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Abstract: The physiological and psychological underpinnings of near-death experiences (NDEs) are not yet understood. In this article, we show that for "critical" NDEs reported after cardiac arrest, two different neurophysiological models have been proposed that, in the literature so far, have not been adequately distinguished from each other. In the real-time model, it is postulated that during critical NDEs, residual activities in the cerebrum were sufficient to generate NDEs in real time. In the reconstruction model, it is assumed that due to severe oxygen deficiency, critical NDEs could not have occurred at the time in question but were reconstructed later during the regeneration phase of the brain. To assess the plausibility of these two models, we analyzed the phenomenology of the view of one's own body from above (autoscopy) that frequently occurs in the beginnings of NDEs. In addition to the available literature, we used original descriptions of autoscopies obtained in an online survey conducted in 2015. We found that the reconstruction model is not supported by empirical findings and that some findings even speak against it. We therefore conclude that future discussions of explanatory models of NDEs should focus primarily on the neurophysiological real-time model and a third alternative according to which autoscopies and NDEs occur in relative independence from the prevailing neurophysiological processes in the brain.
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Unexpected cognitive lucidity and communication in patients with severe dementias, especially around the time of death, have been observed and reported anecdotally. Here, we review what is known about this phenomenon, related phenomena that provide insight into potential mechanisms, ethical implications, and methodologic considerations for systematic investigation. We conclude that paradoxical lucidity, if systematically confirmed, challenges current assumptions and highlights the possibility of network-level return of cognitive function in cases of severe dementias, which can provide insight into both underlying neurobiology and future therapeutic possibilities.
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Neuroscientists typically assume that human mental functions are generated by the brain and that its structural elements, including the different cell layers and tissues that form the neocortex, play specific roles in this complex process. Different functional units are thought to complement one another to create an integrated self-awareness or episodic memory. Still, findings that pertain to brain dysplasia and brain lesions indicate that in some individuals there is a considerable discrepancy between the cerebral structures and cognitive functioning. This seems to question the seemingly well-defined role of these brain structures. This article provides a review of such remarkable cases. It contains overviews of noteworthy aspects of hydrocephalus, hemihydranencephaly, hemispherectomy, and certain abilities of “savants.” We add considerations on memory processing, comment on the assumed role of neural plasticity in these contexts, and highlight the importance of taking such anomalies into account when formulating encompassing models of brain functioning.
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