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Wang R, Lu J, Chow KM. Effectiveness of mind-body interventions in labour pain management during normal delivery: A systematic review and meta-analysis. Int J Nurs Stud 2024; 158:104858. [PMID: 39043113 DOI: 10.1016/j.ijnurstu.2024.104858] [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: 03/06/2024] [Revised: 05/19/2024] [Accepted: 07/04/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND Labour pain is a common experience among women and poses risks to both the mother and neonate. Mind-body interventions have demonstrated effectiveness in diverse contexts, but their effectiveness in labour pain management remains controversial. OBJECTIVE To identify the effects of each category of mind-body interventions on labour pain management, particularly pain intensity; the use of pharmacological pain relief medications; and the consequent outcomes, including the rate of caesarean section, duration of labour, and fear of childbirth. DESIGN Systematic review and meta-analysis. METHODS A systematic search for related articles was conducted in 10 databases. Randomised controlled trials focusing on the effectiveness of mind-body interventions in labour pain management were included. Two researchers independently conducted methodological quality assessments, data extraction and grading the evidence. Meta-analyses were conducted when studies measured the same outcomes. Standardised mean differences were calculated for continuous variables, whilst risk ratios were calculated for dichotomous variables. All analyses were performed using RevMan version 5.3. RESULTS A total of 25 studies from 24 trials were included, and six categories of mind-body interventions, namely hypnosis, mindfulness, breathing skills, muscle relaxation techniques, guided imagery, and therapeutic touch, were identified. Specifically, hypnosis and mindfulness might be effective in relieving labour pain intensity, with large effect sizes (SMD: -1.45, 95 % confidence interval [CI] -2.34, -0.55, I2 = 91 %; SMD: -1.22, 95 % CI -2.07, -0.37, I2 = 93 %, respectively), but could not reduce the use of epidural analgesia. Mindfulness, in particular, yielded statistically significant reductions in the rate of caesarean section, with a small effect size (RR: 0.46, 95 % CI 0.21, 0.97, I2 = 49 %), and in fear of childbirth, with a medium effect size (SMD: -0.63, 95 % CI -1.09, -0.17, I2 = 65 %). Additionally, all categories of mind-body interventions were associated with a significantly decreased duration of labour compared with the control conditions. CONCLUSIONS Mind-body interventions may have potential benefits in terms of decreasing labour pain intensity, the rate of caesarean section, the duration of labour, and fear of childbirth, with small-to-large effect sizes. Particularly, hypnosis and mindfulness exhibited significant positive effects in terms of relieving labour pain intensity, with large effect sizes. These interventions could serve as complementary or alternative methods for labour pain management in clinical practice. Nevertheless, further rigorous randomised controlled trials are warranted to confirm our results. REGISTRATION CRD42024498600 (PROSPERO, January 15, 2024).
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Affiliation(s)
- Ruohan Wang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jinling Lu
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Ka Ming Chow
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
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Leo DG, Keller SS, Proietti R. "Close your eyes and relax": the role of hypnosis in reducing anxiety, and its implications for the prevention of cardiovascular diseases. Front Psychol 2024; 15:1411835. [PMID: 39035095 PMCID: PMC11258040 DOI: 10.3389/fpsyg.2024.1411835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 06/21/2024] [Indexed: 07/23/2024] Open
Abstract
Anxiety is the most common form of mental health disorder, affecting millions of people worldwide. Psychosocial interventions such as mindfulness and cognitive behavioral therapy (CBT) have been suggested as an effective treatment in the management of general anxiety and anxiety disorders, with emerging evidence also suggesting the effectiveness of hypnosis. Moreover, anxiety has shown to be linked to the onset and development of several cardiovascular diseases (CVD), which are the leading cause of global death. In this paper, we review the current literature to examine the role that anxiety has on the onset and development of CVD and summarize the current knowledge on the role that hypnosis and hypnotherapy have in reducing anxiety, also explaining how this can impact the cardiovascular system and the prevention of CVD. Review of the evidence suggests that hypnosis and hypnotherapy are effective in treating anxiety and may positively affect the heart and the cardiovascular system, reducing sympathetic activation and increasing parasympathetic tone, potentially preventing the onset of CVD related to increased sympathetic activation. However, further studies are required to further understand how hypnosis and hypnotherapy affect the cardiovascular system through investigation of the neurophysiological components of the hypnotic state and of the mind-body relationship. Healthcare systems should embed mental health screening in patients at risk of developing CVD as part of the clinical pathway and consider the role that hypnosis and hypnotherapy may play in the management of CVD.
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Affiliation(s)
- Donato Giuseppe Leo
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Faculty of Health and Life Science, University of Liverpool, Liverpool, United Kingdom
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - Simon S. Keller
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Riccardo Proietti
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Faculty of Health and Life Science, University of Liverpool, Liverpool, United Kingdom
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
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Hansen E. Touching the unconscious in the unconscious - hypnotic communication with unconscious patients. Front Psychol 2024; 15:1389449. [PMID: 38966734 PMCID: PMC11223660 DOI: 10.3389/fpsyg.2024.1389449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/30/2024] [Indexed: 07/06/2024] Open
Abstract
If hypnosis means contact to the unconscious to modulate psychological and physiological functions by means of suggestions, and if this is facilitated by attenuation of the critical mind, then the question arises as to whether suggestions also have an effect when waking consciousness is otherwise eliminated, namely by coma or anesthesia. A prerequisite would be perception, which actually is evidenced by reports of patients after traumatic brain injury, artificial coma, resuscitation or general anesthesia. Moreover, posttraumatic stress disorder (PTSD) frequently observed after these medical situations is hardly explainable without some sort of awareness under such conditions. Even advanced neurophysiological diagnostic cannot yet rule out consciousness or sensory processing. Especially reference to perception during unconsciousness is given by the results of a recent multicenter study on the effects of hypnotic communication with patients under controlled adequate deep general anesthesia. The observed reductions in incidence and severity of postoperative pain, opioid use, nausea and vomiting cannot be explained by the reaction of a few but only by a considerable proportion of patients. This leads to a strong plea for a more careful treatment of unconscious patients in the emergency room, operating theater or intensive care unit, for the abandonment of the restriction of therapeutic communication to awake patients, and for new aspects of communication and hypnosis research. Obviously, loss of consciousness does not protect against psychological injury, and continuation of communication is needed. But how and what to talk to unconscious patients? Generally addressing the unconscious mind with suggestions that generally exert their effects unconsciously, hypnotic communication appears to be the adequate language. Especially addressing meaningful topics, as derived from the basic psychological needs and known stressors, appears essential. With respect to negative effects by negative or missing communication or to the proposed protective and supporting effects of therapeutic communication with patients clinically rated as unconscious, the role of consciousness is secondary. For the effects of perceived signals and suggestions it does not matter whether consciousness is absent, or partial, or unrecognized present.
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Affiliation(s)
- Ernil Hansen
- Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany
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Naccache L, Munoz-Musat E. A global neuronal workspace model of functional neurological disorders. DIALOGUES IN CLINICAL NEUROSCIENCE 2024; 26:1-23. [PMID: 38767966 PMCID: PMC11107854 DOI: 10.1080/19585969.2024.2340131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 04/03/2024] [Indexed: 05/22/2024]
Abstract
We introduce here a general model of Functional Neurological Disorders based on the following hypothesis: a Functional Neurological Disorder could correspond to a consciously initiated voluntary top-down process causing involuntary lasting consequences that are consciously experienced and subjectively interpreted by the patient as involuntary. We develop this central hypothesis according to Global Neuronal Workspace theory of consciousness, that is particularly suited to describe interactions between conscious and non-conscious cognitive processes. We then present a list of predictions defining a research program aimed at empirically testing their validity. Finally, this general model leads us to reinterpret the long-debated links between hypnotic suggestion and functional neurological disorders. Driven by both scientific and therapeutic goals, this theoretical paper aims at bringing closer the psychiatric and neurological worlds of functional neurological disorders with the latest developments of cognitive neuroscience of consciousness.
