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Schein B, Beltran G, França BR, Sanches PRS, Silva Jr DP, Torres IL, Fegni F, Caumo W. Effects of Hypnotic Analgesia and Transcranial Direct Current Stimulation on Pain Tolerance and Corticospinal Excitability in Individuals with Fibromyalgia: A Cross-Over Randomized Clinical Trial. J Pain Res 2023; 16:187-203. [PMID: 36718400 PMCID: PMC9884000 DOI: 10.2147/jpr.s384373] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/28/2022] [Indexed: 01/24/2023] Open
Abstract
Objective We compare the effect of HAS, a-tDCS on the left dorsolateral prefrontal cortex (l-DLPFC), and rest-testing on pain measures [(cold pressor test (CPT) (primary outcome) and heat pain threshold]. We also compare their effects on the motor evoked potential (MEP) (primary outcome), short intracortical inhibition (SICI), intracortical facilitation (ICF), and cortical silent period (CSP). Methods This randomized, blind, crossover trial included 18 women with fibromyalgia, aged from 18 to 65 years old. They received at random and in a crossover order a-tDCS over the l-DLPFC (2mA), HAS, or a rest-testing. Results HAS compared to a-tDCS increased the pain tolerance with a moderate effect size (ES) [Cohen's f=-0.78; (CI 95%; -1.48 to -0.12)]. While compared to rest-testing, HAS increased the CPT with a large ES [Cohen's f=-0.87; (CI 95%; -1.84 to -0.09)]. The a-tDCS compared to HAS increased the MEP amplitude with large ES [Cohen's f=-1.73 (CI 95%; -2.17 to -0.17)]. Likewise, its ES compared to rest-testing in the MEP size was large [Cohen's f=-1.03; (CI 95%; -2.06 to -0.08)]. Conclusion These findings revealed that HAS affects contra-regulating mechanisms involved in perception and pain tolerance, while the a-tDCS increased the excitability of the corticospinal pathways. They give a subsidy to investigate their effect as approaches to counter regulate the maladaptive neuroplasticity involved in fibromyalgia. Clinical Trial Registration www.ClinicalTrials.gov, identifier - NCT05066568.
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Affiliation(s)
- Bruno Schein
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul (RS), Brazil,Laboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Gerardo Beltran
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul (RS), Brazil,Laboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil,Institute of Neurosciences, Universidad Catolica de Cuenca, Cuenca, Ecuador
| | - Bárbara Regina França
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul (RS), Brazil,Laboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | | | | | - Iraci Lucena Torres
- Pain and Palliative Care Service, HCPA, Porto Alegre, RS, Brazil,Laboratory of Pharmacology of Pain and Neuromodulation, Experimental Research Center, HCPA, Porto Alegre, RS, Brazil
| | - Felipe Fegni
- Laboratory of Neuromodulation and Center for Clinical Research Learning, Physics and Rehabilitation Department, Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Wolnei Caumo
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul (RS), Brazil,Laboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil,Pain and Palliative Care Service, HCPA, Porto Alegre, RS, Brazil,Department of Surgery, School of Medicine, UFRGS, Porto Alegre, RS, Brazil,Correspondence: Wolnei Caumo, Laboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre at UFRGS, Ramiro Barcelos, 2350 - CEP 90035-003 Bairro Rio Branco, Porto Alegre, RS, Brazil, Tel/Fax +55 51- 33598083, Email
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Palfi B, Parris BA, McLatchie N, Kekecs Z, Dienes Z. Can unconscious intentions be more effective than conscious intentions? Test of the role of metacognition in hypnotic response. Cortex 2020; 135:219-239. [PMID: 33387900 DOI: 10.1016/j.cortex.2020.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/10/2020] [Accepted: 11/17/2020] [Indexed: 11/26/2022]
Abstract
While several theories assume that responses to hypnotic suggestions can be implemented without executive intentions, the metacognitive class of theories postulate that the behaviors produced by hypnotic suggestions are intended and the accompanying feeling of involuntariness is only a consequence of strategically not being aware of the intention. Cold control theory asserts that the only difference between a hypnotic and non-hypnotic response is this metacognitive one, that is, whether or not one is aware of one's intention to perform the relevant act. To test the theory, we compared the performance of highly suggestible participants in reducing the Stroop interference effect in a post-hypnotic suggestion condition (word blindness: that words will appear as a meaningless foreign script) and in a volitional condition (asking the participants to imagine the words as a meaningless foreign script). We found that participants had equivalent expectations that the posthypnotic suggestion and the volitional request would help control the conflicting information. Further, participants felt they had more control over experiencing the words as meaningless with the request rather than the suggestion; and they experienced the request largely as imagination and the suggestion largely as perception. That is, we set up the interventions we required for the experiment to constitute a test of cold control theory. Both the suggestion and the request reduced Stroop interference. Crucially, there was Bayesian evidence that the reduction in Stroop interference was the same between the suggestion and the volitional request. That is, the results support the claim that responding hypnotically does not grant a person greater first order abilities than they have non-hypnotically, consistent with cold control theory.
