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Guiloff RJ, Campero M, Barraza GR, Treede RD, Matamala JM, Castillo JL. Pain-Related Vertex Evoked Potentials. Comparison of Surface Electrical to Heat Stimulation. J Clin Neurophysiol 2023; 40:616-624. [PMID: 37931163 DOI: 10.1097/wnp.0000000000000929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Demonstration of nociceptive fiber abnormality is important for diagnosing neuropathic pain and small fiber neuropathies. This is usually assessed by brief heat pulses using lasers, contact heat, or special electrodes. We hypothesized that pain-related evoked potentials to conventional surface electrical stimulation (PREPse) can index Aδ afferences despite tactile Aß fibers coactivation. PREPse may be more readily used clinically than contact heat evoked potentials (CHEPS). METHODS Twenty-eight healthy subjects. Vertex (Cz-A1/A2) recordings. Electrical stimulation of middle finger and second toe with conventional ring, and forearm/leg skin with cup, electrodes. Contact heat stimulation to forearm and leg. Compression ischemic nerve blockade. RESULTS PREPse peripheral velocities were within the midrange of Aδ fibers. N1-P1 amplitude increased with pain numerical rating scale graded (0-10) electrical stimulation (n = 25) and decreased with increasing stimulation frequency. Amplitudes were unchanged by different presentation orders of four stimulation intensities. PREPse N1 (∼130 milliseconds) and N2 (∼345 milliseconds) peaks were approximately 40 milliseconds earlier than that with CHEPS. PREPse and CHEPS N1-N2 interpeak latency (∼207 milliseconds) were similar. PREPse became unrecordable with nerve blockade of Aδ fibers. CONCLUSIONS PREPse earlier N1 and N2 peaks, and similar interpeak N1-N2 latencies and central conduction velocities, or synaptic delays, to CHEPS are consistent with direct stimulation of Aδ fibers. The relation of vertex PREPse amplitude and pain, or the differential effects of frequency stimulation, is similar to pain-related evoked potential to laser, special electrodes, or contact heat stimulation. The relationship to Aδ was validated by conduction velocity and nerve block. Clinical utility of PREPse compared with CHEPS needs validation in somatosensory pathways lesions.
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Affiliation(s)
- Roberto J Guiloff
- Faculty of Medicine University of Chile, Santiago, Chile
- Imperial College, London, United Kingdom
- Neuromuscular Unit, Department of Neurology and Neurosurgery, Hospital Clinico Universidad de Chile, Santiago, Chile
| | - Mario Campero
- Faculty of Medicine University of Chile, Santiago, Chile
- Neuromuscular Unit, Department of Neurology and Neurosurgery, Hospital Clinico Universidad de Chile, Santiago, Chile
| | - Gonzalo R Barraza
- Neuromuscular Unit, Department of Neurology and Neurosurgery, Hospital Clinico Universidad de Chile, Santiago, Chile
| | | | - Jose M Matamala
- Faculty of Medicine University of Chile, Santiago, Chile
- Department of Neurological Science, Hospital El Salvador, Santiago, Chile
| | - Jose L Castillo
- Department of Neurological Science, Hospital El Salvador, Santiago, Chile
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Perri RL, Perrotta D, Rossani F, Pekala RJ. Boosting the hypnotic experience. Inhibition of the dorsolateral prefrontal cortex alters hypnotizability and sense of agency. A randomized, double-blind and sham-controlled tDCS study. Behav Brain Res 2022; 425:113833. [PMID: 35276309 DOI: 10.1016/j.bbr.2022.113833] [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: 01/17/2022] [Revised: 02/23/2022] [Accepted: 03/05/2022] [Indexed: 11/02/2022]
Abstract
Hypnotizability refers to the individual responsiveness to hypnosis, and literature shows that the greater the hypnotizability, the more effective the hypnotic suggestions. So far, few studies attempted to enhance hypnotizability, and only two adopted brain stimulation with magnetic pulses. In the present study, we aimed to boost hypnotizability through transcranial direct current stimulation (tDCS). To this aim, bilateral tDCS was applied over the dorsolateral prefrontal cortex (DLPFC) with the target electrode providing negative current (cathodal stimulation) over the left hemisphere. Twenty-nine subjects participated in the study and they were randomly assigned to the sham or the active group in a double-blind design. The hypnotic experience was assessed before and after the stimulation through a phenomenological measure of consciousness (the PCI-HAP). The main findings revealed that a single tDCS session enhanced the hypnotic depth by 11% and reduced the volitional control by 30%, while no differences emerged in the sham group. This is the first study adopting the electrical neurostimulation to produce an alteration of hypnotizability and sense of agency, and confirmed the key-role of the DLPFC and executive control in the hypnotic phenomena. If confirmed, these findings could have relevant implications as enhanced hypnotizability could be translated into better outcomes for many hypnotic interventions.
