Neural regions associated with memories of Recalled Experiences of Death (REDs; authentic Near‑Death Experiences [NDEs]): a preliminary functional MRI study

Introduction: This observational study examined brain activation patterns when people relive their memories of recalled experiences of death (REDs), also known as authentic near-death experience (NDE) memories, using structural and functional MRI under normal cerebral perfusion in participants with clinically documented life-threatening events and loss of consciousness. Methods: ≥ 10 voxels. Region-of-interest (ROI) analyses were performed using small-volume correction with voxel-wise family-wise error (FWE) correction (pFWE < 0.05). Results: Significant activations were observed in the precuneus (BA7), posterior cingulate cortex (BA23/31), medial prefrontal cortex (BA10), dorsolateral prefrontal cortex (BA9/46), angular gyrus (BA39), secondary visual cortex (BA18/19), middle temporal gyrus (BA21), and orbitofrontal cortex (BA47). The parahippocampal region (BA36) showed a non-significant trend. No activation was found in primary sensorimotor or limbic areas. Discussion: The reliving of RED/authentic NDE memories was associated with the engagement of brain networks implicated in autobiographical memory and the default mode network (DMN), suggesting the involvement of introspective and self-referential processes. The observed activation patterns were not consistent with those typically reported for primary sensory hallucinations. Conclusions: Controlled reliving of memories of REDs/authentic NDEs may represent a useful experimental paradigm for investigating multisensory autobiographical memory and neural processes related to conscious self-experience. These findings are consistent with vivid episodic recollection and differ from neural patterns commonly associated with imagined or false memories.