Due to difficulties in breathing, case K (№ 83), a female 79 years old when the CA occurred, was originally entered as pulmonology patient at the general hospital. The CA happened during her firstnight there. She was successfully resuscitated and transferred to the emergency unit for further treatment. During the interview 83 d later at home, she surprised her husband (who participated) with the revelation that after losing consciousness she had the agreeable impression of a beautiful meadow with wonderful flowers. The flowers were pink and reminded her of water lilies. Was it a dream? No, she prefers the term ‘impression’; she was “pleased that the clinical staff was able to produce it for her”. She likes this memory: “Now I knew: I will come back.” (See Fig. 2) Greyson point: 1

Key points:

  • She did not report an OBE – she did not say she saw herself from above, or beside her body. She did not report seeing a laptop with an image on it.
  • She reported a memory of seeing a beautiful meadow. This is such a common theme in NDEs that we see it in the previous case, subject J who also reported a meadow. My father who told me about his NDE said he remembers a beautiful meadow with a figure of white at the end of it. These meadows are not OBEs as we understand them, they are a part of the narrative arc that NDEs or REDs follow…the heavenly realm. These usually occur after any OBE reports from the ER room.
  • The wording of her report suggests she is a bit muddled as to what happened to her and this is the only snippet she can remember, and associates it with the doctors. Of note is the fact that many of the subjects knew nothing about NDEs before the report. This is Austria, not the US where the media is very active on this topic.

How on earth did they take this information and come up with the ludicrous statement:

“it vindicated the generally accepted view that consciousness depends solely upon brain function”

CONFLATION – the tool of those who have a weak or non-existent argument. It is something I talk a great deal about in my book on the origin of life DNA:The Elephant in the Lab, (available in all countries) a subject I have academic expertise in. Scientists often conflate different facts to make an argument that isn’t there. I like the Wikipedia description of conflation:

Conflation is the merging of two or more sets of information, texts, ideas or opinions into one, often in error.[1] Conflation is defined as fusing or blending, but is often misunderstood as ‘being equal to’ – treating two similar but disparate concepts as the same.

https://en.wikipedia.org/wiki/Conflation

So what is the conflation here?

The lady reported seeing a meadow during CA[Fact1] + the laptop did not show a picture of a meadow [Fact 2] = consciousness depends solely upon brain function

It is a conflation because the lady’s report of an image and the fact the laptop didn’t show that image are completely and totally unrelated and not even associated. She didn’t see the laptop…so what? She didn’t report an OBE. The laptop image is irrelevant.

This is monstrous, and their outrageous bias destroys the credibility of what was otherwise a very well designed and conducted study, that if interpreted objectively supports data from other studies. Of course, that won’t stop some materialists leaping on this and saying it is proof that the brain produces NDEs because these neurologists have said it does.

A part of me wonders about the backstory here. Imagine that the team hear that a lady has reported an image (an incorrect assumption from my understanding and explanation from above – she reported a memory), and that this gossip spreads to the wider hospital taking on the form of a report from an OBE. In the time between the interview and revealing of images actually displayed, there may have been a cohort of NDE believers that started to believe, and maybe even claim that they had proven an OBE. The materialists may have momentarily been on the back foot, but when the great reveal comes…BOOM!…no image of flowers. Revenge is a dish best served cold and this paper may be revenge. Any researchers involved in the study who were believers retreated and allowed the materialist neurologists to write it up. Big mistake, as I have shown above. They have embarrassed themselves and their colleagues. Anyway, that is just my author’s imagination running wild…but you can see it happening given the size of egos in academia.

Back to square one. This study proves nothing about OBEs or NDEs, except they are relatively infrequent and all but impossible to scientifically measure.

If you enjoyed this post and haven’t “bought me a coffee” yet, then please feel free to show your appreciation:

https://www.buymeacoffee.com/orsonw23W

UNCOOL (updated on 29th January)

This post is a doozy, you will need to get your noodle into high gear as we will be delving into 4 publications on or related to the subject of NDEs during HCA (hypothermic circulatory arrest). Before we start, can I ask you a small favour. This blog costs money to create, and time to write. If you have been coming here for a while and enjoy reading what I write, then I would be grateful if you “bought me a coffee” (if you are rich, you can buy more than 1!). This site is trustworthy and used by media creators around the world to get appreciation for creators like me. You will need a credit card, provide the number, expiry, CVV number AND your zip code – the details are not passed on to me or held on the Buymeacoffee site (BTW it’s easy to forget the ZIP code which tripped me up when I tried it out for the first time today, you need to scroll across the details box). If I get lots of support it may motivate me to write more!