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Affiliation(s)
- Rinaldo L Perri
- University Niccolò Cusano, Rome, Italy; De Sanctis Clinical Center (CCDS), Rome, Italy.
| | | | | | - Ronald J Pekala
- Private Practice, West Chester, PA, USA & Coatesville Veterans Administration Medical Center, Coatesville, PA, USA
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Perri RL, Facco E, Quinzi F, Bianco V, Berchicci M, Rossani F, Di Russo F. Cerebral mechanisms of hypnotic hypoesthesia. An ERP investigation on the expectancy stage of perception. Psychophysiology 2020; 57:e13657. [DOI: 10.1111/psyp.13657] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 01/09/2023]
Affiliation(s)
- Rinaldo Livio Perri
- Department Unicusano University “Niccolò Cusano” Rome Italy
- Department of Movement, Human and Health Sciences University of Rome “Foro Italico” Rome Italy
| | - Enrico Facco
- Studium Patavinum Department of Neurosciences University of Padova Padova Italy
- Institution F. GranoneItalian Center of Clinical & Experimental Hypnosis Turin Italy
| | - Federico Quinzi
- Department of Movement, Human and Health Sciences University of Rome “Foro Italico” Rome Italy
| | | | - Marika Berchicci
- Department of Movement, Human and Health Sciences University of Rome “Foro Italico” Rome Italy
| | | | - Francesco Di Russo
- Department of Movement, Human and Health Sciences University of Rome “Foro Italico” Rome Italy
- IRCCS Santa Lucia Foundation Rome Italy
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Presciuttini S, Carli G, Santarcangelo EL. HYPNOTIZABILITY-RELATED FAAH C385A POLYMORPHISM: POSSIBLE ENDOCANNABINOID CONTRIBUTION TO SUGGESTION-INDUCED ANALGESIA. Int J Clin Exp Hypn 2020; 68:29-37. [PMID: 31914367 DOI: 10.1080/00207144.2020.1682254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Fatty acid amide hydrolase (FAAH) degrades the endogenous endocannabinoid (eCB) anandamide and might be involved in the response to suggestions of analgesia in subjects with high hypnotizability scores (highs). Since the A allele of the FAAH C385A polymorphism (rs324420) is associated with lower FAAH activity, it was studied in 21 highs, 66 low hypnotizable individuals (lows), and 172 individuals not selected for hypnotizability (controls) representing the general population. No significant difference was observed among groups, but the A allele frequency showed a significant trend to increase from lows to controls and from controls to highs. Since eCB small differences can be amplified by eCB interactions with other neurotransmitters, a contribution of the FAAH polymorphism to the highs' analgesia should not be excluded.
