Publications of Helena Cassol
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See detailNociception Coma Scale Revised allows to identify patients with preserved neural basis for pain experience
Bonin, Estelle ULiege; Lejeune, Nicolas ULiege; Thibaut, Aurore ULiege et al

in Journal of Pain (in press)

The Nociception Coma Scale-Revised (NCS-R) was developed to help assess pain in patients with disorders of consciousness (DOC). Several studies have shown its sensitivity in assessing response to acute ... [more ▼]

The Nociception Coma Scale-Revised (NCS-R) was developed to help assess pain in patients with disorders of consciousness (DOC). Several studies have shown its sensitivity in assessing response to acute noxious stimuli. However, they failed to determine a reliable cut-off score that could be used to infer pain processing in these patients. This retrospective cross-sectional study aimed to determine a NCS-R cut-off score supporting preserved neural basis for pain experience, based on brain metabolism preservation as measured by fluorodeoxyglucose positron emission tomography (FDG-PET). We included patients in unresponsive wakefulness syndrome (UWS) confirmed by the FDG-PET and examined the NCS-R total scores. As the highest score was 4, we defined the cut-off to be 5 and compared the brain metabolism of these patients to matched patients with DOC and a NCS-R cut-off score ≥ 5 (i.e., potential pain), as well as healthy subjects. We found a higher global cerebral metabolism in healthy subjects compared to both patient groups and also in patients with potential pain compared with FDG-PET confirmed UWS. We observed a preserved metabolism in the left insula in patients with potential pain compared with FDG-PET confirmed UWS. [less ▲]

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See detailNear-Death Experience Memories Include More Episodic Components Than Flashbulb Memories
Cassol, Helena ULiege; Bonin, Estelle ULiege; Bastin, Christine ULiege et al

in Frontiers in Psychology (2020), 11(888),

Memories of near-death experiences (NDEs) are recalled as “realer” than memories of other real or imagined events. Given their rich phenomenology, emotionality and consequentiality, it was hypothesized ... [more ▼]

Memories of near-death experiences (NDEs) are recalled as “realer” than memories of other real or imagined events. Given their rich phenomenology, emotionality and consequentiality, it was hypothesized that they could meet some aspects of the definition of flashbulb memories. We aimed to identify and compare the episodic and non-episodic information provided in verbal recollections of NDE, flashbulb, and control autobiographical memories. The phenomenological characteristics and centrality of the memories were also compared. Twenty-five participants who had lived a NDE in a life-threatening situation were interviewed and completed the Memory Characteristics Questionnaires as well as the Centrality of Event Scale for their NDE, a flashbulb and another autobiographical memory used as control. Overall, transcribed NDE verbal recollections included a higher overall amount of details and more internal/episodic information than control autobiographical and flashbulb memories. Moreover, flashbulb memories were associated to a lower intensity of feelings while remembering and a lower personal importance, and are less reactivated and less susceptible to be remembered from a first person perspective compared to NDE and control autobiographical memories. Finally, NDE memories are the most central memories to experiencers’ identity, followed by control autobiographical and then by flashbulb memories. These findings corroborate previous studies highlighting the impact and uniqueness of NDE memories. [less ▲]

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See detailNear-death experience as a probe to explore (disconnected) consciousness
Martial, Charlotte ULiege; Cassol, Helena ULiege; Laureys, Steven ULiege et al

in Trends in Cognitive Sciences (2020)

Forty-five years ago, the first evidence of near-death experience (NDE) during comatose state was provided, setting the stage for a new paradigm for studying the neural basis of consciousness in ... [more ▼]

Forty-five years ago, the first evidence of near-death experience (NDE) during comatose state was provided, setting the stage for a new paradigm for studying the neural basis of consciousness in unresponsive states. At present, the state of consciousness associated with NDEs remains an open question. In the common view, consciousness is said to disappear in a coma with the brain shutting down, but it is oversimplified. This article argues that the novel framework distinguishing awareness, wakefulness and connectedness is relevant to comprehend the phenomenon. Classical NDEs correspond to internal awareness experienced in unresponsive conditions, thereby corresponding to an episode of disconnected consciousness. Our proposal suggests new directions for NDE research, and more broadly, consciousness science. [less ▲]

