Pain Modulation in Waking and Hypnosis in Women: Event-Related Potentials and Sources of Cortical Activity

Abstract

Using a strict subject selection procedure, we tested in High and Low Hypnotizable subjects (HHs and LHs) whether treatments of hypoalgesia and hyperalgesia, as compared to a relaxation-control, differentially affected subjective pain ratings and somatosensory event-related potentials (SERPs) during painful electric stimulation. Treatments were administered in waking and hypnosis conditions. LHs showed little differentiation in pain and distress ratings between hypoalgesia and hyperalgesia treatments, whereas HHs showed a greater spread in the instructed direction. HHs had larger prefrontal N140 and P200 waves of the SERPs during hypnotic hyperalgesia as compared to relaxation-control treatment. Importantly, HHs showed significant smaller frontocentral N140 and frontotemporal P200 waves during hypnotic hypoalgesia. LHs did not show significant differences for these SERP waves among treatments in both waking and hypnosis conditions. Source localization (sLORETA) method revealed significant activations of the bilateral primary somatosensory (BA3), middle frontal gyrus (BA6) and anterior cingulate cortices (BA24). Activity of these contralateral regions significantly correlated with subjective numerical pain scores for control treatment in waking condition. Moreover, multivariate regression analyses distinguished the contralateral BA3 as the only region reflecting a stable pattern of pain coding changes across all treatments in waking and hypnosis conditions. More direct testing showed that hypnosis reduced the strength of the association of pain modulation and brain activity changes at BA3. sLORETA in HHs revealed, for the N140 wave, that during hypnotic hyperalgesia, there was an increased activity within medial, supramarginal and superior frontal gyri, and cingulated gyrus (BA32), while for the P200 wave, activity was increased in the superior (BA22), middle (BA37), inferior temporal (BA19) gyri and superior parietal lobule (BA7). Hypnotic hypoalgesia in HHs, for N140 wave, showed reduced activity within medial and superior frontal gyri (BA9,8), paraippocampal gyrus (BA34), and postcentral gyrus (BA1), while for the P200, activity was reduced within middle and superior frontal gyri (BA9 and BA10), anterior cingulate (BA33), cuneus (BA19) and sub-lobar insula (BA13). These findings demonstrate that hypnotic suggestions can exert a top-down modulatory effect on attention/preconscious brain processes involved in pain perception.

The Reorganization of Insular Subregions in Individuals with Below-Level Neuropathic Pain following Incomplete Spinal Cord Injury

“…We also found the enhancive activation in the BA 37 and BA18. The increased activity in BA37 had been reported during the hyperalgesia [60]. And activation in BA 18 was observed responding to virtual pain stimuli by fMRI [61].…”

New directions in hypnosis research: strategies for advancing the cognitive and clinical neuroscience of hypnosis

“…Functional connectivity studies using fMRI have also demonstrated differences in the brain networks of highs ( Hoeft et al 2012 ; Huber et al 2014 ), and structural MRI research suggests that highs exhibit greater volume in the rostrum of the corpus callosum ( Horton et al 2004 ) and medial prefrontal and anterior cingulate cortices ( Huber et al 2014 ; McGeown et al 2015 ). There is also preliminary research indicating that hypnotic responding might be enhanced by procedures which selectively reduce activity in the prefrontal cortex, suggesting that inhibiting psychological functions supported by this region may enhance response to suggestion ( Dienes and Hutton 2013 ; Semmens-Wheeler et al 2013 ; De Pascalis et al 2015 ). Cumulatively, these results suggest pivotal roles for regions of the prefrontal and anterior cingulate cortices in hypnotic suggestibility and in differential response to hypnotic inductions.…”

Spectral and topological analyses of the cortical representation of the head position: Does hypnotizability matter?

“…Theta/delta modulation, however, has not been observed during movement. Hypnotizability‐related EEG spectral differences have been studied during imagery tasks (Cavallaro et al., ), but not during different sensorimotor conditions, with the exception of nociceptive stimulation (Zeev‐Wolf, Goldstein, Bonne, & Abramowitz, ) which, however, has been preferentially investigated through cortically evoked potentials (De Pascalis, Varriale, & Cacace, ; Valentini, Betti, Hu, & Aglioti, ).…”