Neurophysiological correlates of hypnotic analgesia

Abstract

This short review describes recent advances in understanding hypnotic modulation of pain. Our current understanding of pain perception is followed by a critical review of the hypnotic analgesia studies using EEG, evoked potential and functional imaging methodologies. Key words: pain, hypnosis, fMRI, PET-scan, EEGAfter 200 years of inquiry and with varying popularity, the interest in hypnosis has more recently been on the upswing. The phenomena that comprise the domain of 'hypnosis' have attracted the curiosity of researchers and clinicians who have witnessed the changes in hypnotized subjects' behaviour and subjective experience. Evidence for the increasing interest in hypnosis in medical health care is demonstrated in the literature, where hypnosis can have an effective and cost-saving role (Holroyd 1996;Montgomery, DuHamel and Redd, 2000;Stewart 2005). However, there still remains controversy over how hypnosis should be defi ned. Some researchers (Hilgard 1965;Gruzelier 2000;Kallio and Revonsuo 2003) state that hypnotic phenomena cannot be explained without positing a special psychological state -an altered or dissociated state of consciousness, while others (Barber, 1969;Spanos, 1986;Kirsch, 1991) regard all phenomena seen in association with hypnosis as being explainable by using ordinary psychological concepts such as expectations or role playing.The notion of consciousness is at the core of an ongoing debate on the nature of hypnosis. Consciousness is a multifaceted concept that can be conceived as having two major components: awareness of environment and of self (i.e. the content of consciousness) and wakefulness (i.e. the level of vigilance or arousal) (Laureys, 2005). The brain is functionally in a constant state of fl ux and alteration. There are now attempts to systematically explore and conceptualize the so-called altered states of consciousness within the context of neuroscience (Jamieson, 2007). At present, given the absence of a thorough understanding of the neural correlates of consciousness, results from neuroimaging studies should however be used with appropriate caution.Contemporary scientifi c theories of hypnosis emphasize the changes in phenomenal experience where subjects interact in a larger sociocultural context that facilitates modifi cations in basic cognitive mechanisms underlying perception, memory and thought. Although still viewed with scepticism, hypnosis has gained respectability in medicine, in large part due to its demonstrated effects on analgesia (Montgomery, David, Winkel, Silverstein and Bobbjerg, 2002;Patterson and Jensen, 2003). Hypnosis can profoundly alter sensory awareness and cognitive processing and has been used for years to alleviate pain perception in many different clinical circumstances (Faymonville, Mambourg, Joris, Vrijens, Fissette, Albert and Lamy, 1997;Lang, Benotsch, Fick, Lutgendorf, Berbaum, Berbaum, Logan and Spiegel, 2000). There has been a huge explosion in our understanding of the basic mechanisms of pain, yet despite advances in physiology, ...

Comparison of Hypnotic Suggestion and Transcranial Direct-Current Stimulation Effects on Pain Perception and the Descending Pain Modulating System: A Crossover Randomized Clinical Trial

“…These results are in line with those reported by randomized controlled studies of clinical populations, which reported that hypnotic suggestion could improve pain conditions and analgesia (Montgomery et al, 2002; Patterson and Jensen, 2003). These results also indicate that hypnotic suggestion might be an effective procedure for alleviating pain perception in experimental models (Vanhaudenhuyse et al, 2009; Brunoni et al, 2016). Due to the complex mechanisms of pain, it is important to investigate the multiple methods through which hypnotic suggestion can influence pain perception, as evaluated by psychophysical pain measures.…”

Hypnosis, Attachment, and Oxytocin:An Integrative Perspective1

“…Finally, from a neurological perspective, the anterior cingulate cortex (ACC) may constitute another bridge between clinical hypnosis and attachment theory, since it is thought to be involved in social rejection (Cozolino, 2006(Cozolino, , 2010Eisenberger & Lieberman, 2004;Hanson & Mendius, 2009), attachment mechanisms (Neumann, 2008), and hypnotically modulated pain (Faymonville, Boly, & Laureys, 2006;Faymonville et al, 2003;Vanhaudenhuyse, Boly, Laureys, & Faymonville, 2009). Its implication in social interactions and hypnotic phenomena justify its examination from an integrative perspective.…”

General Anesthesia and Altered States of Arousal: A Systems Neuroscience Analysis

“…Conf. 1984), the stages of coma (Giacino et al 2002), schizophrenia (Olney et al 1999), seizures (Blumenfeld & Taylor 2003), locked-in states (Posner et al 2007), drug-induced high or paradoxical excitation (Brown et al 2010), meditation (Lazar et al 2005), hypnosis (Vanhaudenhuyse et al 2009), hibernation (Revel et al 2007), and suspended animation (Blackstone et al 2005). Many of these altered arousal states have analogsin pharmacologic states induced by anesthetic drugs.…”