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See detailCharacterization of near-death experiences using text mining analyses: a preliminary study
Charland-Verville, Vanessa ULiege; Ribeiro de Paula, Demetrius; Martial, Charlotte ULiege et al

in PLoS ONE (2020)

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See detailBrain metabolism but not grey matter volume underlies the presence of language function in the minimally conscious state
Aubinet, Charlène ULiege; Cassol, Helena ULiege; Gosseries, Olivia ULiege et al

in Neurorehabilitation and Neural Repair (2020), 34(2), 172-184

Background. The minimally conscious state (MCS) is subcategorized into MCS- and MCS+, depending on the absence or presence of high-level behavioral responses such as command following. Objective. We aim ... [more ▼]

Background. The minimally conscious state (MCS) is subcategorized into MCS- and MCS+, depending on the absence or presence of high-level behavioral responses such as command following. Objective. We aim to investigate the functional and structural neuroanatomy underlying the presence of these responses in MCS- and MCS+ patients. Methods. In this cross-sectional retrospective study, chronic MCS patients were diagnosed using repeated Coma Recovery Scale-Revised assessments. Fluorodeoxyglucose-positron emission tomography data were acquired on 57 patients (16 MCS-; 41 MCS+) and magnetic resonance imaging with voxel-based morphometry analysis was performed on 66 patients (17 MCS-; 49 MCS+). Brain glucose metabolism and grey matter integrity were compared between patient groups and control groups. A metabolic functional connectivity analysis testing the hypothesis of preserved language network in MCS+ compared to MCS- was also done. Results. Patients in MCS+ presented higher metabolism mainly in the left middle temporal cortex, known to be important for semantic processing, compared to the MCS- group. The left angular gyrus was also functionally disconnected from the left prefrontal cortex in MCS- compared to MCS+. No significant differences were found in grey matter volume between patient groups. Conclusions. The clinical sub-categorization of MCS is supported by differences in brain metabolism but not in grey matter structure, suggesting that brain function in the language network is the main support for recovery of command-following, intelligible verbalization and/or intentional communication in the MCS. Better characterizing the neural correlates of residual cognitive abilities of MCS patients contributes to reduce their misdiagnosis and to adapt therapeutic approaches. [less ▲]

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See detailBrain Metabolism but Not Gray Matter Volume Underlies the Presence of Language Function in the Minimally Conscious State (MCS): MCS+ Versus MCS− Neuroimaging Differences
Aubinet, Charlène ULiege; Cassol, Helena ULiege; Gosseries, Olivia ULiege et al

in Neurorehabilitation and Neural Repair (2020), 34(2), 172-184

Background. The minimally conscious state (MCS) is subcategorized into MCS− and MCS+, depending on the absence or presence, respectively, of high-level behavioral responses such as command-following ... [more ▼]

Background. The minimally conscious state (MCS) is subcategorized into MCS− and MCS+, depending on the absence or presence, respectively, of high-level behavioral responses such as command-following. Objective. We aim to investigate the functional and structural neuroanatomy underlying the presence of these responses in MCS− and MCS+ patients. Methods. In this cross-sectional retrospective study, chronic MCS patients were diagnosed using repeated Coma Recovery Scale–Revised assessments. Fluorodeoxyglucose-positron emission tomography data were acquired on 57 patients (16 MCS−; 41 MCS+) and magnetic resonance imaging with voxel-based morphometry analysis was performed on 66 patients (17 MCS−; 49 MCS+). Brain glucose metabolism and gray matter integrity were compared between patient groups and control groups. A metabolic functional connectivity analysis testing the hypothesis of preserved language network in MCS+ compared with MCS− was also done. Results. Patients in MCS+ presented higher metabolism mainly in the left middle temporal cortex, known to be important for semantic processing, compared with the MCS− group. The left angular gyrus was also functionally disconnected from the left prefrontal cortex in MCS− compared with MCS+ group. No significant differences were found in gray matter volume between patient groups. Conclusions. The clinical subcategorization of MCS is supported by differences in brain metabolism but not in gray matter structure, suggesting that brain function in the language network is the main support for recovery of command-following, intelligible verbalization and/or intentional communication in the MCS. Better characterizing the neural correlates of residual cognitive abilities of MCS patients contributes to reduce their misdiagnosis and to adapt therapeutic approaches. © The Author(s) 2020. [less ▲]