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Affiliation(s)
- Lionel Naccache
- Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France- Sorbonne Université, UPMC Univ Paris 06, Faculté de Médecine Pitié-Salpêtrière, Sorbonne Université, Paris, France
- Department of Neurology, AP-HP, Hôpital Groupe hospitalier Pitié-Salpêtrière, DMU Neurosciences, Paris, France
- Department of Clinical Neurophysiology, AP-HP, Hôpital Groupe hospitalier Pitié-Salpêtrière, DMU Neurosciences, Paris, France
| | - Esteban Munoz-Musat
- Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France- Sorbonne Université, UPMC Univ Paris 06, Faculté de Médecine Pitié-Salpêtrière, Sorbonne Université, Paris, France
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Miltner WHR, Franz M, Naumann E. Neuroscientific results of experimental studies on the control of acute pain with hypnosis and suggested analgesia. Front Psychol 2024; 15:1371636. [PMID: 38638524 PMCID: PMC11025616 DOI: 10.3389/fpsyg.2024.1371636] [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: 01/16/2024] [Accepted: 03/18/2024] [Indexed: 04/20/2024] Open
Abstract
This narrative review summarizes a representative collection of electrophysiological and imaging studies on the neural processes and brain sources underlying hypnotic trance and the effects of hypnotic suggestions on the processing of experimentally induced painful events. It complements several reviews on the effect of hypnosis on brain processes and structures of chronic pain processing. Based on a summary of previous findings on the neuronal processing of experimentally applied pain stimuli and their effects on neuronal brain structures in healthy subjects, three neurophysiological methods are then presented that examine which of these neuronal processes and structures get demonstrably altered by hypnosis and can thus be interpreted as neuronal signatures of the effect of analgesic suggestions: (A) On a more global neuronal level, these are electrical processes of the brain that can be recorded from the cranial surface of the brain with magnetoencephalography (MEG) and electroencephalography (EEG). (B) On a second level, so-called evoked (EPs) or event-related potentials (ERPs) are discussed, which represent a subset of the brain electrical parameters of the EEG. (C) Thirdly, imaging procedures are summarized that focus on brain structures involved in the processing of pain states and belong to the main imaging procedures of magnetic resonance imaging (MRI/fMRI) and positron emission tomography (PET). Finally, these different approaches are summarized in a discussion, and some research and methodological suggestions are made as to how this research could be improved in the future.
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Affiliation(s)
- Wolfgang H. R. Miltner
- Institute of Psychology, Friedrich Schiller University of Jena, Jena, Thuringia, Germany
| | - Marcel Franz
- Institute of Psychology, Friedrich Schiller University of Jena, Jena, Thuringia, Germany
| | - Ewald Naumann
- Institute of Psychology, University of Trier, Trier, Rhineland-Palatinate, Germany
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Geagea D, Ogez D, Kimble R, Tyack Z. Redefining hypnosis: A narrative review of theories to move towards an integrative model. Complement Ther Clin Pract 2024; 54:101826. [PMID: 38199053 DOI: 10.1016/j.ctcp.2023.101826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/14/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024]
Abstract
Hypnosis is an ancient mind-body intervention that has regained interest with the surge of research in the last decade documenting its clinical validity. Yet, theoretical controversies and misconceptions prevail among theorists, clinicians, and the general public, impeding the understanding, acceptance, replication, and use of hypnosis. Providing adequate information, which dispels misconceptions and promotes more balanced views, is warranted to facilitate the implementation and adoption of hypnosis in clinical and research settings. This review re-examines the conceptualisation of hypnosis throughout history and the theoretical controversies surrounding it while highlighting their meeting points and clinical implications. Despite dichotomies, a broad agreement appears across theoretical approaches regarding hypnotic analgesia effects, key components, and vocabulary. Further, theories highlight key factors of hypnotic responding. For instance, social theories highlight social and contextual variables, whereas state theories highlight biopsychosocial mechanisms and individual factors. Based on theories, the terms hypnotherapy or clinical hypnosis are recommended to refer to the therapeutic use of hypnosis in psychotherapeutic and medical contexts, respectively. This review concludes with a model that integrates various theories and evidence and presents hypnosis as a complex multifaceted intervention encompassing multiple procedures, phenomena, and influencing factors. This review intends to deepen our understanding of hypnosis, and promote its more rapid adoption and adequate implementation in research and clinical contexts, in addition to steering research towards evidence-based hypnotic practice. The review can have important research and clinical implications by contributing to advancing knowledge regarding hypnotic procedures, phenomena, and influencing factors.
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Affiliation(s)
- Dali Geagea
- Child Health Research Centre, Centre for Children's Burns and Trauma Research, The University of Queensland, Brisbane, Australia.
| | - David Ogez
- Department of Anaesthesiology and Pain Medicine, University of Montreal, Montreal, Canada
| | - Roy Kimble
- Centre for Children's Burns and Trauma Research, Queensland Children's Hospital, The University of Queensland, Brisbane, Australia
| | - Zephanie Tyack
- Child Health Research Centre, Centre for Children's Burns and Trauma Research, The University of Queensland, Brisbane, Australia; Australian Centre for Health Service Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
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Ma Y, Li Y, Wang C, Zhang Y, Wang L, Hu R, Yin Y, He F. Effects of non-pharmacological interventions on pain in wound patients during dressing change: A systematic review. Nurs Open 2024; 11:e2107. [PMID: 38391098 PMCID: PMC10830920 DOI: 10.1002/nop2.2107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/12/2023] [Accepted: 01/11/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Changes to the wound dressing frequently cause pain. Some adverse side effects of pharmacologic pain management may cause problems or even impede wound healing. There is no systematic study of non-pharmacologic therapies for pain during wound dressing changes, despite the gradual promotion of non-pharmacologic pain reduction methods. OBJECTIVES To give clinical wound pain management a new direction, locating and assessing non-pharmacological interventions regarding pain brought on by wound dressing changes are necessary. METHOD The researchers conducted a comprehensive literature review on non-pharmacological interventions for pain during wound dressing changes across five databases: PubMed, Web of Science, Medline, Embase, and the Cochrane Library spanning the period from January 2010 to September 2022. The evaluation of literature and data extraction was carried out independently by two researchers, and in cases of disagreement, a third researcher participated in the deliberation. To assess the risk of bias in the literature, the researchers utilised the Cochrane Handbook for Reviews of Interventions, version 5.1.0. RESULTS In total, 951 people were involved in 11 investigations covering seven non-pharmacological therapies. For pain triggered by dressing changes, virtual reality (VR) distraction, auditory and visual distractions, foot reflexology, religious and spiritual care, and guided imaging demonstrated partially positive effects, with hypnosis therapy and jaw relaxation perhaps having a weak effect. CONCLUSION The key to managing wounds is pain management. According to our review, there is some indication that non-pharmacologic interventions can help patients feel less discomfort when having their wound dressings changed. However, the evidence supporting this view is weak. It needs to be corroborated by future research studies with multicentre and large samples. To promote and use various non-pharmacologic interventions in the future, it is also necessary to build standardised and homogenised paths for their implementation.
