Near-Death Experiences in patients with locked-in syndrome: Not always a blissful journey

Memories of Near-Death Experiences (NDEs) most often are recounted as emotionally positive events. At present, no satisfactory explanatory model exists to fully account for the rich
phenomenology of NDEs following a severe acute brain injury. The particular population of
patients with locked-in syndrome (LIS) provides a unique opportunity to study NDEs following infratentorial brain lesions. We here retrospectively characterized the content of
NDEs in 8 patients with LIS caused by an acute brainstem lesion (i.e., ‘‘LIS NDEs’’) and 23
NDE experiencers after coma with supratentorial lesions (i.e., ‘‘classical NDEs’’).
Compared to ‘‘classical NDEs’’, ‘‘LIS NDEs’’ less frequently experienced a feeling of peacefulness or well-being. It could be hypothesized that NDEs containing less positive emotions
might have a specific neuroanatomical substrate related to impaired pontine/paralimbic
connectivity or alternatively might be related to the emotional distress caused by the presence of conscious awareness in a paralyzed body.