Migraine aura, a predictor of near-death experiences in a crowdsourced study

Abstract Background Near-death experiences (NDE) occur with imminent death and in situations of stress and danger but are poorly understood. Evidence suggests that NDE are associated with rapid eye movement (REM) sleep intrusion, a feature of narcolepsy. Previous studies further found REM abnormalities and an increased frequency of dream-enacting behavior in migraine patients, as well as an association between migraine with aura and narcolepsy. We therefore investigated if NDE are more common in people with migraine aura. Methods We recruited 1037 laypeople from 35 countries via a crowdsourcing platform. Reports were validated using the Greyson NDE Scale. Results Eighty-one of 1037 participants had NDE (7.8%; CI 6.3-9.7%). There were no significant associations between NDE and age (p>0.6, t-test independent samples) or gender (p>0.9, chi-square test). The only significant association was between NDE and migraine aura: Forty-eight (6.1%) of 783 subjects without migraine aura and 33 (13.0%) of 254 subjects with migraine aura had NDE (p<0.001, chi-square test, odds ratio (OR) = 2.29). In multiple logistic regression analysis, migraine aura remained significant after adjustment for age (p≤0.001, OR 2.31), gender (p<0.001, OR 2.33), or both (p<0.001, OR 2.33). Conclusions In our sample, migraine aura was a predictor of NDE. This indirectly supports the association between NDE and REM intrusion and might have implications for the understanding of NDE, because a variant of spreading depolarization (SD), terminal SD, occurs in humans at the end of life, while a short-lasting variant of SD is considered the pathophysiological correlate of migraine aura.