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Affiliation(s)
- Yanfei Ma
- Mianyang Central Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaMianyangSichuanP.R. China
| | - Yeping Li
- Mianyang Central Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaMianyangSichuanP.R. China
| | - Chunyan Wang
- Mianyang Central Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaMianyangSichuanP.R. China
| | - Yaqing Zhang
- Mianyang Central Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaMianyangSichuanP.R. China
| | - Lihui Wang
- Mianyang Central Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaMianyangSichuanP.R. China
| | - Rong Hu
- Mianyang Central Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaMianyangSichuanP.R. China
| | - Yang Yin
- Mianyang Central Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaMianyangSichuanP.R. China
| | - Fang He
- Mianyang Central Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaMianyangSichuanP.R. China
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Vázquez PG, Whitfield-Gabrieli S, Bauer CCC, Barrios FA. Brain functional connectivity of hypnosis without target suggestion. An intrinsic hypnosis rs-fMRI study. World J Biol Psychiatry 2024; 25:95-105. [PMID: 37786280 DOI: 10.1080/15622975.2023.2265997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/28/2023] [Indexed: 10/04/2023]
Abstract
OBJECTIVE During hypnosis, significant changes in the BOLD signal associated with the anterior default mode network (DMN) and prefrontal attentional systems have been reported as evidence of dissociation defined since Charcot. However, it remains uncertain whether these changes are mainly attributable to the hypnotic state per se or to the target suggestions used to verify subject's state during neuroimaging studies. The aim of the present study is to evidence the brain in hypnosis, contrasting the common resting state versus neutral hypnosis (hypnosis in the absence of target suggestions). METHODS Twenty-four healthy right-handed volunteers (age 28.3 y.o., 12 females) rated moderate hypnotic responsiveness underwent resting state fMRI at 3.0 T in two sessions, once in neutral hypnosis and the other in the common resting state. Each subject's functional data were analyzed for low-frequency BOLD signal correlations seed-to-voxel for the whole brain in the first-level analysis, and seed-to-voxel in a second-level analysis to estimate group results using seeds for five resting state networks: the default mode (DMN), the central executive (CEN), the salience (SaN), the dorso-lateral attention (DAN), and the sensorimotor (SMN) networks. RESULTS In general, all network maps of the hypnotic condition presented higher connectivity than those of the resting condition. However, only contrasts for the DAN, SaN, and SMN were statistically significant, including correlated out-of-the-network regions. CONCLUSION Parietal and occipital regions displayed increased connectivity across networks, implying dissociation from the frontal cortices. This is the first fMRI intrinsic study of hypnosis without target suggestion.
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Affiliation(s)
- Pablo G Vázquez
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Mexico
| | - Susan Whitfield-Gabrieli
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Psychology, Northeastern University, Boston, USA
| | - Clemens C C Bauer
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Mexico
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Psychology, Northeastern University, Boston, USA
| | - Fernando A Barrios
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Mexico
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA
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De Pascalis V. Brain Functional Correlates of Resting Hypnosis and Hypnotizability: A Review. Brain Sci 2024; 14:115. [PMID: 38391691 PMCID: PMC10886478 DOI: 10.3390/brainsci14020115] [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: 12/04/2023] [Revised: 01/12/2024] [Accepted: 01/18/2024] [Indexed: 02/24/2024] Open
Abstract
This comprehensive review delves into the cognitive neuroscience of hypnosis and variations in hypnotizability by examining research employing functional magnetic resonance imaging (fMRI), positron emission tomography (PET), and electroencephalography (EEG) methods. Key focus areas include functional brain imaging correlations in hypnosis, EEG band oscillations as indicators of hypnotic states, alterations in EEG functional connectivity during hypnosis and wakefulness, drawing critical conclusions, and suggesting future research directions. The reviewed functional connectivity findings support the notion that disruptions in the available integration between different components of the executive control network during hypnosis may correspond to altered subjective appraisals of the agency during the hypnotic response, as per dissociated and cold control theories of hypnosis. A promising exploration avenue involves investigating how frontal lobes' neurochemical and aperiodic components of the EEG activity at waking-rest are linked to individual differences in hypnotizability. Future studies investigating the effects of hypnosis on brain function should prioritize examining distinctive activation patterns across various neural networks.
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Affiliation(s)
- Vilfredo De Pascalis
- Department of Psychology, La Sapienza University of Rome, 00185 Rome, Italy
- School of Psychology, University of New England, Armidale, NSW 2351, Australia
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Zech N, Seemann M, Hansen E. Hypnosis measured with monitors of anesthetic depth - EEG changes during the test for Harvard Group Scale of Hypnotic Susceptibility. Front Psychol 2023; 14:1267658. [PMID: 38250101 PMCID: PMC10798158 DOI: 10.3389/fpsyg.2023.1267658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/22/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Hypnotic trance can be defined as a non-ordinary state of consciousness that is accompanied by a number of neurophysiological changes, including brain electrophysiology. In addition to subjective measures, corresponding objective parameters are needed in experimental and clinical hypnosis research but are complex, impractical, or unspecific. A similar challenge exists for the measurement and monitoring of drug-induced hypnosis, namely general anesthesia. The observation of changes in EEG induced by narcotics has led to the development of monitors for the depth of anesthesia based on EEG parameters. We investigated whether two such monitors react to the induction and maintenance of hypnosis during a highly standardized procedure. Methods A total of 56 volunteers were monitored for the bispectral index (BIS) and cerebral state index (CSI) (range 0-100, >95 considered "awake") during the Harvard Group Scale of Hypnotic Susceptibility test. For this test, trance is induced by a taped text and followed by 12 tasks performed under hypnosis. In contrast to random forms of hypnosis, this represents a standardized, worldwide-established condition. According to the resulting score, participants were classified into suggestibility groups in order to evaluate whether the electrophysiological measurements of BIS and CIS indices differ between high and low suggestible persons. Furthermore, participants were asked to rate their hypnotic depth (HD, 1-10) at every task of the test. Results Scores dropped significantly from a mean of 97.7 to 86.4 for BIS and from 94.6 to 77.7 for CSI with the induction of hypnosis to stay throughout hypnosis at levels of approximately 88.6 or 82.9, respectively. Results did not differ between high- and low-suggestible participants. The means of the subjective score of hypnotic depth and of the electrophysiological measurements showed a similar course. However, no correlation was found between BIS or CSI values and scores of hypnotic depths. Conclusion Monitors for depth of anesthesia respond to changes in consciousness, including trance states of hypnosis. However, specificity is unclear. Practically, in hypnosis research with the exclusion of drug effects or sleep, these monitors might be helpful to test and compare the efficacy of induction texts and to detect disturbances of trance state.
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Affiliation(s)
- Nina Zech
- Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany
| | - Milena Seemann
- Department of Anaesthesiology, Agaplesion Diakonieklinikum Hamburg, Hamburg, Germany
| | - Ernil Hansen
- Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany
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Descamps E, Boussac M, Joineau K, Payoux P. Changes of cerebral functional connectivity induced by foot reflexology in a RCT. Sci Rep 2023; 13:17139. [PMID: 37816799 PMCID: PMC10564852 DOI: 10.1038/s41598-023-44325-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 10/06/2023] [Indexed: 10/12/2023] Open
Abstract
Non-Pharmacological Interventions (NPIs) are increasingly being introduced into healthcare, but their mechanisms are unclear. In this study, 30 healthy participants received foot reflexology (FR) and sham massage, and went through a resting-state functional magnetic resonance imaging (rs-fMRI) to evaluate NPIs effect on brain. Rs-fMRI revealed an effect of both NPIs on functional connectivity with changes occurring in the default-mode network, the sensorimotor network and a Neural Network Correlates of Pain (NNCP-a newly discovered network showing great robustness). Even if no differences were found between FR and SM, this study allowed to report brain biomarkers of well-being as well as the safety of NPIs. In further research, it could be relevant to study it in patients to look for a true reflexology induced-effect dependent of patient reported outcomes. Overall, these findings enrich the understanding of the neural correlates of well-being experienced with NPIs and provided insight into the basis of the mechanisms of NPIs.
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Affiliation(s)
- Emeline Descamps
- Inserm Unité ToNIC, UMR 1214, CHU PURPAN - Pavillon BAUDOT, Place du Dr Joseph Baylac, 31024, Toulouse CEDEX 3, France.
