Martial Charlotte, Fritz Pauline, Gosseries Olivia, Bonhomme Vincent, Kondziella Daniel, Nelson Kevin, Lejeune Nicolas
Coma Science Group, GIGA-Consciousness, GIGA Institute, University of Liège, Liège, Belgium.
NeuroRehab & Consciousness Clinic, Neurology Department, University Hospital of Liège, Liège, Belgium.
Nat Rev Neurol. 2025 Mar 31. doi: 10.1038/s41582-025-01072-z.
Near-death experiences (NDEs) are episodes of disconnected consciousness that typically occur in situations that involve an actual or potential physical threat or are perceived as such, and the experiences are characterized by a rich content with prototypical mystical features. Several explanatory theories for NDEs have been proposed, ranging from psychological or neurophysiological to evolutionary models. However, these concepts were often formulated independently, and, owing to the fragmented nature of research in this domain, integration of these ideas has been limited. Lines of empirical evidence from different areas of neuroscience, including non-human studies, studies investigating psychedelic-induced mystical experiences in humans, and research on the dying brain, are now converging to provide a comprehensive explanation for NDEs. In this Review, we discuss processes that might underlie the rich conscious experience in NDEs, mostly focusing on prototypical examples and addressing both the potential psychological mechanisms and neurophysiological changes, including cellular and electrophysiological brain network modifications and alterations in neurotransmitter release. On the basis of this discussion, we propose a model for NDEs that encompasses a cascade of concomitant psychological and neurophysiological processes within an evolutionary framework. We also consider how NDE research can inform the debate on the emergence of consciousness in near-death conditions that arise before brain death.
濒死体验（NDEs）是意识分离的发作，通常发生在涉及实际或潜在身体威胁的情况中，或被视为此类情况，且这些体验的特点是具有丰富内容和典型的神秘特征。已经提出了几种关于濒死体验的解释理论，从心理学或神经生理学模型到进化模型不等。然而，这些概念往往是独立形成的，并且由于该领域研究的碎片化性质，这些观点的整合一直有限。来自神经科学不同领域的实证证据，包括非人类研究、调查人类迷幻药诱发的神秘体验的研究以及对濒死大脑的研究，现在正在汇聚，以提供对濒死体验的全面解释。在这篇综述中，我们讨论了濒死体验中丰富的意识体验可能背后的过程，主要关注典型例子，并探讨潜在的心理机制和神经生理变化，包括细胞和电生理脑网络改变以及神经递质释放的变化。基于这一讨论，我们提出了一个濒死体验模型，该模型在进化框架内包含一系列伴随的心理和神经生理过程。我们还考虑了濒死体验研究如何为关于脑死亡前濒死状态下意识出现的辩论提供信息。
