Mean hemispheric blood perfusion during autogenic training and hypnosis

Cerebral blood flow evaluation during the hypnotic state with transcranial Doppler sonography

Cerebral blood flow was measured in normal waking (alert relaxed mental imagery) and hypnotic states. Mean flow velocity (Vm) in the middle cerebral artery (MCA) was significantly increased in hypnosis (Condition II) from Condition I (5 minutes before hypnotic induction). Vm decreased in Condition III (hypnotic imagination). After hypnosis, Vm values returned to baseline. Pulsatility index values and resistive index values showed significant variations during sonographic monitoring between Conditions I and IV (5 minutes after the completion of hypnosis). Both values were significantly higher in Condition I than IV. These findings show that hypnotic status can modulate cerebral blood flow.

Neurocognition under hypnosis: findings from recent functional neuroimaging studies

Functional neuroimaging studies show that hypnosis affects attention by modulating anterior cingulate cortex activation and uncoupling conflict monitoring and cognitive control function. Considering functional changes in the activation of the occipital and temporal cortices, precuneus, and other extrastriate visual areas, which account for hypnosis-induced altered reality perception, the role of mental imagery areas appears to be central under hypnosis. This is further stressed by the fact that motor commands are processed differently in the normal conscious state, deviating toward the precuneus and extrastriate visual areas. Functional neuroimaging also shows that posthypnotic suggestions alter cognitive processes. Further research should investigate the effects of hypnosis on other executive functions and personality measures.

Autogenic training for tension type headaches: A systematic review of controlled trials

OBJECTIVE

To determine from the published evidence whether autogenic training as sole therapy is effective for prevention of tension-type headaches in adults.

METHOD

Systematic review of controlled trials. Literature searches were performed in January 2005 in six major databases, specifically Medline, EMBASE, AMED, CENTRAL, PsychInfo and CINAHL and information was extracted and evaluated in a pre-defined manner.

RESULTS

Seven controlled clinical trials were included in the review. The methodological quality of these studies was low. Patient samples were generally representative of the more severely affected cases. None of the studies show autogenic training to be convincingly superior to other interventions care. Some trials suggested that the effect of autogenic training is no different from hypnosis and inferior to biofeedback.

CONCLUSION

There is no consistent evidence to suggest that autogenic training is superior to other interventions for prevention of tension headaches, or different from other forms of relaxation. Further studies should investigate the use of standard autogenic training in patients with moderate headache.

Motor and sensory dissociative phenomena associated with induced catalepsy: A brief communication

The purpose of this study was to investigate dissociative symptoms that may occur as an epiphenomenon of tactile-induced catalepsy. In 15 participants, catalepsy was induced in the right arm, and dissociative symptoms were evaluated using a self-report questionnaire. In comparison with the left, noncataleptic arm, the right cataleptic arm was perceived differently. In addition to increased rigidity, the cataleptic arm was characterized by the presence of paresthesias, a decreased perception of sense and a decreased awareness of the arm. Moreover, the self-reported changes in perception were significantly correlated to the hypnotically induced arm-immobilization part of the Stanford Hypnotic Susceptibility Scale. In conclusion, catalepsy induction elicits a variety of dissociative symptoms and provides a useful research paradigm for the study of motor-perceptual dissociative phenomena.

[Laparoscopy under local anaesthesia and hypnoanaesthesia about 35 cholecystectomies and 15 inguinal hernia repair]

OBJECTIVE

To present hypnosedation and the feasibility of this technique performed for laparoscopic procedure.

STUDY DESIGN

Retrospective and descriptive study of feasibility.

PATIENTS AND METHODS

Hypnosis can significantly reduce intraoperative requirements of intravenous sedation for surgery under local anaesthesia. Modifications of surgical procedure: laparoscopic surgery under local anaesthesia and hypnosis is performed using a subcutaneous lifting of anterior abdominal wall. Insufflation is only use to push out smoke. If patient or surgical uncomfort happens, moral contract with patient includes convert to general anaesthesia.

RESULTS

We performed 35 cholecystectomies; 13 needed convert to general anaesthesia, mainly for peritoneal pain induced by CO(2) insufflation; 22 procedures were completed with patients' satisfaction. Upon 15-hernia repairs, only one patient needed convert to general anaesthesia, for dissection difficulty.

CONCLUSION

Probably hypnosis can't be extent to intraperitoneal laparoscopic procedures. On the other hand interest of hypnosis performed for extraperitoneal laparoscopic hernia repair must be explore.

Functional neuroanatomy of hypnotic state

BACKGROUND

The aim of the present study was to describe the distribution of regional cerebral blood flow during the hypnotic state (HS) in humans, using positron-emission tomography (PET) and statistical parametric mapping.

METHODS

The hypnotic state relied on revivification of pleasant autobiographical memories and was compared to imaging autobiographical material in "normal alertness." A group of 9 subjects under polygraphic monitoring received six H215O infusions and was scanned in the following order: alert-HS-HS-HS with color hallucination-HS with color hallucination-alert. PET data were analyzed using statistical parametric mapping (SPM95).

RESULTS

The group analysis showed that hypnotic state is related to the activation of a widespread, mainly left-sided, set of cortical areas involving occipital, parietal, precentral, premotor, and ventrolateral prefrontal cortices and a few right-sided regions: occipital and anterior cingulate cortices.

CONCLUSIONS

The pattern of activation during hypnotic state differs from those induced in normal subjects by the simple evocation of autobiographical memories. It shares many similarities with mental imagery, from which it differs by the relative deactivation of precuneus.