- CNRS, Toulouse, France.
| | - Mathilde Boussac
- Inserm Unité ToNIC, UMR 1214, CHU PURPAN - Pavillon BAUDOT, Place du Dr Joseph Baylac, 31024, Toulouse CEDEX 3, France.
| | - Karel Joineau
- Inserm Unité ToNIC, UMR 1214, CHU PURPAN - Pavillon BAUDOT, Place du Dr Joseph Baylac, 31024, Toulouse CEDEX 3, France
| | - Pierre Payoux
- Inserm Unité ToNIC, UMR 1214, CHU PURPAN - Pavillon BAUDOT, Place du Dr Joseph Baylac, 31024, Toulouse CEDEX 3, France
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Fougère M, Greco-Vuilloud J, Arnous C, Abel F, Lowe C, Elie V, Marchand S. Sensory stimulations potentializing digital therapeutics pain control. FRONTIERS IN PAIN RESEARCH 2023; 4:1168377. [PMID: 37745799 PMCID: PMC10511651 DOI: 10.3389/fpain.2023.1168377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 08/14/2023] [Indexed: 09/26/2023] Open
Abstract
For the past two decades, using Digital Therapeutics (DTx) to counter painful symptoms has emerged as a novel pain relief strategy. Several studies report that DTx significantly diminish pain while compensating for the limitations of pharmacological analgesics (e.g., addiction, side effects). Virtual reality (VR) is a major component of the most effective DTx for pain reduction. Notably, various stimuli (e.g., auditory, visual) appear to be frequently associated with VR in DTx. This review aims to compare the hypoalgesic power of specific stimuli with or without a VR environment. First, this review will briefly describe VR technology and known elements related to its hypoalgesic effect. Second, it will non-exhaustively list various stimuli known to have a hypoalgesic effect on pain independent of the immersive environment. Finally, this review will focus on studies that investigate a possible potentialized effect on pain reduction of these stimuli in a VR environment.
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Affiliation(s)
| | | | | | | | | | | | - Serge Marchand
- Lucine, Bordeaux, France
- Faculté de Médecine et des Sciences de la Santé, Centre de Recherche Clinique du Centre Hospitalier Universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, QC, Canada
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Inthasot V, Taton O, Bondue B, Van Muylem A, Leduc D. [The effects of hypnosis by virtual reality on tolerance to flexible bronchoscopy]. Rev Mal Respir 2023; 40:555-563. [PMID: 37635020 DOI: 10.1016/j.rmr.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/16/2023] [Indexed: 08/29/2023]
Abstract
INTRODUCTION Patients often perceive flexible bronchoscopy as an unpleasant procedure. The aim of this study was to investigate the effect of virtual reality (VR) hypnosis on tolerance to flexible bronchoscopy. MATERIALS AND METHODS We conducted a prospective, randomized, controlled, monocentric study comparing flexible bronchoscopy with VR-induced hypnosis to the usual procedure. Patient tolerance was evaluated using a visual analogue scale (VAS), the state-trait anxiety inventory (STAI) before and after the procedure and, finally, willingness to repeat the examination under the same conditions (WTR). RESULTS Among the 70 patients included, 34 were randomized to the VR hypnosis group and 36 to the control group. There was no difference between the 2 groups in terms of modification of the pre-/post-bronchoscopy VAS for anxiety, pain, cough, choking, nausea and overall discomfort, or modification of the STAI score and WTR. Subgroup analysis among patients who were more anxious before the procedure revealed a trend toward reduced anxiety in the VR hypnosis group. CONCLUSION This study did not observe any effect of VR hypnosis on the tolerance of patients during routine flexible bronchoscopy. However, VR hypnosis may be beneficial in patients with higher anxiety score before bronchoscopy, a hypothesis that needs to be confirmed by further studies with a larger number of subjects.
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Affiliation(s)
- V Inthasot
- Service de pneumologie, Hôpital Erasme, Université Libre de Bruxelles, Bruxelles, Belgique; Service de pneumologie, Centre Hospitalier Universitaire Brugmann, Université Libre de Bruxelles, Bruxelles, Belgique.
| | - O Taton
- Service de pneumologie, Hôpital Erasme, Université Libre de Bruxelles, Bruxelles, Belgique
| | - B Bondue
- Service de pneumologie, Hôpital Erasme, Université Libre de Bruxelles, Bruxelles, Belgique
| | - A Van Muylem
- Service de pneumologie, Hôpital Erasme, Université Libre de Bruxelles, Bruxelles, Belgique
| | - D Leduc
- Service de pneumologie, Hôpital Erasme, Université Libre de Bruxelles, Bruxelles, Belgique
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Cardeña E, Lindström L, Goldin P, van Westen D, Mårtensson J. A neurophenomenological fMRI study of a spontaneous automatic writer and a hypnotic cohort. Brain Cogn 2023; 170:106060. [PMID: 37421816 DOI: 10.1016/j.bandc.2023.106060] [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: 04/21/2023] [Revised: 06/28/2023] [Accepted: 06/28/2023] [Indexed: 07/10/2023]
Abstract
PURPOSE To evaluate the neurophenomenology of automatic writing (AW) in a spontaneous automatic writer (NN) and four high hypnotizables (HH). METHODS During fMRI, NN and the HH were cued to perform spontaneous (NN) or induced (HH) AW, and a comparison task of copying complex symbols, and to rate their experience of control and agency. RESULTS Compared to copying, for all participants AW was associated with less sense of control and agency and decreased BOLD signal responses in brain regions implicated in the sense of agency (left premotor cortex and insula, right premotor cortex, and supplemental motor area), and increased BOLD signal responses in the left and right temporoparietal junctions and the occipital lobes. During AW, the HH differed from NN in widespread BOLD decreases across the brain and increases in frontal and parietal regions. CONCLUSIONS Spontaneous and induced AW had similar effects on agency, but only partly overlapping effects on cortical activity.
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Affiliation(s)
- Etzel Cardeña
- CERCAP, Department of Psychology, Lund University, Sweden.
| | - Lena Lindström
- CERCAP, Department of Psychology, Lund University, Sweden
| | | | - Danielle van Westen
- Institution for Clinical Sciences, Diagnostic Radiology, Lund University, Sweden
| | - Johan Mårtensson
- Department of Clinical Sciences Lund, Logopedics, Phoniatrics and Audiology, Lund University, Sweden
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15
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Geagea D, Ogez D, Kimble R, Tyack Z. Demystifying hypnosis: Unravelling facts, exploring the historical roots of myths, and discerning what is hypnosis. Complement Ther Clin Pract 2023; 52:101776. [PMID: 37402329 DOI: 10.1016/j.ctcp.2023.101776] [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: 04/27/2023] [Revised: 06/04/2023] [Accepted: 06/14/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND AND PURPOSE Hypnosis, a mind-body treatment dating back to early human history, has regained attention in the last decade, with research suggesting its effectiveness for varied physiological and psychological ailments such as distress, pain, and psychosomatic disorders. However, myths and misconceptions have prevailed among the general public and clinicians, hindering the adoption and acceptance of hypnosis. It is important to distinguish myths from facts and discern what is hypnosis and what is not to enhance the understanding, acceptance, and adoption of hypnotic interventions. METHODS This narrative review traces the history of myths surrounding hypnosis in contrast to the evolution of hypnosis as a treatment modality. In addition to comparing hypnosis to other interventions with similar procedures and features, the review unravels misconceptions that have impeded the adoption and acceptance of hypnosis in clinical and research settings and presents evidence to demystify this intervention. RESULTS This review examines the roots of myths while presenting historical facts and evidence that support hypnosis as a treatment modality and alleviate misconceptions depicting it as mystical. Further, the review distinguishes hypnotic and non-hypnotic interventions with overlapping procedures and phenomenological features to enhance our understanding of hypnotic techniques and phenomena. CONCLUSION This review enhances the understanding of hypnosis in historical, clinical, and research contexts by disproving related myths and misconceptions to promote the adoption of hypnosis in clinical and research contexts. Further, this review highlights knowledge gaps requiring further investigations to steer research toward an evidence-based practice of hypnosis and optimise multimodal therapies embedding hypnosis.
