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Malloggi E, Santarcangelo EL. Physiological Correlates of Hypnotizability: Hypnotic Behaviour and Prognostic Role in Medicine. Brain Sci 2023; 13:1632. [PMID: 38137080 PMCID: PMC10742099 DOI: 10.3390/brainsci13121632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
Studies in the field of experimental hypnosis highlighted the role of hypnotizability in the physiological variability of the general population. It is associated, in fact, with a few differences which are observable in the ordinary state of consciousness and in the absence of suggestions. The aim of the present scoping review is summarizing them and indicate their relevance to the neural mechanisms of hypnosis and to the prognosis and treatment of a few medical conditions. Individuals with high, medium and low hypnotizability scores display different cerebral functional differences-i.e., functional equivalence between imagery and perception/action, excitability of the motor cortex, interoceptive accuracy-possibly related to brain structural and functional characteristics, and different control of blood supply at peripheral and cerebral level, likely due to different availability of endothelial nitric oxide. These differences are reviewed to support the idea of their participation in hypnotic behaviour and to indicate their prognostic and therapeutic usefulness in a few medical conditions.
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Affiliation(s)
- Eleonora Malloggi
- Department Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56127 Pisa, Italy;
- Department of Physics, University of Trento, 38122 Trento, Italy
| | - Enrica L. Santarcangelo
- Department Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56127 Pisa, Italy;
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2
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Zelič Ž, Sebastiani L, Santarcangelo EL. Association of Hypnotizability, Interoception, and Emotion. Int J Clin Exp Hypn 2023:1-13. [PMID: 37363858 DOI: 10.1080/00207144.2023.2226188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 06/28/2023]
Abstract
The present scoping review reports the reciprocal relations between hypnotizability, interoception, and emotion. Brain morpho-functional differences may account for the lower interoceptive accuracy, higher interoceptive sensitivity, and different emotional strategies observed in highly hypnotizable participants with respect to medium-to-low hypnotizables. Since interoception is relevant to both physical and mental health and hypnotizability can predict both interoceptive abilities and the efficacy of interoception-based mental training, this allows for the development of new forms of treatment and rehabilitation.
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Affiliation(s)
- Žan Zelič
- Department of Translational Medicine and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - Laura Sebastiani
- Department of Translational Medicine and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - Enrica Laura Santarcangelo
- Department of Translational Medicine and New Technologies in Medicine and Surgery, University of Pisa, Italy
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3
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Does Hypnotizability Affect Neurovascular Coupling During Cognitive Tasks? Physiol Behav 2022; 257:113915. [PMID: 35843420 DOI: 10.1016/j.physbeh.2022.113915] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 11/22/2022]
Abstract
The susceptibility to hypnosis is a very pervasive psychophysiological trait characterized by different attentional abilities, information processing, and cardiovascular control. Since near infrared spectroscopy (NIRS) is a good index of neurovascular coupling, we used it during mental computation (MC) and trail making task (TMT) in 13 healthy low-to-medium (med-lows) and 10 healthy medium-to-high hypnotizable (med-highs) participants classified according to the Stanford Hypnotic Susceptibility Scale (SHSS), form A, and characterized for the level of proneness to be deeply absorbed in cognitive tasks by the Tellegen Absorption Scale (TAS). Med-highs reported greater absorption than med-lows. The tissue hemoglobin index (THI) and the tissue oxygenation index (TOI) increased across the tasks only in med-highs who displayed also different time courses of THI and TOI during MC and TMT, which indicates different tasks processing despite the two groups' similar performance. The findings suggest that the med-highs' tissue oxygenation is more finely adjusted to metabolic demands than med-lows'.
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Cerebral Blood Flow in Healthy Subjects with Different Hypnotizability Scores. Brain Sci 2022; 12:brainsci12050558. [PMID: 35624945 PMCID: PMC9138886 DOI: 10.3390/brainsci12050558] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/11/2022] [Accepted: 04/26/2022] [Indexed: 12/19/2022] Open
Abstract
Hypnotizability is a cognitive trait associated with differences in the brachial artery flow-mediated dilatation of individuals with high hypnotizability (highs) and low hypnotizability scores (lows). The study investigated possible hypnotizability-related cerebrovascular differences. Among 24 healthy volunteers, the Stanford Hypnotic Susceptibility Scale Form A identified 13 medium-to-lows (med-lows), 11 medium-to-highs (med-highs), and 1 medium hypnotizable. Hypnotizability did not influence the significant changes produced by the trail making task (TMT), mental arithmetic task (MAT), hyperventilation (HVT), and rebreathing (RBT) on heart rate (HR), arterial blood pressure (ABP), and partial pressure of end-tidal CO2 (PETCO2), but moderated the correlations between the changes occurring during tasks with respect to basal conditions (Δ) in ABP and PETCO2 with middle cerebral artery flow velocity (MCAv). In HVT, med-lows exhibited a significant correlation between ΔMCAv and ΔPETCO2, and med-highs showed a significant correlation between ΔABP and ΔMCAv. Cerebrovascular reactivity (CVR) and conductance (ΔCVCi) were significantly correlated with ΔMCAv only in med-lows during HVT and RBT. For the first time, cerebrovascular reactivity related to hypnotizability was investigated, evidencing different correlations among hemodynamic variables in med-highs and med-lows.
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Biscuola E, Bongini M, Belcari I, Santarcangelo EL, Sebastiani L. Well-Being in Highly Hypnotizable Persons. Int J Clin Exp Hypn 2022; 70:123-135. [PMID: 35344452 DOI: 10.1080/00207144.2022.2049972] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Both hypnotizability and well-being are relevant to health. This study aimed to investigate whether high hypnotizability was positively associated with well-being and whether the latter was related to the activity of the behavioral inhibition/approach system (BIS/BAS). ANOVA revealed significantly higher scores on the General Well-Being Index (PGWBI) in highly hypnotizable (highs, n = 31) compared with low hypnotizable participants (lows, n = 53), with medium hypnotizable participants (mediums, n = 41) exhibiting intermediate values. This finding was discussed in relation to other hypnotizability-related traits, such as morpho-functional brain characteristics, equivalence between imagery and perception, and interoceptive sensitivity. A secondary finding was a nonsignificant gender difference in scores on the PGWBI. The highs' higher well-being could be considered a favorable prognostic factor for physical and mental health.