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See detailLes expériences de mort imminente
Cassol, Helena ULiege; Martial, Charlotte ULiege; Laureys, Steven ULiege

in Dechene, Antoine; Dupont, Bruno (Eds.) Crises (2019)

Les expériences de mort imminente (EMI) désignent un ensemble d’événements mentaux émotionnellement variés associant des éléments mystiques et spirituels, et survenant généralement suite à une situation ... [more ▼]

Les expériences de mort imminente (EMI) désignent un ensemble d’événements mentaux émotionnellement variés associant des éléments mystiques et spirituels, et survenant généralement suite à une situation de danger réel ou perçu. Ces phénomènes, caractérisés par une phénoménologie riche et une intensité réaliste, peuvent être considérés comme synonymes de crises, en ce sens qu’ils correspondent à des événements charnières et déterminants dans la vie des expérienceurs (personnes ayant vécu une EMI). En effet, après leur EMI, ces personnes présentent généralement une moindre crainte de la mort, sont davantage spirituelles et sont moins matérialistes. Cet impact sur le long terme exige une meilleure caractérisation ainsi qu’une description rigoureuse de ces phénomènes. Des théories psychologiques aux théories sociologiques, en passant par les analyses des récits de ces expériences, cet article s’intéresse à la répercussion de ces phénomènes sur la vie des expérienceurs. [less ▲]

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See detailNeurophenomenology of near-death experience memory in hypnotic recall: a within-subject EEG study
Martial, Charlotte ULiege; Mensen, Armand ULiege; CHARLAND-VERVILLE, Vanessa ULiege et al

in Scientific Reports (2019)

The neurobiological basis of near-death experiences (NDEs) is unknown, but a few studies attempted to investigate it by reproducing in laboratory settings phenomenological experiences that seem to closely ... [more ▼]

The neurobiological basis of near-death experiences (NDEs) is unknown, but a few studies attempted to investigate it by reproducing in laboratory settings phenomenological experiences that seem to closely resemble NDEs. So far, no study has induced NDE-like features via hypnotic modulation while simultaneously measuring changes in brain activity using high-density EEG. Five volunteers who previously had experienced a pleasant NDE were invited to re-experience the NDE memory and another pleasant autobiographical memory (dating to the same time period), in normal consciousness and with hypnosis. We compared the hypnosis-induced subjective experience with the one of the genuine experience memory. Continuous high-density EEG was recorded throughout. At a phenomenological level, we succeeded in recreating NDE-like features without any adverse effects. Absorption and dissociation levels were reported as higher during all hypnosis conditions as compared to normal consciousness conditions, suggesting that our hypnosis-based protocol increased the felt subjective experience in the recall of both memories. The recall of a NDE phenomenology was related to an increase of alpha activity in frontal and posterior regions. This study provides a proof-of-concept methodology for studying the phenomenon, enabling to prospectively explore the NDE-like features and associated EEG changes in controlled settings. [less ▲]

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See detailThe self-defining aspect of near-death experiences
Cassol, Helena ULiege

Conference (2019, September 05)

Near-Death Experiences (NDEs) can be defined as profound psychological events with highly emotional and self-related content, typically encompassing transcendental and mystical elements and occurring when ... [more ▼]

Near-Death Experiences (NDEs) can be defined as profound psychological events with highly emotional and self-related content, typically encompassing transcendental and mystical elements and occurring when people come close to death. Studies have highlighted that 6 to 23% of cardiac arrest survivors have reported this phenomenon, which supports its frequent occurrence. Intriguingly, similar experiences have been described after situations that do not imply any danger for physical or mental health. These experiences have been termed “NDEs-like” and have been described in contexts such as meditative states or syncope. Along with its particular circumstances of appearance and its mystical connotation, the widespread NDE phenomenon seems to be characterized by a rich phenomenology and a realistic intensity. Consequently, NDEs appear to have short and long term consequences on people’s lives (so-called NDE experiencers). Specifically, it was recently shown that NDE and NDE-like memories constitute a particular type of autobiographical memories referred to as self-defining memories (SDMs). SDMs are emotionally intense, vivid, and frequently recalled memories that reflect important themes and conflicts in one’s life. These emotional memories are the building blocks of our identity and contribute, in particular, to our sense of self-continuity, which represents the ability to consider oneself as an entity that extends back into the past and forward into the future. This ability is central to numerous processes such as planning future actions, giving meaning to new experiences or taking responsibility. The self-defining status of NDE memories confirms that they constitute an important part of NDE experiencers’ personal identities and highlights the importance for clinicians to facilitate their integration within their selves. The aim of this symposium is to have a closer look at the factors that contribute to making this experience self-defining, such as the content and intensity of the experience, as well as religious beliefs of experiencers. [less ▲]