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Affiliation(s)
- Dali Geagea
- Child Health Research Centre, Centre for Children's Burns and Trauma Research, The University of Queensland, Brisbane, Australia.
| | - David Ogez
- Department of Anaesthesiology and Pain Medicine, University of Montreal, Montreal, Canada
| | - Roy Kimble
- Centre for Children's Burns and Trauma Research, Queensland Children's Hospital, The University of Queensland, Brisbane, Australia
| | - Zephanie Tyack
- Child Health Research Centre, Centre for Children's Burns and Trauma Research, The University of Queensland, Brisbane, Australia; Australian Centre for Health Service Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
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16
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Sodré ME, Wießner I, Irfan M, Schenck CH, Mota-Rolim SA. Awake or Sleeping? Maybe Both… A Review of Sleep-Related Dissociative States. J Clin Med 2023; 12:3876. [PMID: 37373570 DOI: 10.3390/jcm12123876] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 06/29/2023] Open
Abstract
Recent studies have begun to understand sleep not only as a whole-brain process but also as a complex local phenomenon controlled by specific neurotransmitters that act in different neural networks, which is called "local sleep". Moreover, the basic states of human consciousness-wakefulness, sleep onset (N1), light sleep (N2), deep sleep (N3), and rapid eye movement (REM) sleep-can concurrently appear, which may result in different sleep-related dissociative states. In this article, we classify these sleep-related dissociative states into physiological, pathological, and altered states of consciousness. Physiological states are daydreaming, lucid dreaming, and false awakenings. Pathological states include sleep paralysis, sleepwalking, and REM sleep behavior disorder. Altered states are hypnosis, anesthesia, and psychedelics. We review the neurophysiology and phenomenology of these sleep-related dissociative states of consciousness and update them with recent studies. We conclude that these sleep-related dissociative states have a significant basic and clinical impact since their study contributes to the understanding of consciousness and the proper treatment of neuropsychiatric diseases.
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Affiliation(s)
| | - Isabel Wießner
- Brain Institute, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
| | - Muna Irfan
- Department of Neurology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Carlos H Schenck
- Department of Neurology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Sergio A Mota-Rolim
- Brain Institute, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
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17
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Cyna AM, Hewson DW, Hardman JG. Clinical hypnosis: implications in anaesthesia and perioperative care. Br J Anaesth 2023; 130:647-650. [PMID: 36967280 DOI: 10.1016/j.bja.2023.02.024] [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: 01/27/2023] [Revised: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 05/19/2023] Open
Abstract
A randomised trial published in the British Journal of Anaesthesia describes hypnosis compared with general anaesthesia in 60 children undergoing superficial surgery. We describe a definition of clinical hypnosis; the goals and conduct of hypnotic communication; and its potential as both an adjunct and, in suitable cases, alternative to traditional pharmacological anaesthesia.
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Affiliation(s)
- Allan M Cyna
- Women's and Children's Hospital, North Adelaide, Australia; Discipline of Acute Care Medicine, University of Adelaide, Adelaide, Australia
| | - David W Hewson
- Department of Anaesthesia and Critical Care Medicine, Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK; Department of Anaesthesia, Queen's Medicine Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.
| | - Jonathan G Hardman
- Department of Anaesthesia and Critical Care Medicine, Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK; Department of Anaesthesia, Queen's Medicine Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
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18
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Carvalho V, Rangrej SB, Rathore R. The Benefits of Integrative Medicine for Pain Management in Oncology: A Narrative Review of the Current Evidence. Cureus 2023; 15:e41203. [PMID: 37525791 PMCID: PMC10387299 DOI: 10.7759/cureus.41203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2023] [Indexed: 08/02/2023] Open
Abstract
The aim of this evidence-based study is to narrate and evaluate the current evidence on recommendations for practicing physicians and other healthcare providers regarding integrative approaches to managing pain in patients with cancer. This review will assess the guideline recommendations and analyze the role of integrative medicine in addressing cancer pain in patients. The literature search highlights relevant studies that will inform evidence-based recommendations for practicing physicians, highlighting their relevance and weaknesses. Acupuncture, massage, and hypnosis have intermediate-strength evidence quality and are moderately recommended for various types of cancer pain. Most of the evidence points to acupuncture being recommended for aromatase inhibitor-related joint pain, hypnosis for procedural pain, and massage for palliative care pain. Other practices with lower-quality evidence include yoga and guided imagery with progressive muscle relaxation, mostly recommended for general cancer pain or musculoskeletal pain. Additionally, music therapy is recommended for procedural or surgical pain. Low-quality or inconclusive evidence was found for other mind-body interventions or natural products. Similarly, there is insufficient evidence to provide recommendations for pediatric patients. Further research is required to enhance our understanding of the role of integrative medicine interventions in caring for cancer patients.
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Affiliation(s)
| | - Shahid B Rangrej
- Anatomy/Research, Saint James School of Medicine, Arnos Vale, VCT
| | - Rajni Rathore
- Pharmacology and Therapeutics, Saint James School of Medicine, Arnos Vale, VCT
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19
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Geagea D, Tyack Z, Kimble R, Polito V, Ayoub B, Terhune DB, Griffin B. Clinical Hypnosis for Procedural Pain and Distress in Children: A Scoping Review. PAIN MEDICINE (MALDEN, MASS.) 2023; 24:661-702. [PMID: 36448690 PMCID: PMC10233484 DOI: 10.1093/pm/pnac186] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 07/25/2023]
Abstract
OBJECTIVE Pain and distress are common in children undergoing medical procedures, exposing them to acute and chronic biopsychosocial impairments if inadequately treated. Clinical hypnosis has emerged as a potentially beneficial treatment for children's procedural pain and distress due to evidence of effectiveness and potential superiority to other psychological interventions. However, systematic reviews of clinical hypnosis for children's procedural pain and distress have been predominantly conducted in children undergoing oncology and needle procedures and are lacking in broader pediatric contexts. This scoping review maps the evidence of clinical hypnosis for children's procedural pain and distress across broad pediatric contexts while highlighting knowledge gaps and areas requiring further investigation. METHODS Published databases (PubMed, Cochrane Library, PsycINFO, Embase, CINAHL, Scopus, and Web of Science) and grey literature were searched in addition to hand-searching reference lists and key journals (up to May 2022). Two independent reviewers screened the titles and abstracts of search results followed by a full-text review against eligibility criteria. Articles were included if they involved a clinical hypnosis intervention comprising an induction followed by therapeutic suggestions for pain and distress in children undergoing medical procedures. This review followed the Arksey and O'Malley (2005) methodology and incorporated additional scoping review recommendations by the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses. RESULTS A total of 38 eligible studies involving 2,205 children were included after 4,775 articles were screened. Research on clinical hypnosis for children's procedural pain and distress was marked by a lack of fidelity measures and qualitative data as well as by inadequate intervention reporting and high attrition rates. Evidence regarding the safety of clinical hypnosis, pain unpleasantness outcomes, factors influencing outcomes, as well as barriers and facilitators to implementing hypnosis and study procedures was also lacking. Clinical hypnosis has potential benefits for children's procedural pain and distress based on evidence of superiority to control conditions and nonpharmacological interventions (e.g., distraction, acupressure) with moderate to large effect sizes as reported in 76% of studies. However, heterogeneous interventions, contexts, study designs, and populations were identified, and the certainty of the evidence was not evaluated. CONCLUSIONS The review suggests potential benefits of clinical hypnosis for children's procedural pain and distress and thus provides a precursor for further systematic reviews and trials investigating the effectiveness of clinical hypnosis. The review also indicates the need to further explore the feasibility, acceptability, implementation, and safety of clinical hypnosis in children undergoing painful procedures. Based on the review, researchers implementing clinical hypnosis should adequately report interventions or use treatment manuals, follow recommended research guidelines, and assess the fidelity of intervention delivery to promote replicating and comparing interventions. The review also highlights common methodological shortcomings of published trials to avoid, such as the lack of implementation frameworks, small sample sizes, inadequate reporting of standard care or control conditions, and limited evidence on pain unpleasantness outcomes.