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Affiliation(s)
- Edith Biscuola
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - Marianna Bongini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - Iacopo Belcari
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - Enrica L Santarcangelo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - Laura Sebastiani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
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6
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Heartbeat-Evoked Cortical Potential during Sleep and Interoceptive Sensitivity: A Matter of Hypnotizability. Brain Sci 2021; 11:brainsci11081089. [PMID: 34439708 PMCID: PMC8391801 DOI: 10.3390/brainsci11081089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/28/2021] [Accepted: 07/28/2021] [Indexed: 12/30/2022] Open
Abstract
Individuals with different hypnotizability display different interoceptive sensitivity/awareness (IS) and accuracy (IA), likely sustained by morphofunctional differences in interoception-related brain regions and, thus, possibly also observable during sleep. We investigated the heartbeat-evoked cortical potential amplitude (HEP) during sleep, its association with IS, and the role of hypnotizability in such association. We performed a retrospective analysis of polysomnographic recordings of 39 healthy volunteers. Participants completed the Multidimensional Assessment of Interoceptive Awareness (MAIA), measuring IS and IA, and underwent hypnotic assessment via the Stanford Hypnotic Susceptibility Scale, form A. The amplitude of the early and late HEP components was computed at EEG frontal and central sites. In both regions, the early HEP component was larger in N3 than in N2 and REM, with no difference between N2 and REM. Greater HEP amplitude at frontal than at central sites was found for the late HEP component. HEP amplitudes were not influenced by the autonomic state assessed by heart rate variability in the frequency and time domains. We report for the first time a positive correlation between the central late HEP component and MAIA dimensions, which became non-significant after removing the effects of hypnotizability. Our findings indicate that hypnotizability sustains the correlation between IS and HEP amplitude during sleep.
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Santarcangelo EL, Carli G. Individual Traits and Pain Treatment: The Case of Hypnotizability. Front Neurosci 2021; 15:683045. [PMID: 34149351 PMCID: PMC8206467 DOI: 10.3389/fnins.2021.683045] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/05/2021] [Indexed: 12/11/2022] Open
Affiliation(s)
- Enrica Laura Santarcangelo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giancarlo Carli
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
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Santarcangelo EL, Carli G, Sebastiani L. An evolutionary approach to hypnotizability. THE AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2021; 63:294-301. [PMID: 33999772 DOI: 10.1080/00029157.2020.1860893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We propose here an evolutionary interpretation of the presence of highly hypnotizable persons (highs) among the general population. Current experimental evidence suggests the presence of stronger functional equivalence between imagery and perception, non-opioid cognitive control of pain, favorable cardiovascular asset, and greater interoceptive sensitivity in highs. We hypothesize that these characteristics were greatly relevant to our ancestors' survival, and that they may have facilitated the natural selection of individuals who are now named "highs" due to one of their side effects - the proneness to accept suggestions - as part of the reported physiological features. Unfortunately, our theoretical hypothesis cannot be currently experimentally proven. We believe, however, that looking at hypnotizability in a naturalistic, evolutionary perspective may emphasize the importance of its physiological correlates in daily life and in the prediction of the outcome of medical treatments.
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Wang A, Gao Y, Wang J, Tong TK, Sun Y, Yu S, Zhao H, Zou D, Zhang Z, Qi Y, Zuo N, Bu D, Zhang D, Xie Y, Baker JS. Effects of a School-Based Physical Activity Intervention for Obesity and Health-Related Physical Fitness in Adolescents With Intellectual Disability: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e25838. [PMID: 33749611 PMCID: PMC8088867 DOI: 10.2196/25838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/12/2021] [Accepted: 02/16/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Childhood obesity accompanied by lower levels of health-related physical fitness (HRPF) is a major threat to public health both internationally and locally. Children with intellectual disability, especially adolescents, have a higher risk of being overweight/obese and having poor HRPF levels. Therefore, more interventions are needed to help this population attain their optimal health levels. However, there has been relatively limited research on this population compared with on their typically developing peers. OBJECTIVE The proposed study aims to fill this knowledge gap by developing and examining the success of a physical activity (PA) intervention for the target population. METHODS The proposed study will be a 12-week, school-based randomized controlled trial. The participants (N=48) will be recruited from special schools for students with mild intellectual disability and then randomly allocated to either the intervention group (IG) or the wait-list control group (CG). During the intervention period, the participants in the IG will receive a fun game-based moderate-to-vigorous PA (MVPA) training program (2 sessions/week, 60 minutes/session, for a total of 24 sessions). The intensity of the activities will increase in a progressive manner. Participants in the CG will receive no program during the study period, but the same PA program will be provided to them after the completion of the study. To observe and evaluate the sustaining effects of the intervention, follow-up testing will be scheduled for the participants 12 weeks after the intervention concludes. The study outcomes will include primary outcomes (obesity- and fitness-related outcomes) and a secondary outcome (blood pressure). All of the measurements will be taken at 3 time points. After the follow-up tests, the same PA training program will be provided to the participants in the CG. RESULTS This study is ongoing. The participants were recruited from October 2020 to November 2020. The total duration of the study is 13 months. Study results are expected at the end of 2021. CONCLUSIONS The proposed study is expected to reduce obesity and improve HRPF levels in children with intellectual disability. If proven effective, the intervention will be made accessible to more special schools and mainstream schools with students with intellectual disability. Furthermore, the study can serve as an example for international researchers, policy makers, and members of the public who are seeking to tackle the problem of obesity and poor HRPF among children with intellectual disability. TRIAL REGISTRATION ClinicalTrials.gov NCT04554355; https://www.clinicaltrials.gov/ct2/show/NCT04554355. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/25838.
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Affiliation(s)
- Aiwei Wang
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Yang Gao
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China.,Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China
| | - Jingjing Wang
- Mass Sports Research Center, Institute of Sport Science, Beijing, China
| | - Tomas K Tong
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Yan Sun
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Siyue Yu
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Hong Zhao
- Qianjiang Special Education School, Qianjiang, China
| | - Daozhi Zou
- Qianjiang Special Education School, Qianjiang, China
| | - Ziheng Zhang
- Zhijiang Special Education School, Zhijiang, China
| | - Yuling Qi
- Dangyang Special Education School, Dangyang, China
| | - Nan Zuo
- Yingshan Special Education School, Yingshan, China
| | - Danran Bu
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China.,HuBei Institute of Sport Science, Wuhan, China
| | - Dexing Zhang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yaojie Xie
- School of Nursing, Faculty of Health and Social Science, The Hong Kong Polytechnic University, Hong Kong, China
| | - Julien S Baker
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China.,Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China
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10
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Zarei SP, Briscese L, Capitani S, Rossi B, Carboncini MC, Santarcangelo EL, Motie Nasrabadi A. Hypnotizability-Related Effects of Pain Expectation on the Later Modulation of Cortical Connectivity. Int J Clin Exp Hypn 2020; 68:306-326. [PMID: 32510271 DOI: 10.1080/00207144.2020.1762196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study examined hypnotizability-related modulation of the cortical network following expected and nonexpected nociceptive stimulation. The electroencephalogram (EEG) was recorded in 9 high (highs) and 8 low (lows) hypnotizable participants receiving nociceptive stimulation with (W1) and without (noW) a visual warning preceding the stimulation by 1 second. W1 and noW were compared to baseline conditions to assess the presence of any later effect and between each other to assess the effects of expectation. The studied EEG variables measured local and global features of the cortical connectivity. With respect to lows, highs exhibited scarce differences between experimental conditions. The hypnotizability-related differences in the later processing of nociceptive information could be relevant to the development of pain-related individual traits. Present findings suggest a lower impact of nociceptive stimulation in highs than in lows.