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Affiliation(s)
- B Palfi
- School of Psychology, University of Sussex, Brighton, UK; Sackler Centre for Consciousness Science, University of Sussex, Brighton, UK.
| | - B A Parris
- Department of Psychology, University of Bournemouth, UK
| | - N McLatchie
- Department of Psychology, Lancaster University, UK
| | - Z Kekecs
- Department of Affective Psychology, ELTE, Budapest, UK; Department of Psychology, Lund University, Sweden
| | - Z Dienes
- School of Psychology, University of Sussex, Brighton, UK; Sackler Centre for Consciousness Science, University of Sussex, Brighton, UK
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Martin JR, Sackur J, Dienes Z. Attention or instruction: Do sustained attentional abilities really differ between high and low hypnotisable persons? PSYCHOLOGICAL RESEARCH 2017; 82:700-707. [PMID: 28271230 PMCID: PMC6013507 DOI: 10.1007/s00426-017-0850-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 02/07/2017] [Indexed: 11/24/2022]
Abstract
Previous research has suggested that highly hypnotisable participants (‘highs’) are more sensitive to the bistability of ambiguous figures—as evidenced by reporting more perspective changes of a Necker cube—than low hypnotisable participants (‘lows’). This finding has been interpreted as supporting the hypothesis that highs have more efficient sustained attentional abilities than lows. However, the higher report of perspective changes in highs in comparison to lows may reflect the implementation of different expectation-based strategies as a result of differently constructed demand characteristics according to one’s level of hypnotisability. Highs, but not lows, might interpret an instruction to report perspective changes as an instruction to report many changes. Using a Necker cube as our bistable stimulus, we manipulated demand characteristics by giving specific information to participants of different hypnotisability levels. Participants were told that previous research has shown that people with similar hypnotisability as theirs were either very good at switching or maintaining perspective versus no information. Our results show that highs, but neither lows nor mediums, were strongly influenced by the given information. However, highs were not better at maintaining the same perspective than participants with lower hypnotisability. Taken together, these findings favour the view that the higher sensitivity of highs in comparison to lows to the bistability of ambiguous figures reflect the implementation of different strategies.
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Affiliation(s)
| | - Jérôme Sackur
- École des Hautes Études en Sciences Sociales (EHESS), PSL Research University, Département d'études cognitives, Laboratoire de Sciences Cognitives et Psycholinguistique (CNRS/ENS/EHESS), Paris, France
- École Polytechnique, Palaiseau, France
| | - Zoltan Dienes
- School of Psychology, University of Sussex, Brighton, UK
- Sackler Centre for Consciousness Science, University of Sussex, Brighton, UK
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Bob P, Siroka I. Attentional Dissociation in Hypnosis And Neural Connectivity: Preliminary Evidence from Bilateral Electrodermal Activity. Int J Clin Exp Hypn 2016; 64:331-49. [PMID: 27267677 DOI: 10.1080/00207144.2016.1171096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
According to recent findings, interhemispheric interactions and information connectivity represent crucial mechanisms used in processing information across various sensory modalities. To study these interactions, the authors measured bilateral electrodermal activity (EDA) in 33 psychiatric outpatients. The results show that, during congruent Stroop stimuli in hypnosis, the patients with higher hypnotizability manifest a decreased level of interhemispheric information transfer measured by pointwise transinformation (PTI) that was calculated from left and right EDA records. These results show that specific shifts of attentional focus during hypnosis are related to changes of interhemispheric interactions that may be reflected in neural connectivity calculated from the bilateral EDA measurement. This attentional shift may cause dissociated attentional control disturbing integrative functions of consciousness and contextual experiences.