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Affiliation(s)
- Dali Geagea
- Child Health Research Centre, Centre for Children's Burns and Trauma Research, The University of Queensland, Brisbane, Australia
| | - Zephanie Tyack
- Child Health Research Centre, Centre for Children's Burns and Trauma Research, The University of Queensland, Brisbane, Australia
- Australian Centre for Health Service Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Roy Kimble
- Centre for Children's Burns and Trauma Research, Queensland Children's Hospital, The University of Queensland, Brisbane, Australia
| | - Vince Polito
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Bassel Ayoub
- Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Devin B Terhune
- Department of Psychology, Goldsmiths University of London, London, UK
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Bronwyn Griffin
- School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia
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20
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Bastek V, van Vliet M. A whole new world of healing: exploring medical hypnotherapy for pediatric patients : A review. Eur J Pediatr 2023:10.1007/s00431-023-04983-5. [PMID: 37145215 PMCID: PMC10160735 DOI: 10.1007/s00431-023-04983-5] [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: 01/19/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 05/06/2023]
Abstract
This narrative review aims to unravel the potential of medical hypnotherapy for the treatment of children with a variety of diseases and symptoms. Going beyond its history and assumed neurophysiology, the chances of success for hypnotherapy will be outlined per pediatric speciality, accentuated by clinical research and experiences. Future implications and recommendations are given on extracting the positive effects of medical hypnotherapy for all pediatricians. Conclusion: Medical hypnotherapy is an effective treatment for children with specified conditions such as abdominal pain or headache. Studies suggest effectiveness for other pediatric disciplines, from the first line up to third line of care. In a time in which health is defined as 'a state of complete physical, mental and social well-being', hypnotherapy stays an underrated treatment option for children. It is a unique mind-body treatment, which true potential still needs to be unraveled. What is Known: • Mind-body health techniques become a more relevant and accepted part of treatment in pediatric patients. • Medical hypnotherapy is an effective treatment for children with specified conditions such as functional abdominal pain. What is New: • Studies suggest the effectiveness of hypnotherapy in a high variety of pediatric symptoms and disease. • Hypnotherapy is a unique mind-body treatment which potential goes far beyond its current utilization.
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Affiliation(s)
- Vanessa Bastek
- Department of Child And Adolescent Psychiatry, Klinikum Region Hannover GmbH, Wunstorf, Germany
| | - Michel van Vliet
- Department of Social Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
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21
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Schein B, Beltran G, França BR, Sanches PRS, Silva Jr DP, Torres IL, Fegni F, Caumo W. Effects of Hypnotic Analgesia and Transcranial Direct Current Stimulation on Pain Tolerance and Corticospinal Excitability in Individuals with Fibromyalgia: A Cross-Over Randomized Clinical Trial. J Pain Res 2023; 16:187-203. [PMID: 36718400 PMCID: PMC9884000 DOI: 10.2147/jpr.s384373] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/28/2022] [Indexed: 01/24/2023] Open
Abstract
Objective We compare the effect of HAS, a-tDCS on the left dorsolateral prefrontal cortex (l-DLPFC), and rest-testing on pain measures [(cold pressor test (CPT) (primary outcome) and heat pain threshold]. We also compare their effects on the motor evoked potential (MEP) (primary outcome), short intracortical inhibition (SICI), intracortical facilitation (ICF), and cortical silent period (CSP). Methods This randomized, blind, crossover trial included 18 women with fibromyalgia, aged from 18 to 65 years old. They received at random and in a crossover order a-tDCS over the l-DLPFC (2mA), HAS, or a rest-testing. Results HAS compared to a-tDCS increased the pain tolerance with a moderate effect size (ES) [Cohen's f=-0.78; (CI 95%; -1.48 to -0.12)]. While compared to rest-testing, HAS increased the CPT with a large ES [Cohen's f=-0.87; (CI 95%; -1.84 to -0.09)]. The a-tDCS compared to HAS increased the MEP amplitude with large ES [Cohen's f=-1.73 (CI 95%; -2.17 to -0.17)]. Likewise, its ES compared to rest-testing in the MEP size was large [Cohen's f=-1.03; (CI 95%; -2.06 to -0.08)]. Conclusion These findings revealed that HAS affects contra-regulating mechanisms involved in perception and pain tolerance, while the a-tDCS increased the excitability of the corticospinal pathways. They give a subsidy to investigate their effect as approaches to counter regulate the maladaptive neuroplasticity involved in fibromyalgia. Clinical Trial Registration www.ClinicalTrials.gov, identifier - NCT05066568.
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Affiliation(s)
- Bruno Schein
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul (RS), Brazil,Laboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Gerardo Beltran
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul (RS), Brazil,Laboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil,Institute of Neurosciences, Universidad Catolica de Cuenca, Cuenca, Ecuador
| | - Bárbara Regina França
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul (RS), Brazil,Laboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | | | | | - Iraci Lucena Torres
- Pain and Palliative Care Service, HCPA, Porto Alegre, RS, Brazil,Laboratory of Pharmacology of Pain and Neuromodulation, Experimental Research Center, HCPA, Porto Alegre, RS, Brazil
| | - Felipe Fegni
- Laboratory of Neuromodulation and Center for Clinical Research Learning, Physics and Rehabilitation Department, Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Wolnei Caumo
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul (RS), Brazil,Laboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil,Pain and Palliative Care Service, HCPA, Porto Alegre, RS, Brazil,Department of Surgery, School of Medicine, UFRGS, Porto Alegre, RS, Brazil,Correspondence: Wolnei Caumo, Laboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre at UFRGS, Ramiro Barcelos, 2350 - CEP 90035-003 Bairro Rio Branco, Porto Alegre, RS, Brazil, Tel/Fax +55 51- 33598083, Email
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Abrahamsen R, Naish P. Studies in patients with temporomandibular disorders pain: Can scales of hypnotic susceptibility predict the outcome on pain relief? AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2022; 64:12-19. [PMID: 34748465 DOI: 10.1080/00029157.2020.1863183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Many medical conditions are claimed to benefit when hypnosis is incorporated into their treatment. For some conditions, the claims are largely anecdotal, but the treatment of pain stands out in two ways. First, there is a strong body of evidence that hypnosis can produce clinically useful analgesic effects. Second, since innocuous pain can be induced in the laboratory, the process can be explored rigorously. This idea assumes that experimentally induced pain and clinical pain behave identically. We describe using experimentally induced pain in patients already suffering from temporomandibular disorders. Scanning results indicate that the pain and its amelioration are the same in the two circumstances. Moreover, the absence of any impact upon a nociceptive trigemino-facial reflex implies that the impact of hypnosis is purely cortical. Finally, we address the observation that clinical success correlates poorly with hypnotic susceptibility scores. It is proposed that a painful experimental situation induces anxiety. This, like hypnosis, has been associated with an emphasis on right hemisphere activity. Thus, clinical anxiety may render a person more responsive to hypnosis than would be indicated by a susceptibility test delivered in stress-free circumstances.
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23
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Sciortino P, Kayser C. The rubber hand illusion is accompanied by a distributed reduction of alpha and beta power in the EEG. PLoS One 2022; 17:e0271659. [PMID: 35905100 PMCID: PMC9337658 DOI: 10.1371/journal.pone.0271659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 07/05/2022] [Indexed: 11/18/2022] Open
Abstract
Previous studies have reported correlates of bodily self-illusions such as the rubber hand in signatures of rhythmic brain activity. However, individual studies focused on specific variations of the rubber hand paradigm, used different experimental setups to induce this, or used different control conditions to isolate the neurophysiological signatures related to the illusory state, leaving the specificity of the reported illusion-signatures unclear. We here quantified correlates of the rubber hand illusion in EEG-derived oscillatory brain activity and asked two questions: which of the observed correlates are robust to the precise nature of the control conditions used as contrast for the illusory state, and whether such correlates emerge directly around the subjective illusion onset. To address these questions, we relied on two experimental configurations to induce the illusion, on different non-illusion conditions to isolate neurophysiological signatures of the illusory state, and we implemented an analysis directly focusing on the immediate moment of the illusion onset. Our results reveal a widespread suppression of alpha and beta-band activity associated with the illusory state in general, whereby the reduction of beta power prevailed around the immediate illusion onset. These results confirm previous reports of a suppression of alpha and beta rhythms during body illusions, but also highlight the difficulties to directly pinpoint the precise neurophysiological correlates of the illusory state.