My Buy Me a Coffee page (yes, my real name is Orson…Ben Williams is a character in one of my novels)

Now to the blog. So this is not a great news blog for those longing for that illusive scientifically verified OBE, and may be bad news for Parnia’s HCA study, but there is a caveat with that.

So to the first paper (big shout out to Constiproute for alerting me to this one – how did I miss it!!):

Does Hypothermic Circulatory Arrest for Aortic Surgery Trigger Near-Death Experience? Incidence of Near-Death Experiences after Aortic Surgeries Performed under Hypothermic Circulatory Arrest

Ref: Manduit et al; Aorta (Stamford). 2021 Apr; 9(2):76-82. doi: 10.1055/s-0041-1725091

Brief summary of design, methods and results:

Design: It was a prospective study looking at consecutive patients who underwent thoracic aortic surgery between July 2018 and September 2019. Procedures without HCA were included to constitute a control group. The primary outcome was the incidence of NDE assessed with the Greyson NDE scale during the immediate postoperative course, via a standardized interview.

Results: None of the patients reported any recollection from their period of unconsciousness. There was no NDE experiencer in the study cohort.

This makes AWARE II look like a resounding success! The authors sound slightly bitter in their summary of the results, as far is it possible to sound bitter in a clinical study publication.

Firstly let’s get into the weeds. This is a well designed prospective controlled study which makes it a very credible study.

The procedure basically requires cooling the body to 21-28oC by using a bypass technique that cools the blood, and once this temperature is achieved circulation is halted. At this temp many of the metabolic processes that occur within cells are slowed to the extent that damage will not occur, particular to brain tissue. However, after 30 minutes things may get more dangerous and another technique is initiated that restores flow of fluid to the brain. Here are the numbers recruited.:

Overall ( n  = 101)HCA group ( n  = 67)Control group ( n  = 34)

All patients survived, and while it is not stated (something the editors or reviewers should have picked up) I assume that all were interviewed. Given data from previous NDE studies looking at CA survivors, you would expect about 6 reports of NDEs from the HCA group given that they were in circulatory arrest. However there were none.

In the lengthy discussion section a number of factors were listed as potential confounders which might have caused this lack of NDEs. Here they are verbatim:

  • The hypnotic agents and analgesics used during general anesthesia may induce retrograde amnesia, or merely prevent NDE, although some NDE during anesthesia have previously been described. 
  • The potential influence of modified neurotransmitter release and systemic inflammatory response induced by the CPB, along with the varying degrees of ischemia/reperfusion during aortic surgery, should also be taken into consideration. 
  • The duration of unconsciousness in our study (14.4 hours on average), inherent to the prolonged general anesthesia, might prevent the patient from remembering NDE events. Furthermore, the time between awakening from anesthesia and the patient’s interviews might have been too long.
  • The number of patients included in our study might also be too limited to evidence NDE, although the incidence rates reported among cardiac arrest survivors suggest that such cohort size should be adequate.
  • The level of hypothermia and the optional use of adjunctive cerebral perfusion during circulatory arrest might also play a crucial part. 

The first 4 are self explanatory. The issue of being under sedation prior to CA is something that I think is potentially relevant. Does the consiousness need to be consious when CA occurs for an NDE to occur? Not convinced personally since I can recall of NDEs that have been reported when patients were under anesthesia, had a CA during a procedure and consiousness started at that point with the NDE ensuing. Moreover we have the cases from the HCA study in Montreal (the original COOL study) led by Mario Beauregard. I will return to that in a moment.

It is the fifth point that interests me and two papers that are cited in the section of the discussion that delves into this.