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Affiliation(s)
| | - Lucia Briscese
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa , Italy
| | - Simone Capitani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa , Italy
| | - Bruno Rossi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa , Italy
| | - Maria C Carboncini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa , Italy
| | - Enrica L Santarcangelo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa , Italy
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11
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Diolaiuti F, Fantozzi MPT, Di Galante M, D'Ascanio P, Faraguna U, Sebastiani L, Santarcangelo EL. Association of hypnotizability and deep sleep: any role for interoceptive sensibility? Exp Brain Res 2020; 238:1937-1943. [PMID: 32561965 DOI: 10.1007/s00221-020-05853-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 06/11/2020] [Indexed: 12/21/2022]
Abstract
The aim of the study was to investigate the possible association of hypnotizability and deep sleep (N3) duration, and whether the interoceptive sensibility influences this association. This was motivated by the proneness of highly hypnotizable individuals to easily change their psychophysiological state, i.e., from wakefulness to hypnosis and sleep, and by the positive association observed between hypnotizability and interoceptive sensibility. Forty-seven healthy participants previously enrolled in a polysomnographic night sleep study completed the questionnaire for Multidimensional Assessment of Interoceptive Awareness (MAIA) and underwent hypnotic assessment through the Stanford Hypnotic Susceptibility Scale, form A (SHSS,A). Results showed that N3 duration is not linearly correlated with hypnotizability. Controlling for a few MAIA scales did not modify the relation between hypnotizability and deep sleep. A polynomial relation indicates that N3 duration and N3 percentage of the total sleep time increase with hypnotizability in the low-to-medium range of hypnotizability and decrease in the medium-to-high range. In conclusion, hypnotic assessment predicts N3 duration and their association is not modified by interoceptive awareness/sensitivity.
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Affiliation(s)
- Francesca Diolaiuti
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno, 31, 56127, Pisa, Italy
| | - Maria Paola Tramonti Fantozzi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno, 31, 56127, Pisa, Italy
| | - Marco Di Galante
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno, 31, 56127, Pisa, Italy
| | - Paola D'Ascanio
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno, 31, 56127, Pisa, Italy
| | - Ugo Faraguna
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno, 31, 56127, Pisa, Italy.,Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Laura Sebastiani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno, 31, 56127, Pisa, Italy.
| | - Enrica L Santarcangelo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno, 31, 56127, Pisa, Italy
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12
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Spina V, Chisari C, Santarcangelo EL. High Motor Cortex Excitability in Highly Hypnotizable Individuals: A Favourable Factor for Neuroplasticity? Neuroscience 2020; 430:125-130. [PMID: 32036016 DOI: 10.1016/j.neuroscience.2020.01.042] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 01/28/2020] [Accepted: 01/29/2020] [Indexed: 12/17/2022]
Abstract
Hypnotizability is a psychophysiological trait associated with morphofunctional brain peculiarities and with several cognitive, sensorimotor and cardiovascular correlates. Behavioral and EEG studies indicate stronger functional equivalence (FE) between motor imagery and action in the individuals with high hypnotizability scores (Highs). We hypothesized that stronger FE leading to greater proneness to ideomotor behavior could be due to greater cortical excitability of the motor cortex. The aim of the study was to evaluate the motor cortical excitability through measurements of the muscle potentials (MEPs) evoked in the left abductor pollicis brevis by transcranial magnetic stimulation (TMS) of the right motor cortex in 10 Highs, 10 medium (Mediums) and 10 low hypnotizable individuals (Lows) classified according to the Stanford Hypnotic Susceptibility Scale, form A (SHSS). They were studied in basal conditions (B) and during motor imagery (MI). Results showed significant, negative correlations (i) between hypnotizability and MEPs Resting Motor Threshold (RMT) in basal conditions, and (ii) between hypnotizability and both MEPs RMT and suprathreshold (I1mv) stimulation intensities during MI. ANOVA revealed significantly lower stimulation intensities in Highs than in Lows, with Mediums exhibiting intermediate values. Thus, the Highs' greater cortical excitability could sustain their greater FE and proneness to ideomotor behavior. In cognitive neuroscience these findings are relevant to the physiological interpretation of the response to sensorimotor suggestions by participants in the ordinary state of consciousness. In the clinical field they can predict the efficacy of mental training based on motor imagery and, possibly, the degree of imagery-induced cortical plasticity.
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Affiliation(s)
- Vincenzo Spina
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Carmelo Chisari
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Enrica L Santarcangelo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
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13
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Santarcangelo EL, Scattina E. RESPONDING TO SENSORIMOTOR SUGGESTIONS: From Endothelial Nitric Oxide to the Functional Equivalence Between Imagery and Perception. Int J Clin Exp Hypn 2019; 67:394-407. [PMID: 31526264 DOI: 10.1080/00207144.2019.1649539] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The reduced cerebellar gray matter (GM) volume observed in highly hypnotizable individuals (highs) is likely due to the excessive release of endothelial nitric oxide in the brain and could account for their behavioral (postural and visuomotor control) and physiological (paradoxical pain control after cerebellar anodal stimulation) characteristics. Reduced cerebellar GM can induce low inhibition of the cerebral cortex, thus stronger functional equivalence (FE) between imagery and perception and greater proneness to respond to sensorimotor suggestions. In fact, stronger FE suggested in highs by behavioral studies has been confirmed by topological data analysis of EEG signals recorded during sensorimotor and imagery tasks. The authors' hypothesis cannot be applied to obstructive suggestions likely sustained by mechanisms related to socio-cognitive factors, i.e., oxytocin availability.