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Affiliation(s)
- Placido Sciortino
- Department of Cognitive Neuroscience, Faculty of Biology, Bielefeld University, Bielefeld, Germany
- * E-mail:
| | - Christoph Kayser
- Department of Cognitive Neuroscience, Faculty of Biology, Bielefeld University, Bielefeld, Germany
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24
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Geagea D, Griffin B, Kimble R, Polito V, Terhune DB, Tyack Z. Hypnotherapy for procedural pain, itch, and state anxiety in children with acute burns: a feasibility and acceptability study protocol. Pilot Feasibility Stud 2022; 8:58. [PMID: 35264248 PMCID: PMC8905723 DOI: 10.1186/s40814-022-01017-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Burns and related procedures are painful and distressing for children, exposing them to acute and chronic sequelae that can negatively affect their physiological, psychological, and social functions. Non-pharmacological interventions such as distraction techniques are beneficial adjuncts to pharmacological agents for procedural pain, state anxiety, and itch in children with burns but have limitations (e.g. lack of research on burn-related itch, tailoring, and consensus on optimal treatment). Hypnotherapy is a non-pharmacological intervention that can be tailored for varied settings and populations with evidence of benefit for itch and superior effectiveness in comparison to other non-pharmacological interventions for children’s procedural pain and state anxiety. Thus, children with burns can benefit from hypnotherapy as an adjunct to pharmacological agents. Yet, in paediatric burns, rigorous studies of effectiveness are limited and no studies have been identified that screen for hypnotic suggestibility, an important predictor of hypnotherapy outcomes. Considering potential barriers to the delivery of hypnotherapy in paediatric burns, the proposed study will examine the feasibility and acceptability of hypnotic suggestibility screening followed by hypnotherapy for procedural pain, state anxiety, and itch in children with acute burns. Methods An observational mixed-methods feasibility and acceptability study will be conducted over 15 weeks. Eligible children (N = 30) aged 4 to 16 years presenting to a paediatric burns outpatient centre in a metropolitan children’s hospital in Australia with acute burns requiring dressing changes will be included. Eligible parents of children (N = up to 30) and clinicians who perform dressing changes (N = up to 20) will also be included. Child participants screened as having medium to high suggestibility as assessed by behavioural measures will receive hypnotherapy during dressing changes. A process evaluation will target feasibility and acceptability as primary outcomes and implementation (i.e. fidelity in delivery), reach, potential effectiveness, and adoption of evaluation procedures and intervention as secondary outcomes. Discussion Ethical approval was obtained from the Queensland Children’s Hospital and Health Service ethics committee. Results will be published in peer-reviewed publications and conference proceedings. The findings will guide the design of future trials on the effectiveness of hypnotherapy and inform the development of child-centred hypnotic interventions in children with burns. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12620000988954 Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01017-z.
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Affiliation(s)
- Dali Geagea
- Centre for Children's Burns and Trauma Research, Centre for Children's Health Research, Level 7, 62 Graham Street, South Brisbane, QLD, 4101, Australia. .,Faculty of Medicine, The University of Queensland, Brisbane, QLD, 4067, Australia.
| | - Bronwyn Griffin
- Centre for Children's Burns and Trauma Research, Centre for Children's Health Research, Level 7, 62 Graham Street, South Brisbane, QLD, 4101, Australia.,Faculty of Health, School of Nursing, Queensland University of Technology, Kelvin Grove, QLD, 4058, Australia.,Pegg Leditschke Paediatric Burns Centre, The Queensland Children's Hospital, South Brisbane, QLD, 4101, Australia
| | - Roy Kimble
- Centre for Children's Burns and Trauma Research, Centre for Children's Health Research, Level 7, 62 Graham Street, South Brisbane, QLD, 4101, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, QLD, 4067, Australia.,Faculty of Health, School of Nursing, Queensland University of Technology, Kelvin Grove, QLD, 4058, Australia.,Pegg Leditschke Paediatric Burns Centre, The Queensland Children's Hospital, South Brisbane, QLD, 4101, Australia
| | - Vince Polito
- School of Psychological Sciences, Macquarie University, Macquarie Park, NSW, 2109, Australia
| | - Devin B Terhune
- Department of Psychology, Goldsmiths University of London, London, SE14 6NW, UK
| | - Zephanie Tyack
- Centre for Children's Burns and Trauma Research, Centre for Children's Health Research, Level 7, 62 Graham Street, South Brisbane, QLD, 4101, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, QLD, 4067, Australia.,Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, Queensland University of Technology, Kelvin Grove, QLD, 4059, Australia
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25
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Grégoire C, Marie N, Sombrun C, Faymonville ME, Kotsou I, van Nitsen V, de Ribaucourt S, Jerusalem G, Laureys S, Vanhaudenhuyse A, Gosseries O. Hypnosis, Meditation, and Self-Induced Cognitive Trance to Improve Post-treatment Oncological Patients' Quality of Life: Study Protocol. Front Psychol 2022; 13:807741. [PMID: 35222195 PMCID: PMC8866821 DOI: 10.3389/fpsyg.2022.807741] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction A symptom cluster is very common among oncological patients: cancer-related fatigue (CRF), emotional distress, sleep difficulties, pain, and cognitive difficulties. Clinical applications of interventions based on non-ordinary states of consciousness, mostly hypnosis and meditation, are starting to be investigated in oncology settings. They revealed encouraging results in terms of improvements of these symptoms. However, these studies often focused on breast cancer patients, with methodological limitations (e.g., small sample size, no control group, and no follow-up). Another non-ordinary state of consciousness may also have therapeutic applications in oncology: self-induced cognitive trance (SICT). It seems to differ from hypnosis and meditation, as it involves the body more directly. Thus, investigating its clinical applications, along with hypnosis and meditation interventions, could improve available therapeutic options in oncology. This article details the study protocol of a preference-based longitudinal controlled superiority trial aiming to assess the effectiveness of 3 group interventions (hypnosis, meditation, and SICT) to improve oncological patients’ quality of life, and more specifically CRF, emotional distress, sleep, pain, and cognitive difficulties (primary outcomes). Methods and analysis A power analysis required a total sample of 160 patients. Main inclusion criteria are: cancer diagnosis, active treatments completed for less than a year, no practice of hypnosis, meditation, or SICT, and presence of at least one of these four symptoms: fatigue, sleep difficulties, depression, or anxiety. Each participant will choose the intervention in which they want to participate (hypnosis, mindful self-compassion meditation, SICT, or no intervention—control group). To test the effectiveness of the interventions, data will be collected by questionnaires and neurobiological measures and directly from the medical record at four time points: before inclusion in the study (baseline); immediately after the intervention; and at 3- and 12-month follow-up. The longitudinal data in each group will then be measured. Discussion In addition to standard cancer therapies, there is a growing interest from patients in complementary approaches, such as hypnosis, meditation, and SICT. The results of this study will be useful to increase knowledge about short- and long-term effectiveness of 3 group interventions for CRF, emotional distress, sleep, pain, and cognitive difficulties in patients with different cancers. Clinical Trial Registration ClinicalTrials.gov/ (NCT04873661). Retrospectively registered on the 29th of April 2021. url: https://clinicaltrials.gov/ct2/show/NCT04873661
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Affiliation(s)
- Charlotte Grégoire
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium.,Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
| | - Nolwenn Marie
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium.,Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
| | | | - Marie-Elisabeth Faymonville