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See detailStudy of the impact of non-pharmacological techniques (self-hypnosis/self-care) on cognitive complaints in cancer patients
Bicego, Aminata Yasmina ULiege; Grégoire, Charlotte ULiege; Cassol, Helena ULiege et al

Conference (2019, May 30)

Cancer diagnosis generates a number of physical, psychological and cognitive impairments such as memory, attentional and informational processing deficits that can undermine patients’ quality of life (QoL ... [more ▼]

Cancer diagnosis generates a number of physical, psychological and cognitive impairments such as memory, attentional and informational processing deficits that can undermine patients’ quality of life (QoL). Self-hypnosis combined to self-care learning have been used in the past years to treat these symptoms, at the moment of diagnosis, during and/or after the cancer treatments. However, the impact of self-hypnosis/self-care upon cognitive difficulties has not been investigated yet.The aim of this study is to better understand the impact of self hypnosis/self-care upon the cognitive functions by means of the Functional Assessment of Cancer Therapy-Cognitive Function1 (FACT-COG). [less ▲]

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See detailAux confins de la conscience: intelligence artificielle et expériences de mort imminente
Sanz, Leandro ULiege; Cassol, Helena ULiege

Scientific conference (2019, March 28)

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See detailMemories of near-death experiences: are they self-defining?
Cassol, Helena ULiege; D'Argembeau, Arnaud ULiege; Charland-Verville, Vanessa ULiege et al

in Neuroscience of Consciousness (2019), 5(1),

Some people report memories of near-death experiences (NDEs) after facing situations of impending death and these memories appear to have significant consequences on their lives (here referred to as “real ... [more ▼]

Some people report memories of near-death experiences (NDEs) after facing situations of impending death and these memories appear to have significant consequences on their lives (here referred to as “real NDE experiencers”; real NDErs). We assessed to what extent NDE memories are considered self-defining: memories that help people to define clearly how they see themselves. We screened 71 participants using the Greyson NDE scale (48 real NDErs and 23 NDErs-like who had lived a similar experience in absence of a threat to their life). Participants described their two main self-defining memories (SDMs). For each SDM, they completed the Centrality of Event Scale (CES) to assess how central the event is to their identity. The two subgroups did not differ regarding the proportion of NDErs who recalled their NDE (30 real NDErs out of 48 and 11 NDErs-like out of 23). Real NDErs and NDErs-like who recalled their NDE (n ¼ 41) reported richer experiences as assessed by the Greyson NDE scale. Furthermore, these participants rated their NDE memory as more central to their identity as compared to other SDMs, and the richness of the NDE memory was positively associated to its centrality (CES scores). Overall, these findings suggest that the self-defining aspect of the experience might be related to its phenomenological content rather than its circumstances of occurrence. The self-defining status of NDE memories confirms that they constitute an important part of NDErs’ personal identity and highlights the importance for clinicians to facilitate their integration within the self. [less ▲]

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See detailNeurochemical models of near-death experiences: a large-scale study based on the semantic similarity of written reports
Martial, Charlotte ULiege; Cassol, Helena ULiege; Charland-Verville, Vanessa ULiege et al

in Consciousness and Cognition (2019)

The real or perceived proximity to death often results in a non-ordinary state of consciousness characterized by phenomenological features such as the perception of leaving the body boundaries, feelings ... [more ▼]

