Laser‐evoked potentials to noxious stimulation during hypnotic analgesia and distraction of attention suggest different brain mechanisms of pain control

Abstract

Psychological accounts of hypnosis have hypothesized that hypnosis and attention might share similar mechanisms and that hypnosis simply represents an extensive state of reduced attention. This assumption implies that reports of pain and electrocortical brain responses to painful stimulation should be similarly reduced when subjects are exposed to suggestions of hypnotic analgesia (HA) or requested to distract their attention from painful stimuli (distraction of attention: DA) as compared to a control condition (CC). To test this hypothesis, we recorded event-related electrical brain potentials to noxious laser-heat stimuli and pain reports during HA, DA, and CC from subjects highly susceptible to hypnotic suggestions. Pain reports were significantly reduced during HA and DA as compared to CC. The amplitudes of the late laser-evoked brain potential (LEP) components N200 and P320 were also significantly smaller during DA than during CC. However, no significant difference of these late LEP amplitudes was obtained for HA as compared to CC. Results indicate that hypnotic analgesia and distraction of attention represent different mechanisms of pain control and involve different brain mechanisms.

Distraction produces an increase in pain‐evoked anterior cingulate activity

“…Subjective pain ratings were lowest in the distraction condition, as has been shown in several other studies (Frankenstein et al, 2001; Friederich et al, 2001; Garcia‐Larrea et al, 1997; Miron et al, 1989; Petrovic et al, 2000; Peyron et al, 1999; Willer et al, 1979; Yamasaki et al, 2000). These data demonstrate that the subjects were attending to the arithmetic task during the distraction condition.…”

“…Attention plays an important role in pain perception. Attention has been shown to alter experimental pain (Frankenstein, Richter, McIntyre, & Remy, 2001; Friederich et al, 2001; Garcia‐Larrea, Peyron, Laurent, & Mauguiere, 1997; Miron, Duncan, & Bushnell, 1989; Petrovic, Petersson, Ghatan, Stone‐Elander, & Ingvar, 2000; Peyron et al, 1999; Willer, Boureau, & Albe‐Fessard, 1979; Yamasaki, Kakigi, Watanabe, & Hoshiyama, 2000) and to play an important role in the treatment of clinical pain (Weisenberg, 1994). Most electrophysiological studies of the effects of attention on the human pain pathways have involved the laser‐evoked potential (LEP).…”

Connectivity Analysis of Somatosensory Evoked Potentials in Patients with Major Depression

“…Thus, our experimental noxious stimuli might not have been sufficiently strong enough to produce a switch between states. A similar mechanism has been proposed for hypnotic analgesia [55,56].…”

Pain‐Related and Negative Semantic Priming Enhances Perceived Pain Intensity

“…T he perception and processing of painful events is modulated by environmental and interpersonal conditions such as attention, anticipation and negative mood (1)(2)(3)(4)(5)(6)(7). In recent studies, different affective states were induced by pictures, video sequences or odours before noxious stimulation, showing that such negative emotional priming is associated with enhanced physiological responses and increased pain ratings to noxious target stimuli (8)(9)(10)(11)(12), according to the assumptions of the motivational priming theory (13).…”