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Affiliation(s)
- Enrica L Santarcangelo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa , Italy
| | - Eliana Scattina
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa , Italy
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14
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D'Urzo KA, La Rocque CL, Williams JS, Stuckless TJR, King TJ, Plotnick MD, Gurd BJ, Harkness KL, Pyke KE. The impact of acute mental stress on brachial artery flow-mediated dilation in women diagnosed with depression. Int J Psychophysiol 2019; 135:113-120. [PMID: 30529360 DOI: 10.1016/j.ijpsycho.2018.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 11/26/2018] [Accepted: 12/03/2018] [Indexed: 02/05/2023]
Abstract
Endothelial function, assessed by flow-mediated dilation (FMD), may be transiently attenuated in healthy adults following acute mental stress. However, the impact of acute mental stress on endothelial function in the context of clinical depression is unknown. This study examined the impact of acute mental stress on FMD in women with a diagnosis of a depressive disorder. Forty-three otherwise healthy women (33 ± 14 years) participated. Brachial artery diameter and blood velocity were assessed with ultrasound. FMD was assessed immediately prior to and 15 min following the Trier Social Stress Test (TSST). The FMD protocol included 5 min of forearm cuff occlusion (pressure = 250 mm Hg), followed by release. Shear stress was estimated by calculating shear rate (SR = brachial artery blood velocity/diameter). Stress reactivity was assessed via changes in mean arterial pressure (MAP), heart rate (HR) and salivary cortisol. Results are mean ± SD. A significant stress response was elicited by the TSST [MAP, HR and salivary cortisol increased (p < 0.05)]. Neither the SR stimulus nor FMD response differed pre-versus post-stress (p = 0.124 and p = 0.641, respectively). There was a modest negative correlation between cortisol reactivity and change in FMD from pre- to post-stress (R = -0.392, p = 0.011). To conclude, acute mental stress did not consistently impair endothelial function in women diagnosed with a depressive disorder; however, higher cortisol reactivity may increase the likelihood of post-stress endothelial dysfunction. Further research is required to better understand the factors influencing the relationship between acute mental stress, cortisol and endothelial function in women with depression.
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Affiliation(s)
- Katrina A D'Urzo
- School of Kinesiology and Health Studies, 28 Division Street, Queen's University, Kingston K7L 3N6, Ontario, Canada
| | - Cherie L La Rocque
- Department of Psychology, 62 Arch Street, Queen's University, Kingston K7L 3N6, Ontario, Canada
| | - Jennifer S Williams
- School of Kinesiology and Health Studies, 28 Division Street, Queen's University, Kingston K7L 3N6, Ontario, Canada
| | - Troy J R Stuckless
- School of Kinesiology and Health Studies, 28 Division Street, Queen's University, Kingston K7L 3N6, Ontario, Canada
| | - Trevor J King
- School of Kinesiology and Health Studies, 28 Division Street, Queen's University, Kingston K7L 3N6, Ontario, Canada
| | - Meghan D Plotnick
- School of Kinesiology and Health Studies, 28 Division Street, Queen's University, Kingston K7L 3N6, Ontario, Canada
| | - Brendon J Gurd
- School of Kinesiology and Health Studies, 28 Division Street, Queen's University, Kingston K7L 3N6, Ontario, Canada
| | - Kate L Harkness
- Department of Psychology, 62 Arch Street, Queen's University, Kingston K7L 3N6, Ontario, Canada
| | - Kyra E Pyke
- School of Kinesiology and Health Studies, 28 Division Street, Queen's University, Kingston K7L 3N6, Ontario, Canada.
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15
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Varanini M, Balocchi R, Carli G, Paoletti G, Santarcangelo EL. HYPNOTIZABILITY AND PAIN MODULATION: A Body-Mind Perspective. Int J Clin Exp Hypn 2018; 66:265-281. [PMID: 29856285 DOI: 10.1080/00207144.2018.1460561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The study investigated whether the cardiac activity and cognitive-emotional traits sustained by the behavioral inhibition/activation system (BIS/BAS) may contribute to hypnotizability-related pain modulation. Nociceptive stimulation (cold-pressor test) was administered to healthy participants with high (highs) and low (lows) hypnotizability in the presence and absence of suggestions for analgesia. Results showed that heart rate increased abruptly at the beginning of nociceptive stimulation in all participants. Then, only in highs heart rate decreased for the entire duration of hand immersion. During stimulation with suggestions of analgesia, pain threshold negatively correlated with heart rate. BIS/BAS activity partially accounted for the observed hypnotizability-related differences in the relation between cardiac interoception and pain experience.
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Affiliation(s)
- Maurizio Varanini
- a Institute of Physilogy , National Council of Research , Pisa , Italy
| | - Rita Balocchi
- a Institute of Physilogy , National Council of Research , Pisa , Italy
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Santarcangelo EL, Briscese L, Capitani S, Orsini P, Varanini M, Rossi B, Carboncini MC. Blink reflex in subjects with different hypnotizability: New findings for an old debate. Physiol Behav 2016; 163:288-293. [DOI: 10.1016/j.physbeh.2016.05.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 05/11/2016] [Accepted: 05/12/2016] [Indexed: 12/26/2022]
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Menzocchi M, Mecacci G, Zeppi A, Carli G, Santarcangelo EL. Hypnotizability and Performance on a Prism Adaptation Test. THE CEREBELLUM 2016; 14:699-706. [PMID: 25913127 DOI: 10.1007/s12311-015-0671-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The susceptibility to hypnosis, which can be measured by scales, is not merely a cognitive trait. In fact, it is associated with a number of physiological correlates in the ordinary state of consciousness and in the absence of suggestions. The hypnotizability-related differences observed in sensorimotor integration suggested a major role of the cerebellum in the peculiar performance of healthy subjects with high scores of hypnotic susceptibility (highs). In order to provide behavioral evidence of this hypothesis, we submitted 20 highs and 21 low hypnotizable participants (lows) to the classical cerebellar Prism Adaptation Test (PAT). We found that the highs' performance was significantly less accurate and more variable than the lows' one, even though the two groups shared the same characteristics of adaptation to prismatic lenses. Although further studies are required to interpret these findings, they could account for earlier reports of hypnotizability-related differences in postural control and blink rate, as they indicate that hypnotizability influences the cerebellar control of sensorimotor integration.
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Affiliation(s)
- Manuel Menzocchi
- Department of Medical and Surgical Sciences and Neuroscience, University of Siena, Siena, Italy
| | - Giulio Mecacci
- Department of Medical and Surgical Sciences and Neuroscience, University of Siena, Siena, Italy
| | - Andrea Zeppi
- Department of Medical and Surgical Sciences and Neuroscience, University of Siena, Siena, Italy
| | - Giancarlo Carli
- Department of Medical and Surgical Sciences and Neuroscience, University of Siena, Siena, Italy
| | - Enrica L Santarcangelo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno 31, 56127, Pisa, Italy.