Electroencephalography During Hemiarch Replacement With Moderate Hypothermic Circulatory Arrest by Keenan et al in 2016

and

Deep hypothermic circulatory arrest: I. Effects of cooling on electroencephalogram and evoked potentials by Stecker et al in 2001

To summarize the key points, with the application of cerebral perfusion (used in both studies), the EEG does not in general become silent until the body has reached a temperature of 16oC. Below about 24oC it goes into burst suppression, during which consiousness is not possible. This is the status usually encountered during anesthesia.

In summary there are 3 states and outcomes to consider:

  1. Temp >16oC no circulation (artificial or natural) = isoelectric EEG or clinical brain death in under a minute.
  2. Temp >16oC with some kind of circulation, either natural or artificial = EEG activity of some kind.
  3. Temp <16oC with or without circulation = no EEG activity and clinical brain death.

Now I will discuss the Beauregard study from Montreal. The details were published in a journal as a letter which does not require peer review. It was more hypothesis generating than anything, and was supposed to be the launch pad for a larger scale prospective study, but it never happened. Anyway, here is a link to the letter:

Conscious mental activity during a deep hypothermic cardiocirculatory arrest? Beauregard et al 2011

In summary, it was a retrospective study looking at cases between 2005-2010 in which 33 patients underwent DHCA ( deep hypothermnic circulatory arrest), and were interviewed afterwards. 3 reported consious recollections, and one had an OBE, the details of which were later confirmed to be accurate. Given it was retrospective and in such a small cohort, the evidence is a little sketchy (unless you add it to the mountain of other evidence), however this is what has inspired further study. So there is one huge question to ask, why did Beauregard’s study have NDEs and Manduit’s not?

It is noteworthy that when looking at Keenan’s paper, the methods for HCA appeared to change around 2010-2013, with cooling often going to 21-28oC, whereas during DHCA conducted prior to 2010, it appears the body may have been cooled to 16oC or lower.

This may be the key difference between Beauregard’s (recruited 2005-2010) study and Manduit’s (recruited 2018-2019). However, given that in Manduit’s study only 31% of patients had ancilliary cerebral perfusion, therefore 69% would have had isolectric EEG (although they did not measure this), I am not sure this would make any difference in terms of potential for NDEs.

However, this is potentially hypothesis generating regarding the interation between consiousness and the brain in a dualist understanding of our existence, and which I will delve into during the discussion or in another post because I think this is enough for now.

Finally, this has implications for Parnia’s HCA study. Is he using DHCA cooling to 16oC, or MHCA (moderate HCA) and only going to 21-28oC. Is there cerebral perfusion? The answers could effect the outcome.

Wow, my brain is overheating – definitely not 16 or even 21-28oC…it is smoking!

Please review the papers yourselves and see if I am adding 2 and 2 and getting 762, but I think I may be right on this.

Finally, surely after that, you want to buy me a coffee

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AWARE II preprint analysis

So having had time to look through the preprint of the AWARE II paper, I will only add comments on new information that wasn’t present in the talk at AHA, and it basically boils down to two things – the reports of external awareness – in particular the visual report, and the EEG data.

On the report of visual awareness, this is from the paper:

“…one describing “hands being on him” and voices shouting. Another, “heard people talking…” and drugs given but without specifics. The same person (1/28 [3.5%]) perceived visual awareness of doctors. He felt like he was further away but could see what was going on, including hearing/seeing doctors getting organized and a doctor with a “surgical hat and blue scrubs”. He said he “could feel someone rubbing the bony bit” on his chest. During stage 3, no further information for independent corroboration was provided.”

When you look at this case, I would say this is much more likely to be CIPRIC than a genuine OBE. Not what I would like to say, but nonetheless feels true given he reports feeling procedures. It is possible he was “half-in half-out” but no evidence to support this UNLESS they also collected EEG and it was flat during the episode he describes…which brings me on to the EEG data. I refer specifically to this paragraph:

“EEG data were obtained from n=85 subjects, but due to electrical interference, electrode malfunction, motion artifact data, only 53 had interpretable EEG data. Thus, of 851 total EEG images captured, 466(55%) were interpretable (Figure 1.A). Of these 53, n=49 also had rSO 2 with mean SD rSO 2 43.49, consistent with significant ischemia (normal~70%). Those not-interviewed had a similar rSO 2 to those interviewed. Among the 28 interviewed survivors, mean rSO 2 was similar between those with and without memories. Although, absence of cortical brain activity (suppressed EEG) was a dominant finding (47% of data/images), seizure-like (epileptiform) activity also emerged (5%) (Figure 1.B). Importantly, near-normal/physiological EEG consistent with consciousness also emerged: delta, theta activity in 22% and 12% respectively (up to CPR 60 minutes), alpha 6% of data/images (up to CPR 35 minutes) and beta 1% (Figure 1.B). Near-normal EEG patterns were observed throughout CPR, however, their relative frequency declined over time, especially after 50 minutes of CPR. In parallel, there was a relative increase in suppressed (absent) EEG. Seizure-like activity occurred after 10mins of CPR but remained steady (~12-24% of all EEG recordings) throughout (Figure 1.B). Modeling the likelihood of the emergence of the EEG patterns, we identified a significant difference in the predicted probability of the emergence of the three categories of EEG (normal-near normal, seizure like activity, absence) with prolonged CPR duration (p<0.001) (Figure 1.C)2”

Firstly, the Parnia lab are to be congratulated on what is a truly innovative and ground-breaking piece of research. As they state in the discussion, this is the first time that real-time EEG data has been collected in a prospective study during CPR, and given the fact that near normal EEG patterns were observed in some patients throughout CPR, it raises the possibility that NDEs could be explained by brain activity. However, without further detail, and specifically the tables, I am going to guess that it is quite unlikely given that one of the 6 patients who had “transcendental” experiences has EEG data given that less than 10% of all subjects had interpretable EEG (I am assuming the percentages quoted in the above paragraph are for the whole EEG population, not just those who were interviewed…this should be changed by the editor before final publication with numbers as well as percentages). Now if one of the 6 did have interpretable EEG, then it could prove positive for either camp, but would favour the dualists. There are two scenarios if there was interpretable EEG data for any of the 6:

  1. The EEG data was inconsistent with conscious activity. This would be slightly positive for dualists…but only slightly without time stamping of validated external recollections…which we already know don’t exist.
  2. The EEG data was consistent with the potential for conscious activity. This would be slightly supportive or the materialists, but for the same reason as it would not be conclusive in scenario one it would not be conclusive here.

Ultimately, even when we do see the tables, I am pretty certain we will not be able to draw any definitive conclusions about the nature of consciousness, or of the cause of NDEs from AWARE II. Most, if not all of the EEG data, is for people who didn’t report an NDE.

Parnia points to his study in patients undergoing hypothermic circulatory arrest as maybe unlocking the puzzle. My next post will be about this, and why I am concerned that this may be a false hope, and if he did stop collecting data for AWARE II in March 2020, then he may come to regret it.

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)

11k downloads and crickets – Poll

Apologies for diverging from the main subject, and I know some of you really get the hump when I do this, but rest assured, I will be creating a new on-topic post by the end of the month. (As a reminder, there are no ads on this site)

I learned something this morning that is troubling me. Last summer I created a post around a novel that I had been working on for a few years…actually it was intended to be a series. I uploaded the first 3 chapters of the latest draft, and asked people to let me know what they thought. I had a small number of positive comments, and 1 negative comment. I decided there wasn’t enough interest in it for me to invest hundreds more hours and dollars on finishing this draft and getting it edited.

Today I was going through last years stats which were the best yet, with quarter of a million views and 40k unique visitors (thank you!), then I noticed the downloads. To date there have been over 11,000 downloads of the novel sample! Now I know I asked people to comment, but either it was so embarrassingly bad, or it’s possible people are lazy, or didn’t notice my request to send comments. Anyway, to get final closure on this matter, I decided to create a poll which is much easier to respond to than sending a comment or message. Please only answer this poll if you read the sample chapters, or started reading them and thought they were so bad you stopped (here is the link if you wish to download again or for the first time: CLICK TO DOWNLOAD FIRST 3 CHAPTERS

If you answered yes to the above question, and the novel was 60,000 words (say 300 pages), what would you define as reasonably priced? (unless I am approached by an agent or publisher, I would self publish which is much more expensive per copy and the cost per copy would be at least $6 – ebook is a minimum of $3 on Amazon, with them gobbling the lion’s share)

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!!

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