The real or perceived proximity to death often results in a non-ordinary state of consciousness characterized by phenomenological features such as the perception of leaving the body boundaries, feelings of peace, bliss and timelessness, life review, the sensation of traveling through a tunnel and an irreversible threshold. Near-death experiences (NDEs) are comparable among individuals of different cultures, suggesting an underlying neurobiological mechanism. Anecdotal accounts of the similarity between NDEs and certain drug-induced altered states of consciousness prompted us to perform a large-scale comparative analysis of these experiences. After assessing the semantic similarity between ≈15,000 reports linked to the use of 165 psychoactive substances with 625 NDE narratives, we determined that the N-methyl-D-aspartate (NMDA) receptor antagonist ketamine consistently resulted in reports most similar to those associated with NDEs. Ketamine was followed by Salvia divinorum (a plant containing a potent and selective κ receptor agonist) and a series of serotonergic psychedelics, including the endogenous serotonin 2A receptor agonist N,N Dimethyltryptamine (DMT). This similarity was driven by semantic concepts related to consciousness of the self and the environment, but also by those associated with the therapeutic, ceremonial and religious aspects of drug use. Our analysis sheds light on the long-standing link between certain drugs and the experience of “dying“, suggests that ketamine could be used as a safe and reversible experimental model for NDE phenomenology, and supports the speculation that endogenous NMDA antagonists with neuroprotective properties may be released in the proximity of death. [less ▲]

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See detailA Graph Signal Processing Approach to Study High Density EEG Signals in Patients with Disorders of Consciousness
Mortaheb, Sepehr ULiege; Annen, Jitka ULiege; Chatelle, Camille ULiege et al

in Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society (2019)

Graph signal processing (GSP) is a novel approach to analyse multi-dimensional neuroimaging data, constraining functional measures by structural characteristics in a single framework (i.e. graph signals ... [more ▼]

Graph signal processing (GSP) is a novel approach to analyse multi-dimensional neuroimaging data, constraining functional measures by structural characteristics in a single framework (i.e. graph signals). In this approach, functional time series are assigned to the vertices of the underlying weighted graph and GSP analysis is performed in each time point of the signal. Here we used GSP to study local brain connectivity changes in patients with disorders of consciousness based on resting state high density electroencephalography (hdEEG) recordings. Total variation of the graph signals is a measure of signal smoothness over the underlying graph. In this study, we constructed the underlying graph based on the geometrical distances between each electrode pairs in such a way that local smoothness of the signal can be studied. Total variation analysis in α-band showed that in the pathological states of altered consciousness, local short range communication of brain regions in this frequency band is stronger than in healthy states which shows that information is segregated in local regions in patients with disorders of consciousness. © 2019 IEEE. [less ▲]

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See detailDecreased integration of EEG source-space networks in disorders of consciousness
Rizkallah, Jennifer; Annen, Jitka ULiege; Modolo, Julien et al

in NeuroImage: Clinical (2019), 23

Increasing evidence links disorders of consciousness (DOC) with disruptions in functional connectivity between distant brain areas. However, to which extent the balance of brain network segregation and ... [more ▼]

Increasing evidence links disorders of consciousness (DOC) with disruptions in functional connectivity between distant brain areas. However, to which extent the balance of brain network segregation and integration is modified in DOC patients remains unclear. Using high-density electroencephalography (EEG), the objective of our study was to characterize the local and global topological changes of DOC patients' functional brain networks. Resting state high-density-EEG data were collected and analyzed from 82 participants: 61 DOC patients recovering from coma with various levels of consciousness (EMCS (n=6), MCS+ (n=29), MCS- (n=17) and UWS (n=9)), and 21 healthy subjects (i.e., controls). Functional brain networks in five different EEG frequency bands and the broadband signal were estimated using an EEG connectivity approach at the source level. Graph theory-based analyses were used to evaluate their relationship with decreasing levels of consciousness as well as group differences between healthy volunteers and DOC patient groups. Results showed that networks in DOC patients are characterized by impaired global information processing (network integration) and increased local information processing (network segregation) as compared to controls. The large-scale functional brain networks had integration decreasing with lower level of consciousness. [less ▲]

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See detailNear-death experiences Are they self-defining?
Cassol, Helena ULiege; D'Argembeau, Arnaud ULiege; Charland-Verville, Vanessa ULiege et al

Poster (2018, October 19)

Background: Near-Death Experiences (NDEs) are profound psychological events with highly emotional and self-related content, typically encompassing transcendental and mystical elements and occurring when ... [more ▼]