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Santarcangelo EL, Scattina E. Complementing the Latest APA Definition of Hypnosis: Sensory-Motor and Vascular Peculiarities Involved in Hypnotizability. Int J Clin Exp Hypn 2016; 64:318-30. [PMID: 27267676 DOI: 10.1080/00207144.2016.1171093] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The aim of this article is to complement the recently revised American Psychological Association (APA) definition of hypnotizability. It (a) lists a few differences in sensorimotor integration between subjects with high (highs) and low (lows) hypnotizability scores in the ordinary state of consciousness and in the absence of suggestions, (b) proposes that hypnotizability-related cerebellar peculiarities may account for them,
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Solari G, Orsini P, Santarcangelo EL. Asymmetric Tactile Foot Stimulation: How Postural Studies May Suggest New Views of Hypnotizability. Int J Clin Exp Hypn 2016; 64:305-17. [PMID: 27267675 DOI: 10.1080/00207144.2016.1171092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Earlier studies have shown hypnotizability-related postural effects of visual suppression and of leg and neck proprioceptive alteration. This study completes this investigation by demonstrating the postural effects of asymmetric tactile foot stimulation in standing participants with different hypnotizability scores. During this stimulation, body sway changed in medium-to-high more than in low-to-medium hypnotizable participants. Findings support the view that high hypnotizability is associated with higher vulnerability of posture to sensory alteration; together with earlier results, they suggest a role of the cerebellum in the observed hypnotizability-related differences and prompt investigation of cerebral structures and factors potentially responsible for both the cognitive and physiological aspects of hypnotizability.
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Madeo D, Castellani E, Mocenni C, Santarcangelo EL. Pain perception and EEG dynamics: does hypnotizability account for the efficacy of the suggestions of analgesia? Physiol Behav 2015; 145:57-63. [PMID: 25837836 DOI: 10.1016/j.physbeh.2015.03.040] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 03/26/2015] [Accepted: 03/28/2015] [Indexed: 12/19/2022]
Abstract
We report novel findings concerning the role of hypnotizability, suggestions of analgesia and the activity of the Behavioral Inhibition/Activation System (BIS/BAS) in the modulation of the subjective experience of pain and of the associated EEG dynamics. The EEG of high (highs) and low hypnotizable participants (lows) who completed the BIS/BAS questionnaire was recorded during basal conditions, tonic nociceptive stimulation without (PAIN) and with suggestions for analgesia (AN). Participants scored the perceived pain intensity at the end of PAIN and AN. The EEG midline dynamics was characterized by indices indicating the signal predictability (Determinism) and complexity (Entropy) obtained through the Recurrence Quantification Analysis. The reduced pain intensity reported by highs during AN was partially accounted for by the activity of the Behavioral Activation System. The decreased midline cortical Determinism observed during nociceptive stimulation in both groups independently of suggestions remained significantly reduced only in lows after controlling for the activity of the Behavioral Activation System. Finally, controlling for the activity of the Behavioral Inhibition System abolished stimulation, suggestions and hypnotizability-related differences. Results indicate that the BIS/BAS activity may be more important than hypnotizability itself in pain modulation and in the associated EEG dynamics.
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Affiliation(s)
- Dario Madeo
- Department of Information Engineering and Mathematical Sciences, Italy; Complex Systems Community, University of Siena, Siena, Italy
| | - Eleonora Castellani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Chiara Mocenni
- Department of Information Engineering and Mathematical Sciences, Italy; Complex Systems Community, University of Siena, Siena, Italy
| | - Enrica Laura Santarcangelo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
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Xue YT, Tan QW, Li P, Mou SF, Liu SJ, Bao Y, Jiao HC, Su WG. Investigating the role of acute mental stress on endothelial dysfunction: a systematic review and meta-analysis. Clin Res Cardiol 2014; 104:310-9. [PMID: 25391292 DOI: 10.1007/s00392-014-0782-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 10/21/2014] [Indexed: 12/16/2022]
Abstract
Chronic stress is a known risk factor for both endothelial dysfunction and cardiovascular disease (CVD), but less is known of how acute mental stress affects the vasculature. In this systematic review and meta-analysis, we analyzed the impact of acute mental stress on flow-mediated dilation (FMD), an indicator of endothelial function. We searched the Medline, Cochrane, EMBASE, and ISI Web of Knowledge databases through May 2014, to identify publications in English-language journals. The primary outcome was the change in FMD from baseline to the time of measurement. We also assessed the risk of bias and the heterogeneity of included studies. Our search identified eight prospective studies, which displayed significant heterogeneity. Four studies measured FMD while the subject was performing the task; six measured FMD after the task had been completed. The total number of participants was 164. The pooled results indicate that FMD did not change significantly while the task was being performed (pooled difference in means: -0.853; 95 % confidence interval (CI), -3.926/2.220; P = 0.586); however, FMD measured after the task was completed was significantly less than baseline (pooled difference in means: -2.450; 95 %CI, -3.925/-0.975; P = 0.001). In conclusions, our findings provide evidence that an acute stressful experience has a delayed, negative impact on the function of the endothelium. Repeated exposure to short-term stress may lead to permanent injury of the vasculature. Therefore, assessment of patients' exposure to both repeated acute mental stress and chronic stress may be useful in determining their risk of developing CVD.