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Affiliation(s)
- Petr Bob
- a Charles University , Prague , Czech Republic
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Anderson HP, Seth AK, Dienes Z, Ward J. Can grapheme-color synesthesia be induced by hypnosis? Front Hum Neurosci 2014; 8:220. [PMID: 24829555 PMCID: PMC4009433 DOI: 10.3389/fnhum.2014.00220] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 03/28/2014] [Indexed: 12/30/2022] Open
Abstract
Grapheme-color synesthesia is a perceptual experience where graphemes, letters or words evoke a specific color, which are experienced either as spatially coincident with the grapheme inducer (projector sub-type) or elsewhere, perhaps without a definite spatial location (associator sub-type). Here, we address the question of whether synesthesia can be rapidly produced using a hypnotic color suggestion to examine the possibility of "hypnotic synesthesia", i.e., subjectively experienced color hallucinations similar to those experienced by projector synesthetes. We assess the efficacy of this intervention using an "embedded figures" test, in which participants are required to detect a shape (e.g., a square) composed of local graphemic elements. For grapheme-color synesthetes, better performance on the task has been linked to a higher proportion of graphemes perceived as colored. We found no performance benefits on this test when using a hypnotic suggestion, as compared to a no-suggestion control condition. The same result was found when participants were separated according to the degree to which they were susceptible to the suggestion (number of colored trials perceived). However, we found a relationship between accuracy and subjective reports of color in those participants who reported a large proportion of colored trials: trials in which the embedded figure was accurately recognized (relative to trials in which it was not) were associated with reports of more intense colors occupying a greater spatial extent. Collectively, this implies that hypnotic color was only perceived after shape detection rather than aiding in shape detection via color-based perceptual grouping. The results suggest that hypnotically induced colors are not directly comparable to synesthetic ones.
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Affiliation(s)
- Hazel P Anderson
- School of Psychology, University of Sussex Brighton, UK ; Sackler Centre for Consciousness Science, University of Sussex Brighton, UK
| | - Anil K Seth
- School of Psychology, University of Sussex Brighton, UK ; School of Engineering and Informatics, University of Sussex Brighton, UK
| | - Zoltan Dienes
- School of Psychology, University of Sussex Brighton, UK ; Sackler Centre for Consciousness Science, University of Sussex Brighton, UK
| | - Jamie Ward
- School of Psychology, University of Sussex Brighton, UK ; Sackler Centre for Consciousness Science, University of Sussex Brighton, UK
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Guidetti G. The role of cognitive processes in vestibular disorders. HEARING, BALANCE AND COMMUNICATION 2013. [DOI: 10.3109/21695717.2013.765085] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Dienes Z, Brown E, Hutton S, Kirsch I, Mazzoni G, Wright DB. Hypnotic suggestibility, cognitive inhibition, and dissociation. Conscious Cogn 2009; 18:837-47. [DOI: 10.1016/j.concog.2009.07.009] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2009] [Revised: 07/20/2009] [Accepted: 07/24/2009] [Indexed: 11/17/2022]
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Carli G, Manzoni D, Santarcangelo EL. Hypnotizability-related integration of perception and action. Cogn Neuropsychol 2009; 25:1065-76. [PMID: 18608323 DOI: 10.1080/02643290801913712] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Hypnotizability is a cognitive trait able to modulate many behavioural/physiological processes and associated with peculiar functional characteristics of the frontal executive system. This review summarizes experimental results on hypnotizability-related differences in sensorimotor integration at a reflex and an integrated level (postural control) and suggests possible interpretations based on morpho-functional considerations. In particular, hypnotizability-related differences in spinal motoneurones excitability are described, and the role of attention and imagery in maintaining a stable upright stance when sensory information is reduced or altered and when attention is absorbed in cognitive tasks is discussed as a function of hypnotic susceptibility. The projections from prefrontal cortex to spinal motoneurones and the balance between the activation of the right and left cortical hemisphere are considered responsible for the hypnotizability-related modulation of reflex responses, while the differences in postural control between subjects with high (highs) and low (lows) hypnotic susceptibility are considered a possible consequence of the activity of the locus coeruleus, which is also involved in attention, and of the cerebellum, which might be responsible for different internal models of postural control. We suggest a highly pervasive role of hypnotic susceptibility in human behaviour through the modulation of the integration of perception and action, which could be relevant for neurorehabilitative treatments and for the adaptation to special environments.
