Is hypnotic assessment relevant to neurology?

Abstract

Studies conducted in healthy subjects have clearly shown that different hypnotic susceptibility, which is measured by scales, is associated with different functional equivalence between imagery and perception/action (FE), cortical excitability, and information processing. Of note, physiological differences among individuals with high (highs), medium (mediums), and low hypnotizability scores (lows) have been observed in the ordinary state of consciousness, thus independently from the induction of the hypnotic state, and in the absence of specific suggestions. The potential role of hypnotic assessment and its relevance to neurological diseases have not been fully explored. While current knowledge and therapies allow a better survival rate, there is a constant need to optimize rehabilitation treatments and quality of life. The aim of this paper is to provide an overview of hypnotizability-related features and, specifically, to discuss the hypothesis that the stronger FE, the different mode of information processing, and the greater proneness to control pain and the activity of the immune system observed in individuals with medium-to-high hypnotizability scores have potential applications to neurology. Current evidence of the outcome of treatments based on hypnotic induction and suggestions administration is not consistent, mainly owing to the small sample size in clinical trials and inadequate control groups. We propose that hypnotic assessment may be feasible in clinical routine and give additional cues into the treatment and rehabilitation of neurological diseases.

Medical hypnosis on depression and interleukin-6 levels in lung cancer patients

“…Improvement in IL-6 levels may also be caused by lifestyle changes and improvement in appetite or diet. 23 This is consistent with previous research findings that self-efficacy leads to improvements in lifestyle practices and health behaviours in adults. 8 Selfreported changes in health habits may reflect hypnotic suggestions aimed at addressing skills, self-esteem, and self-efficacy, which in turn facilitate improvements in health behaviours such as healthy and nutritious eating.…”

Effect of hypnosis versus mindfulness on self-defined treatment goals and sleep following acquired brain injury: a randomized actively controlled trial

“…In a recent theoretical framework, we deliberate on the mechanisms of change in hypnosis for cognitive rehabilitation arguing that hypnosis is a powerful way to attenuate negative self-expectancies induced by the brain injury [19]. Our framework aligns with recent appeals for the use of hypnosis in neurology [14,69]. The current study is not designed to evaluate the credibility of this motivation, but one result does lend support to it: participants erred on the side of being too pessimistic about their objective improvements, which may be a consequence of a "negative surprise" if they expected to be able to perform even better.…”

“…In other words, the expected sequelae become a self-fulfilling prophecy [10,11], likely through a mechanism with high similarity-if not identity-to the nocebo effect [12]. Therefore, injury expectation may be an important target in rehabilitation, counselling, and psychotherapy to improve the patients' functioning, activities, and social participation [13][14][15]. This article reports the potential effects of using a hypnotic procedure to change such negative expectations in the chronic phase following acquired brain injury.…”

Physiological Correlates of Hypnotizability: Hypnotic Behaviour and Prognostic Role in Medicine

“…In highs, hypnotic suggestions of relaxation and wellbeing buffer the decline in NKP, CD8, and CD8/CD4 ratio occurring during examination-related stress in students and upregulate the expression of immune-related genes [89]. In cancer patients and geriatric patients' positive immune effects of hypnotic relaxation have also been reported [69]. Finally, the highs' ability to modulate their autonomic activity [83,90,91], challenged by only one study [92] could positively influence their microbiota, whose alteration is involved in cognitive decline owing to the cerebral effects of locally produced cytokines and the activation of afferent vagal fibers [93].…”

“…The highs' better cerebrovascular reactivity may buffer transient alteration of blood flow and, theoretically, their stronger FE between imagery and perception/action [14], together with the higher excitability of the motor cortex [15,16], makes highs more prone than lows to take advantage from mental training after brain lesions of any origin [69]. The latter finding suggests that hypnotic assessment could predict the outcome of mental training and Brain Computer Interface interventions, which display large variability in the outcome and is ineffective in part of the general population [70].…”