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Affiliation(s)
- Yi-Tao Xue
- Department of Cardiology, Shandong University School of Medicine Affiliated Hospital of Shandong University of Traditional Chinese Medicine, 42 West Wenhua Road, Jinan, 250011, Shandong Province, China,
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Poitras VJ, Slattery DJ, Levac BM, Fergus S, Gurd BJ, Pyke KE. The combined influence of fat consumption and repeated mental stress on brachial artery flow-mediated dilatation: a preliminary study. Exp Physiol 2014; 99:715-28. [DOI: 10.1113/expphysiol.2013.077131] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Veronica J. Poitras
- School of Kinesiology and Health Studies; Queen's University; Kingston Ontario Canada
| | - David J. Slattery
- School of Kinesiology and Health Studies; Queen's University; Kingston Ontario Canada
| | - Brendan M. Levac
- School of Kinesiology and Health Studies; Queen's University; Kingston Ontario Canada
| | - Stevenson Fergus
- School of Kinesiology and Health Studies; Queen's University; Kingston Ontario Canada
| | - Brendon J. Gurd
- School of Kinesiology and Health Studies; Queen's University; Kingston Ontario Canada
| | - Kyra E. Pyke
- School of Kinesiology and Health Studies; Queen's University; Kingston Ontario Canada
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Presciuttini S, Gialluisi A, Barbuti S, Curcio M, Scatena F, Carli G, Santarcangelo EL. Hypnotizability and Catechol-O-Methyltransferase (COMT) polymorphysms in Italians. Front Hum Neurosci 2014; 7:929. [PMID: 24431998 PMCID: PMC3880894 DOI: 10.3389/fnhum.2013.00929] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Accepted: 12/20/2013] [Indexed: 11/21/2022] Open
Abstract
Higher brain dopamine content depending on lower activity of Catechol-O-Methyltransferase (COMT) in subjects with high hypnotizability scores (highs) has been considered responsible for their attentional characteristics. However, the results of the previous genetic studies on association between hypnotizability and the COMT single nucleotide polymorphism (SNP) rs4680 (Val158Met) were inconsistent. Here, we used a selective genotyping approach to re-evaluate the association between hypnotizability and COMT in the context of a two-SNP haplotype analysis, considering not only the Val158Met polymorphism, but also the closely located rs4818 SNP. An Italian sample of 53 highs, 49 low hypnotizable subjects (lows), and 57 controls, were genotyped for a segment of 805 bp of the COMT gene, including Val158Met and the closely located rs4818 SNP. Our selective genotyping approach had 97.1% power to detect the previously reported strongest association at the significance level of 5%. We found no evidence of association at the SNP, haplotype, and diplotype levels. Thus, our results challenge the dopamine-based theory of hypnosis and indirectly support recent neuropsychological and neurophysiological findings reporting the lack of any association between hypnotizability and focused attention abilities.
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Affiliation(s)
- Silvano Presciuttini
- Laboratory of Cognitive and Behavioral Neurosciences, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa Pisa, Italy
| | - Alessandro Gialluisi
- Laboratory of Cognitive and Behavioral Neurosciences, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa Pisa, Italy ; Language and Genetics Department, Max Planck Institute for Psycholinguistics Nijmegen, Netherlands
| | - Serena Barbuti
- Immunohematology Unit, Azienda Ospedaliera-Universitaria Pisana Pisa, Italy
| | - Michele Curcio
- Immunohematology Unit, Azienda Ospedaliera-Universitaria Pisana Pisa, Italy
| | - Fabrizio Scatena
- Immunohematology Unit, Azienda Ospedaliera-Universitaria Pisana Pisa, Italy
| | - Giancarlo Carli
- Laboratory of Cognitive and Behavioral Neurosciences, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa Pisa, Italy ; Department of Medicine, Surgery and Neuroscience, University of Siena Siena, Italy
| | - Enrica L Santarcangelo
- Laboratory of Cognitive and Behavioral Neurosciences, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa Pisa, Italy
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The role of motivational factors in the relationship between hypnotizability and pain-inducing imagery. Neurosci Lett 2013; 557 Pt B:181-3. [DOI: 10.1016/j.neulet.2013.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 09/06/2013] [Indexed: 01/17/2023]
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Szijgyarto IC, King TJ, Ku J, Poitras VJ, Gurd BJ, Pyke KE. The impact of acute mental stress on brachial artery flow-mediated dilation differs when shear stress is elevated by reactive hyperemia versus handgrip exercise. Appl Physiol Nutr Metab 2013; 38:498-506. [DOI: 10.1139/apnm-2012-0328] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Acute mental stress can impair brachial artery (BA) flow-mediated dilation (FMD) in response to reactive hyperemia (RH) induced increases in shear stress. Handgrip exercise (HGEX) is emerging as a useful tool to increase shear stress for FMD assessment; however, the impact of acute mental stress on HGEX-FMD is unknown. The purpose of this study was to determine whether acute mental stress attenuates RH- and HGEX-induced BA-FMD to a similar extent. In 2 counterbalanced visits, 16 healthy males (19–27 years of age) performed RH-FMD or HGEX-FMD tests after a counting control task (prestress FMD) and a speech and arithmetic stress task (poststress FMD). BA diameter and mean blood velocity were assessed with echo and Doppler ultrasound, respectively. Shear stress was estimated using shear rate (SR = BA blood velocity/BA diameter). Mean arterial pressure (MAP), heart rate (HR), and salivary cortisol were used to assess stress reactivity. Results are expressed as mean ± SE. The stress task elevated MAP (Δ24.0 ± 2.6 mm Hg) and HR (Δ15.5 ± 1.9 beats·min–1), but not cortisol (prestress vs. poststress: 4.4 ± 0.7 nmol·L–1 vs. 4.7 ± 0.7 nmol·L–1; p = 0.625). There was no difference between the pre- and poststress SR stimulus for RH (p = 0.115) or HGEX (p = 0.664). RH-FMD decreased from 5.2% ± 0.6% prestress to 4.1% ± 0.5% poststress (p = 0.071); however, stress did not attenuate HGEX-FMD (prestress vs. poststress: 4.1% ± 0.6% vs. 5.3% ± 0.6%; p = 0.154). The pre- to poststress change in FMD was significantly different in the RH-FMD vs. the HGEX-FMD test (–1.1% ± 0.6% vs. +1.1% ± 0.8%; p = 0.015). In conclusion, acute mental stress appears to have a disparate impact on FMD stimulated by RH vs. HGEX induced increases in shear stress.
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Affiliation(s)
- Ingrid C. Szijgyarto
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Trevor J. King
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Jennifer Ku
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Veronica J. Poitras
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Brendon J. Gurd
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Kyra E. Pyke
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada
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Poitras VJ, Pyke KE. The impact of acute mental stress on vascular endothelial function: evidence, mechanisms and importance. Int J Psychophysiol 2013; 88:124-35. [PMID: 23562766 DOI: 10.1016/j.ijpsycho.2013.03.019] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 03/21/2013] [Accepted: 03/26/2013] [Indexed: 01/23/2023]
Abstract
Cardiovascular disease is a principle cause of morbidity and mortality worldwide, and it has a complex etiology that involves lifestyle factors such as psychosocial stress. Recent evidence suggests that temporary impairments in vascular endothelial cell function may contribute to the relationship between stress and cardiovascular disease. Indeed, impaired endothelial function has been observed to occur transiently (lasting up to 1.5h) following mental stress, and such periods of impairment could accumulate to become clinically relevant over the long term. The finding of acute stress induced endothelial dysfunction is not universal however, and both physiological (e.g. sympathetic nervous system and hypothalamic-pituitary-adrenal axis reactivity), and methodological factors contribute to the conflicting results. A clear understanding of the interaction between stress response activation and endothelial function is critical to elucidating the complexities of the relationship between psychosocial stress and cardiovascular disease. Therefore, the purpose of this review is: 1) to briefly describe the importance of vascular endothelial function and how it is assessed, 2) to review the literature investigating the impact of acute mental stress on endothelial function in humans, identifying factors that may explain contradictory results, and 3) to summarize our current understanding of the mechanisms that may mediate an acute mental stress-endothelial function interaction.