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Affiliation(s)
- Silvano Presciuttini
- 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
| | - Enrica L Santarcangelo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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Perri RL, Rossani F, Di Russo F. Neuroelectric evidences of top-down hypnotic modulation associated with somatosensory processing of sensory and limbic regions. Neuroimage 2019; 202:116104. [DOI: 10.1016/j.neuroimage.2019.116104] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 04/19/2019] [Accepted: 08/14/2019] [Indexed: 02/02/2023] Open
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Peng W, Babiloni C, Mao Y, Hu Y. Subjective pain perception mediated by alpha rhythms. Biol Psychol 2015; 109:141-50. [PMID: 26026894 DOI: 10.1016/j.biopsycho.2015.05.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 05/23/2015] [Accepted: 05/23/2015] [Indexed: 01/26/2023]
Abstract
Suppression of spontaneous alpha oscillatory activities, interpreted as cortical excitability, was observed in response to both transient and tonic painful stimuli. The changes of alpha rhythms induced by pain could be modulated by painful sensory inputs, experimental tasks, and top-down cognitive regulations such as attention. The temporal and spatial characteristics, as well as neural functions of pain induced alpha responses, depend much on how these factors contribute to the observed alpha event-related desynchronization/synchronization (ERD/ERS). How sensory-, task-, and cognitive-related changes of alpha oscillatory activities interact in pain perception process is reviewed in the current study, and the following conclusions are made: (1) the functional inhibition hypothesis that has been proposed in auditory and visual modalities could be applied also in pain modality; (2) the neural functions of pain induced alpha ERD/ERS were highly dependent on the cortical regions where it is observed, e.g., somatosensory cortex alpha ERD/ERS in pain perception for painful stimulus processing; (3) the attention modulation of pain perception, i.e., influences on the sensory and affective dimensions of pain experience, could be mediated by changes of alpha rhythms. Finally, we propose a model regarding the determinants of pain related alpha oscillatory activity, i.e., sensory-discriminative, affective-motivational, and cognitive-modulative aspects of pain experience, would affect and determine pain related alpha oscillatory activities in an integrated way within the distributed alpha system.
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Affiliation(s)
- Weiwei Peng
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, China
| | - Claudio Babiloni
- Department of Physiology and Pharmacology, University of Rome "La Sapienza", Rome, Italy; IRCCS San Raffaele Pisana, Rome, Italy
| | - Yanhui Mao
- Department of Developmental and Social Process Psychology, University of Rome "La Sapienza", Rome, Italy
| | - Yong Hu
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, China.
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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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Lanfranco RC, Canales-Johnson A, Huepe D. Hypnoanalgesia and the study of pain experience: from Cajal to modern neuroscience. Front Psychol 2014; 5:1126. [PMID: 25324822 PMCID: PMC4179709 DOI: 10.3389/fpsyg.2014.01126] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 09/16/2014] [Indexed: 12/13/2022] Open
Abstract
Santiago Ramón y Cajal (1852–1934) did not only contribute to neurobiology and neurohistology. At the end of the 19th century, he published one of the first clinical reports on the employment of hypnotic suggestion to induce analgesia (hypnoanalgesia) in order to relieve pain in childbirth. Today, the clinical application of hypnoanalgesia is considered an effective technique for the treatment of pain in medicine, dentistry, and psychology. However, the knowledge we have today on the neural and cognitive underpinnings of hypnotic suggestion has increased dramatically since Cajal’s times. Here we review the main contributions of Cajal to hypnoanalgesia and the current knowledge we have about hypnoanalgesia from neural and cognitive perspectives.
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Affiliation(s)
- Renzo C Lanfranco
- Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Chile Santiago, Chile ; Laboratory of Cognitive and Social Neuroscience, UDP-INECO Foundation Core on Neuroscience, Universidad Diego Portales Santiago, Chile
| | - Andrés Canales-Johnson
- Laboratory of Cognitive and Social Neuroscience, UDP-INECO Foundation Core on Neuroscience, Universidad Diego Portales Santiago, Chile ; Medical Research Council, Cognition and Brain Sciences Unit Cambridge, UK
| | - David Huepe
- Laboratory of Cognitive and Social Neuroscience, UDP-INECO Foundation Core on Neuroscience, Universidad Diego Portales Santiago, Chile
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