Background: Near-Death Experiences (NDEs) are profound psychological events with highly emotional and self-related content, typically encompassing transcendental and mystical elements and occurring when people come close to death (Greyson, 2000). These experiences appear to have significant consequences on peoples’ lives (so-called "NDE experiencers" or "NDErs"; e.g., Noyes, 1980). Given their documented life-transforming effects and their reported importance, NDE memories appear to share similarities with a particular type of autobiographical memories referred to as a self-defining memories (SDMs; Blagov and Singer, 2004). SDMs are the building blocks of identity (Blagov and Singer, 2004) and contribute, in particular, to the sense of self-continuity (Conway et al., 2004) which represents the ability to consider oneself as an entity that extends back into the past and forward into the future (Chandler, 1994). <br />Objectives: This study aimed at 1) assessing if NDE memories are considered as SDMs and 2) determining whether the potential self-defining dimension of NDEs is due to their phenomenal content or their circumstances of appearance (i.e., presence or absence of impeding death). <br />Methods: 71 participants were screened using the Greyson NDE scale (48 real NDErs and 23 NDErs-like who had lived a similar experience in absence of life threat; Greyson, 1983). This 16-item multiple-choice validated scale enables to quantify the richness of the experience (scores ranging from 0 to 32) and allows a standardized identification of NDEs (cut-off score of 7). Participants described their two main self-defining memories (SDMs) and completed the Centrality of Event Scale (CES; Berntsen and Rubin, 2006) for each one of them. The CES is a 20-item scale (scores ranging from 0 to 100) designed to assess how central the event is to their identity. Proportions of NDErs who recalled their NDE were calculated for each subgroup (real NDErs and NDErs-like) and a Pearson’s chi square test was performed to compare ratios between them. Later, all participants were divided into two subgroups depending on whether or not they recalled their NDE (no matter its context of occurrence; "NDE recalled" and "NDE not recalled"). The last step of analyses focused on the CES scale and was only carried out on the “NDE recalled” subgroup. Differences in CES total scores between the NDE memory and the other SDM were assessed using a Student’s t-test. Additionally, a Spearman’s correlation was performed to examine associative strength between CES and Greyson NDE scale total scores. <br />Results: Real NDErs and NDErs-like did not differ regarding the proportion of NDErs who recalled their NDE (30 real NDErs out of 48 and 11 NDErs-like out of 23; p=0.24), suggesting that the self-defining aspect of the experience could be explained by its phenomenological content rather than context of occurrence. These participants (n=41) rated the NDE memory as more central to their identity as compared to the other SDM (p<0.001). Furthermore, the richness of the NDE memory (Greyson NDE scale scores) was positively associated to its centrality (CES scores; p<0.01). <br />Conclusions: The self-defining status of NDE memories confirms that they constitute an important part of NDErs’ personal identity and highlights the importance for clinicians to facilitate their integration within the self. SDMs are indeed essential to one’s sense of self-continuity, which is crucial for psychological well-being. [less ▲]

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See detailCERVEAU ET CONSCIENCE: QUE NOUS DIT LA RECHERCHE ET L'ÉTUDE DES EXPÉRIENCES DE MORT IMMINENTE ?
Cassol, Helena ULiege

Conference given outside the academic context (2018)

Les expériences de mort imminente désignent un phénomène mental associant des éléments mystiques et spirituels, et survenant généralement suite à une situation de danger réel ou perçu. Ces expériences ... [more ▼]

Les expériences de mort imminente désignent un phénomène mental associant des éléments mystiques et spirituels, et survenant généralement suite à une situation de danger réel ou perçu. Ces expériences comprennent un ensemble de caractéristiques distinguables parmi lesquelles nous pouvons citer un sentiment de paix et de bien-être intenses, la sensation d’être hors de son corps physique et d’exister en dehors de lui, la vision d’une lumière brillante décrite par certains comme ayant une origine mystique et provoquant une attirance inexorable, une perception altérée du temps, ainsi que l’entrée dans un monde non terrestre. Les expériences de mort imminente sont de plus en plus rapportées comme reflétant une réalité physiologique et psychologique clairement identifiable d'importance clinique et scientifique. Cependant, la définition et les causes du phénomène ainsi que l'identification des « expérienceurs » (personnes ayant vécu ces expériences) sont encore sujettes à débat. Bien que le phénomène a été fréquemment décrit et exploité par les médias, son étude scientifique est plutôt récente et manque encore de données expérimentales rigoureuses. Au cours de cette conférence, nous tenterons de faire le point sur les recherches qui ont tenté de comprendre et de mieux décrire les expériences de mort imminente. [less ▲]

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