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Affiliation(s)
- Veronica J Poitras
- Queen's University School of Kinesiology and Health Studies, 28 Division St. Kingston, Ontario, Canada
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Santarcangelo EL, Paoletti G, Balocchi R, Carli G, Morizzo C, Palombo C, Varanini M. Hypnotizability modulates the cardiovascular correlates of subjective relaxation. Int J Clin Exp Hypn 2012; 60:383-96. [PMID: 22917104 DOI: 10.1080/00207144.2012.700609] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Mean values and the spectral variability of heart rate (HRV), blood pressure, and skin blood flow were studied in high and low hypnotizable subjects during simple relaxation. Similar subjective relaxation was reported by highs and lows. A parasympathetic prevalence (indicated by a higher High-Frequency component of HRV and a lower High/Low-Frequency ratio) and lower renin-angiotensin activity (indicated by a lower Very-Low-Frequency component of HRV) could be attributed to highs with respect to lows. Hypnotizability did not affect blood pressure and its variability and modulated the skin blood flow across the session only in lows. The findings confirm that relaxation cannot be defined solely on cardiovascular parameters and also indicate that hypnotizability modulates cardiovascular activity during simple relaxation and suggest it may have a protective role against cardiovascular disease.
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Toda N, Nakanishi-Toda M. How mental stress affects endothelial function. Pflugers Arch 2011; 462:779-94. [PMID: 21947555 DOI: 10.1007/s00424-011-1022-6] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Revised: 08/22/2011] [Accepted: 08/24/2011] [Indexed: 01/23/2023]
Abstract
Mental stress is an important factor contributing to recognized mechanisms underlying cardiovascular events. Among these, stress-related endothelial dysfunction is an early risk factor that predicts future development of severe cardiovascular disorders. Acute mental stress by a variety of tests impairs endothelial function in humans, although the opposite results have been reported by some investigators. Chronic stress always deteriorates endothelial function in humans and experimental animals. Stress hormones, such as glucocorticoids and pro-inflammatory cytokines, and endothelin-1 liberated in response to mental stress participate in endothelial dysfunction possibly via downregulation of endothelial nitric oxide synthase (eNOS) expression, eNOS inactivation, decreased nitric oxide (NO) actions, and increased NO degradation, together with vasoconstriction counteracting against NO-induced vasodilatation. Catecholamines do not directly affect endothelial function but impair its function when blood pressure elevation by the amines is sustained. Endogenous opioids favorably affect endothelial function, which counteract deteriorating effects of other stress hormones and mediators. Inhibition of cortisol and endothelin-1 production, prevention of pro-inflammatory mediator accumulation, hypnotics, mirthful laughter, humor orientation, and lifestyle modification would contribute to the prevention and treatment for stress-related endothelial dysfunction and future serious cardiovascular disease.
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Affiliation(s)
- Noboru Toda
- Toyama Institute for Cardiovascular Pharmacology Research, 7-13, 1-Chome, Azuchi-machi, Chuo-ku, Osaka 541-0052, Japan.
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Santarcangelo EL, Scattina E, Carli G, Ghelarducci B, Orsini P, Manzoni D. Can imagery become reality? Exp Brain Res 2010; 206:329-35. [PMID: 20848275 DOI: 10.1007/s00221-010-2412-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Accepted: 09/02/2010] [Indexed: 10/19/2022]
Abstract
Previous studies showed that highly hypnotizable persons imagining a specific sensory context behave according to the corresponding real stimulation and perceive their behaviour as involuntary. The aim of the study was to confirm the hypothesis of a translation of sensory imagery into real perception and, thus, of a true involuntary response. We studied the imagery-induced modulation of the vestibulospinal (VS) reflex earlier component in highly (Highs) and low hypnotizable subjects (Lows), as it is not affected by voluntary control, its amplitude depends on the stimulus intensity, and the plane of body sway depends on the position of the head with respect to the trunk. Results showed that the effects of the "obstructive" imagery of anaesthesia are different from those elicited by the "constructive" imagery of head rotation. Indeed, both Highs and Lows having their face forward and reporting high vividness of imagery experienced anaesthesia and reduced their VS reflex amplitude in the frontal plane, while only Highs changed the plane of body sway according to the imagined head rotation that is from the frontal to the sagittal one. These effects cannot be voluntary and should be attributed to translation of sensory imagery into the corresponding real perception.
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Affiliation(s)
- E L Santarcangelo
- Department of Physiological Sciences, University of Pisa, Via San Zeno 31, Pisa, Italy.
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Menzocchi M, Paoletti G, Carli G, Scattina E, Manzoni D, Santarcangelo EL. Hypnotizability-related effects of vestibular impairment on posture and locomotion. Int J Clin Exp Hypn 2010; 58:329-44. [PMID: 20509072 DOI: 10.1080/00207141003761155] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Body sway and locomotion are differentially modulated in high (highs) and low (lows) hypnotizable subjects undergoing alteration of visual and neck/leg proprioceptive inputs. The study's aim was to investigate whether partial impairment of vestibular information due to backward head extension affects postural (Study 1) and locomotor behavior (Study 2) differentially in highs and lows. Results showed that, at variance with the visual and proprioceptive modalities, vestibular inactivation did not induce major differences between the 2 groups, with the exception of improvement in walking straight across consecutive trials, which was observed only in highs. The article presents an overview of the structures and mechanisms possibly involved in the observed hypnotizability-related differences in motor control and suggests that hypnotic susceptibility might be a relevant factor in neuro-rehabilitative treatments because it accounts for part of the variability in the sensorimotor self.