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Modulation of the postural effects of cognitive load by hypnotizability. Exp Brain Res 2009; 194:323-8. [PMID: 19252902 DOI: 10.1007/s00221-009-1740-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2008] [Accepted: 02/10/2009] [Indexed: 10/21/2022]
Abstract
Aim of the experiment was to study whether cognitive load affects postural control more in low (Lows) than in highly hypnotizable (Highs) subjects due to the latter's greater attentional abilities. Standing Highs and Lows underwent an experimental session (closed eyes) consisting of a basal condition and of mental computation in an easy (stable support) and a difficult (unstable support) postural condition. Variability [standard deviation (SD)] and complexity [sample entropy (SampEn)] of the movement of the centre of pressure (CoP), its mean velocity (Velocity), the area swept by the CoP (Area) and the ratio between the CoP trajectory length and area [length for surface (LFS)] were measured. Few hypnotizability-related differences were detected (reduction in the Highs' SD and increases in the Lows' LFS in the difficult postural condition). Thus, the hypnotizability-related postural differences observed in previous studies during sensory alteration could not be accounted mainly by attentional abilities.
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Santarcangelo EL, Scattina E, Carli G, Macerata A, Manzoni D. Hypnotizability-dependent modulation of postural control: effects of alteration of the visual and leg proprioceptive inputs. Exp Brain Res 2008; 191:331-40. [PMID: 18709367 DOI: 10.1007/s00221-008-1526-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2008] [Accepted: 07/28/2008] [Indexed: 11/26/2022]
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Egner T, Jamieson G, Gruzelier J. Hypnosis decouples cognitive control from conflict monitoring processes of the frontal lobe. Neuroimage 2005; 27:969-78. [PMID: 15964211 DOI: 10.1016/j.neuroimage.2005.05.002] [Citation(s) in RCA: 153] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2005] [Revised: 05/02/2005] [Accepted: 05/03/2005] [Indexed: 11/30/2022] Open
Abstract
Hypnosis can profoundly alter sensory awareness and cognitive processing. While the cognitive and behavioral phenomena associated with hypnosis have long been thought to relate to attentional processes, the neural mechanisms underlying susceptibility to hypnotic induction and the hypnotic condition are poorly understood. Here, we tested the proposal that highly hypnotizable individuals are particularly adept at focusing attention at baseline, but that their attentional control is compromised following hypnosis due to a decoupling between conflict monitoring and cognitive control processes of the frontal lobe. Employing event-related fMRI and EEG coherence measures, we compared conflict-related neural activity in the anterior cingulate cortex (ACC) and control-related activity in the lateral frontal cortex (LFC) during Stroop task performance between participants of low and high hypnotic susceptibility, at baseline and after hypnotic induction. The fMRI data revealed that conflict-related ACC activity interacted with hypnosis and hypnotic susceptibility, in that highly susceptible participants displayed increased conflict-related neural activity in the hypnosis condition compared to baseline, as well as with respect to subjects with low susceptibility. Cognitive-control-related LFC activity, on the other hand, did not differ between groups and conditions. These data were complemented by a decrease in functional connectivity (EEG gamma band coherence) between frontal midline and left lateral scalp sites in highly susceptible subjects after hypnosis. These results suggest that individual differences in hypnotic susceptibility are linked with the efficiency of the frontal attention system, and that the hypnotized condition is characterized by a functional dissociation of conflict monitoring and cognitive control processes.
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Affiliation(s)
- Tobias Egner
- Functional MRI Research Center, Columbia University, Neurological Institute Box 108, 710 West 168th Street, New York, NY 10032, USA.
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