Reply to ‘Limitations of neurocentric models for near-death experiences’

We thank O’Grady and Varghese for their comments on our recent Review (Martial, C. et al. A neuroscientific model of near-death experiences. Nat. Rev. Neurol. 21, 297–311; 2025)¹. We appreciate their engagement (O’Grady, G. & Varghese, C. Limitations of neurocentric models for near-death experiences. Nat. Rev. Neurol. https://doi.org/10.1038/s41582-025-01117-3; 2025)² and agree wholeheartedly that near-death experiences (NDEs) “remain one of the most intriguing experiences in modern clinical science.”

We recognize the need for multidisciplinary discourse that considers all available evidence. However, such inclusivity must extend to contemporary knowledge from neuroscience and cognitive psychology — key fields for understanding NDEs. Intellectual honesty and methodological rigour are essential in this belief-laden field. In this spirit, our NEPTUNE model¹ was not intended to diminish the phenomenological richness or personal value of NDEs, but rather to propose a cognitive-neurobiologically plausible integrative framework grounded in empirical findings. Far from precluding neuroscientific explanation, the compelling phenomenology and profound impact of these experiences call for investigation into how such effects can emerge from extreme states, thereby motivating our evolutionary perspective^1,3.