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Cardiovascular and respiratory correlates of deep nociceptive stimulation, suggestions for analgesia, pain imagery and cognitive load as a function of hypnotizability. Brain Res Bull 2010; 82:65-73. [DOI: 10.1016/j.brainresbull.2010.03.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2009] [Revised: 03/04/2010] [Accepted: 03/08/2010] [Indexed: 11/21/2022]
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Presciuttini S, Curcio M, Chillemi R, Barbuti S, Scatena F, Carli G, Ghelarducci B, Santarcangelo EL. Promoter polymorphisms of the NOS3 gene are associated with hypnotizability-dependent vascular response to nociceptive stimulation. Neurosci Lett 2009; 467:252-5. [DOI: 10.1016/j.neulet.2009.10.056] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2009] [Revised: 10/06/2009] [Accepted: 10/18/2009] [Indexed: 10/20/2022]
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Caratelli E, Menzocchi M, Carli G, Fontani G, Santarcangelo E. Is high hypnotizability a trouble in balance control? Eur J Appl Physiol 2009; 108:201-6. [DOI: 10.1007/s00421-009-1280-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2009] [Indexed: 10/20/2022]
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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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36
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Santarcangelo EL, Carli G, Migliorini S, Fontani G, Varanini M, Balocchi R. Heart-rate control during pain and suggestions of analgesia without deliberate induction of hypnosis. Int J Clin Exp Hypn 2008; 56:255-69. [PMID: 18569137 DOI: 10.1080/00207140802039649] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Heart rate and heart-rate variability (HRV) were studied through a set of different methods in high (highs) and low hypnotizable subjects (lows) not receiving any deliberate hypnotic induction in basal conditions (simple relaxation) and during nociceptive-pressor stimulation with and without suggestions of analgesia. ANOVA did not reveal any difference between highs and lows for heart rate and for the HRV indexes extracted from the series of the interbeat intervals (RR) of the ECG in the frequency (spectral analysis) and time domain (standard deviation, Poincare plot) in both basal and stimulation conditions. Factors possibly accounting for the results and likely responsible for an underestimation of group differences are discussed.
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Carli G, Huber A, Santarcangelo EL. Hypnotizability and chronic pain: an ambiguous connection. ACTA ACUST UNITED AC 2008. [DOI: 10.1002/ch.356] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Hypnotizability-dependent modulation of the changes in heart rate control induced by upright stance. Brain Res Bull 2008; 75:692-7. [DOI: 10.1016/j.brainresbull.2007.11.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2007] [Revised: 08/22/2007] [Accepted: 11/21/2007] [Indexed: 10/22/2022]
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Gemignani A, Sebastiani L, Simoni A, Santarcangelo EL, Ghelarducci B. Hypnotic trait and specific phobia: EEG and autonomic output during phobic stimulation. Brain Res Bull 2006; 69:197-203. [PMID: 16533670 DOI: 10.1016/j.brainresbull.2005.12.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2005] [Accepted: 12/01/2005] [Indexed: 10/25/2022]
Abstract
In a previous study we showed that healthy highly hypnotizable subjects, during the suggestion of a moderately unpleasant situation administered in awake conditions, exhibited a sympathetic response greatly attenuated with respect to non-hypnotizable individuals. This was interpreted as a natural protection of hypnotizable subjects against the cardiovascular effects of cognitive stress. Aim of the present study was to investigate whether the hypnotic trait is able to modulate the autonomic and cerebral activities also in specific phobic awake hypnotizable (Highs) and non-hypnotizable (Lows) subjects. Electroencephalogram, electrooculogram, electromiogram of corrugator muscle, electrocardiogram, respirogram and tonic electrodermal activity were recorded during a guided mental imagery of an animal phobic object. Phobic stimulation induced in both groups the rise of heart and respiratory frequency and the lowering of skin resistance. These changes are less pronounced in Highs than in Lows and are sustained by a different modulation of the sympatho-vagal balance. During phobic stimulation both groups exhibited a similar significant increase of EEG gamma relative power. At variance, significant stimulation-related decrements of alpha1, theta1 and theta2 activities were found only in Highs that exhibited similar changes during the control and phobic stimulation. Results suggest that hypnotizability is able to modulate cerebral and autonomic responses also in specific phobic subjects. However, the presence of a specific phobia attenuates the effectiveness of hypnotizability as a protective factor against possible stress-related cardiac illness.
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Affiliation(s)
- Angelo Gemignani
- Department of Physiology and Biochemistry, G. Moruzzi, University of Pisa, Via San Zeno 31, 56127 Pisa, Italy.
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Jambrik Z, Santarcangelo EL, Rudisch T, Varga A, Forster T, Carli G. Modulation of pain-induced endothelial dysfunction by hypnotisability. Pain 2005; 116:181-186. [PMID: 15979790 DOI: 10.1016/j.pain.2005.03.041] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2004] [Revised: 02/15/2005] [Accepted: 03/14/2005] [Indexed: 11/25/2022]
Abstract
Mental stress induces endothelial dysfunction, that is a reduction of the post-occlusion brachial artery flow-mediated vasodilation (FMD). This does not occur in subjects highly susceptible to hypnosis (Highs) in either the waking or hypnotic state. The aim of the present experiment was to assess whether endothelial dysfunction is also induced by acute nociceptive stimulation and whether high hypnotisability and/or the specific instruction of analgesia prevent its occurrence in awake highly hypnotizable individuals. Thus, nine Highs and nine subjects with low susceptibility to hypnosis (Lows) underwent an experimental session including the administration of pressor pain and of pressor pain associated with the instruction of analgesia. Heart rate, basal artery diameters and brachial artery flow-mediated vasodilation were measured during stimulation and rest conditions. Heart rate exhibited slight changes not modulated by hypnotisability. During painful stimulation both Highs and Lows showed a decrease of FMD, but it was significantly less pronounced in Highs. During the administration of painful stimulation together with the instruction of analgesia, only Highs reported analgesia and their FMD no longer decreased. This study provides the first evidence of pain-related endothelial dysfunction and extends previous findings concerning a sort of natural protection of Highs against the vascular effects of mental stress to acute pain.
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Affiliation(s)
- Zoltan Jambrik
- II Department of Internal Medicine and Cardiology Centre, University of Sciences, Szeged, Hungary Department of Physiology and Biochemistry, Pisa University, Italy Department of Neuropsychology Rehabilitation, Szeged University, Hungary Department of Physiology, University of Siena, Via A. Moro, 4 Siena, Italy
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Jambrik Z, Sebastiani L, Picano E, Ghelarducci B, Santarcangelo EL. Hypnotic modulation of flow-mediated endothelial response to mental stress. Int J Psychophysiol 2005; 55:221-7. [PMID: 15649553 DOI: 10.1016/j.ijpsycho.2004.07.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2003] [Revised: 07/02/2004] [Accepted: 07/27/2004] [Indexed: 11/26/2022]
Abstract
Post-ischaemic flow mediated dilation of peripheral arteries (FMD) is transiently reduced during mental stress. This experiment was aimed at assessing whether hypnosis, which is a powerful relaxation technique, modulated the FMD response to mental stress in subjects with different hypnotic susceptibility. Results showed that hypnotic relaxation prevented the expected stress-related reduction of FMD only in highly hypnotizable subjects, suggesting a protective role of hypnotisability against vascular damage.
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Affiliation(s)
- Zoltan Jambrik
- National Council of Research, Institute of Clinical Physiology, Pisa, Italy
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