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From the Departments of Neurology (K.R.N., M.M., F.A.S.) and Education and Counseling (S.A.L.) and Sanders-Brown Center on Aging (F.A.S.), Departments of Neurology, Psychiatry, Psychology, and Behavioral Sciences, University of Kentucky, Lexington.
Address correspondence to Dr Nelson, Department of Neurology, Kentucky Clinic L-445, College of Medicine, University of Kentucky, 800 Rose St., Lexington, KY 40536-0284; e-mail: knelson{at}email.uky.edu
The neurophysiologic basis of near death experience (NDE) is unknown. Clinical observations suggest that REM state intrusion contributes to NDE. Support for the hypothesis follows five lines of evidence: REM intrusion during wakefulness is a frequent normal occurrence, REM intrusion underlies other clinical conditions, NDE elements can be explained by REM intrusion, cardiorespiratory afferents evoke REM intrusion, and persons with an NDE may have an arousal system predisposing to REM intrusion. To investigate a predisposition to REM intrusion, the life-time prevalence of REM intrusion was studied in 55 NDE subjects and compared with that in age/gender-matched control subjects. Sleep paralysis as well as sleep-related visual and auditory hallucinations were substantially more common in subjects with an NDE. These findings anticipate that under circumstances of peril, an NDE is more likely in those with previous REM intrusion. REM intrusion could promote subjective aspects of NDE and often associated syncope. Suppression of an activated locus ceruleus could be central to an arousal system predisposed to REM intrusion and NDE.
Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the April 11 issue to find the title link for this article.
Disclosure: The authors report no conflicts of interest.
Received August 22, 2005. Accepted in final form December 20, 2005.
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