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium.,Arsène Burny Cancerology Institute, CHU Liège, Liège, Belgium
| | - Ilios Kotsou
- Faculty of Psychology and Educational Sciences, Free University of Brussels and Emergences Association, Brussels, Belgium
| | - Valérie van Nitsen
- Faculty of Psychology and Educational Sciences, Free University of Brussels and Emergences Association, Brussels, Belgium
| | - Sybille de Ribaucourt
- Faculty of Psychology and Educational Sciences, Free University of Brussels and Emergences Association, Brussels, Belgium
| | - Guy Jerusalem
- Medical Oncology Department, CHU Liège and University of Liège, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau2, CHU Liège, Liège, Belgium
| | - Audrey Vanhaudenhuyse
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium.,Algology Interdisciplinary Center, CHU Liège, Liège, Belgium
| | - Olivia Gosseries
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium.,Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau2, CHU Liège, Liège, Belgium
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26
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Langlois P, Perrochon A, David R, Rainville P, Wood C, Vanhaudenhuyse A, Pageaux B, Ounajim A, Lavallière M, Debarnot U, Luque-Moreno C, Roulaud M, Simoneau M, Goudman L, Moens M, Rigoard P, Billot M. Hypnosis to manage musculoskeletal and neuropathic chronic pain: a systematic review and meta-analysis. Neurosci Biobehav Rev 2022; 135:104591. [DOI: 10.1016/j.neubiorev.2022.104591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/17/2022] [Accepted: 02/17/2022] [Indexed: 12/22/2022]
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27
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Berner A, Tobler C, Reinmann-Assouline M, Degrauwe S, Coen M. Arrhythmia conversion to sinus rhythm during a hypnosis: Is hypnosis a normal bystander or a guilty accomplice? INTERNATIONAL JOURNAL OF CARDIOLOGY. HEART & VASCULATURE 2022; 38:100930. [PMID: 35024427 PMCID: PMC8724937 DOI: 10.1016/j.ijcha.2021.100930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/25/2021] [Accepted: 12/14/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Amandine Berner
- Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Caroline Tobler
- Department of Pediatrics, Fribourg Hospital HFR, Fribourg, Switzerland
| | | | - Sophie Degrauwe
- Cardiology Division, Geneva University Hospitals, Geneva, Switzerland
| | - Matteo Coen
- Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland.,Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, Geneva, Switzerland
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28
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Bauer PR, Sabourdy C, Chatard B, Rheims S, Lachaux JP, Vidal JR, Lutz A. Neural dynamics of mindfulness meditation and hypnosis explored with intracranial EEG: A feasibility study. Neurosci Lett 2022; 766:136345. [PMID: 34785313 DOI: 10.1016/j.neulet.2021.136345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/26/2021] [Accepted: 11/09/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE Intracranial electroencephalography (iEEG) offers a unique window on brain dynamics with excellent temporal and spatial resolution and is less prone to recording artefacts than surface EEG. This study used a within-subject design to explore the feasibility to compare iEEG data during mind wandering, mindfulness meditation and hypnosis. RESULTS Three patients who had iEEG for clinical monitoring and who were new to mindfulness meditation and hypnosis were able to enter these states. We found non-specific and wide-spread amplitude modulations. Data-driven connectivity analysis revealed widespread connectivity patterns that were common across the three conditions. These were predominant in the low frequencies (delta, theta and alpha) and characterised by positively correlated activity. Connectivity patterns that were unique to the three conditions predominated in the gamma band, one third of the correlations in these patterns were negative. CONCLUSIONS This study is the first to support the feasibility of a direct comparison of the neural correlates of mindfulness meditation and hypnosis using iEEG. These modulations may reflect the complex interplay between different known brain networks, and warrant further functional investigations in particular in the gamma band.
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Affiliation(s)
- Prisca R Bauer
- Lyon Neuroscience Research Center, INSERM U1028 - CNRS UMR5292 -Lyon 1 University, Centre Hospitalier Le Vinatier (Bât. 462) - Neurocampus, 95 Bd Pinel, 69675 Bron cédex, France; Department of Psychosomatic Medicine and Psychotherapy University Medical Center Freiburg, Faculty of Medicine, University of Freiburg Freiburg, Germany.
| | - Cécile Sabourdy
- Neurophysiology Unit, Division of Neurology, Grenoble Alpes University, Grenoble, France
| | - Benoît Chatard
- Lyon Neuroscience Research Center, INSERM U1028 - CNRS UMR5292 -Lyon 1 University, Centre Hospitalier Le Vinatier (Bât. 462) - Neurocampus, 95 Bd Pinel, 69675 Bron cédex, France
| | - Sylvain Rheims
- Lyon Neuroscience Research Center, INSERM U1028 - CNRS UMR5292 -Lyon 1 University, Centre Hospitalier Le Vinatier (Bât. 462) - Neurocampus, 95 Bd Pinel, 69675 Bron cédex, France; Department of Functional Neurology and Epileptology, Hospices Civils de Lyon and Lyon 1 University, Lyon, France
| | - Jean-Philippe Lachaux
- Lyon Neuroscience Research Center, INSERM U1028 - CNRS UMR5292 -Lyon 1 University, Centre Hospitalier Le Vinatier (Bât. 462) - Neurocampus, 95 Bd Pinel, 69675 Bron cédex, France
| | - Juan R Vidal
- Catholic University of Lyon, Sciences and Humanities Confluence Research Center, 2 Place des Archives, 69002 Lyon, France
| | - Antoine Lutz
- Lyon Neuroscience Research Center, INSERM U1028 - CNRS UMR5292 -Lyon 1 University, Centre Hospitalier Le Vinatier (Bât. 462) - Neurocampus, 95 Bd Pinel, 69675 Bron cédex, France
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29
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Michel-Cherqui M, Szekely B, Fessler J, Glorion M, Sage E, Le Guen M, Trichereau J, Vallée A, Fischler M. Feasibility and usefulness of self-hypnosis in patients undergoing double-lung transplantation during the pre and postoperative periods: A randomized study. J Cardiothorac Vasc Anesth 2022; 36:2490-2499. [DOI: 10.1053/j.jvca.2022.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/20/2021] [Accepted: 01/19/2022] [Indexed: 11/11/2022]
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Effectiveness of Hypnoanalgesia in Paediatric Dermatological Surgery. CHILDREN 2021; 8:children8121195. [PMID: 34943391 PMCID: PMC8700317 DOI: 10.3390/children8121195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 12/02/2021] [Accepted: 12/08/2021] [Indexed: 11/16/2022]
Abstract
Background and objective. Stress in surgical settings has subtle psychological and physiological repercussions in children. The objective is to evaluate whether hypnosedation is effective in reducing the doses of sedation and analgesia required during the periprocedural period in children undergoing dermatological surgery, without negatively affecting pain and satisfaction. Patients and methods: A prospective, longitudinal, observational study where paediatric patients (aged 5–16 years) scheduled for dermatological surgery were analysed according to whether they received hypnosis or distraction during surgery (both common procedures at the centre). As outcome measurements we used sedation doses (propofol) during surgery and the need for analgesia; pain assessment post-surgery and at 24 h using a visual analogue scale (VAS) or revised face pain scale (FPS-r) (both 0–10) depending on age, as well as patient and guardian satisfaction (on a scale of 0–10). Results: Of the 68 patients eligible during the follow-up period, 65 were included. Of these, 33 were treated with hypnosis and 32 with distraction. Children who underwent hypnosis required less total propofol (45.5 ± 11.8 mg vs. 69.3 ± 16.8 mg; p < 0.001) and metamizole in the immediate postoperative period (34.4% vs. 65.6%; p = 0.018). After 24 h, they required less ibuprofen (9.1% vs. 28.1%; p = 0.048) and paracetamol (48.5% vs. 75.0%; p = 0.028). Mean pain according to VAS or FPS-r at 24 h was 3.1 with hypnosis vs. 4.3 with distraction (p < 0.001). Overall satisfaction was higher in the hypnosis group (8.7 ± 0.1 vs. 8.1 ± 0.2; p = 0.009). Conclusions: Hypnoanalgesia in children undergoing dermatological outpatient surgery could not only reduce sedation and analgesia requirements, but also improve child and guardian(s) satisfaction.
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31
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Geagea D, Tyack Z, Kimble R, Eriksson L, Polito V, Griffin B. Hypnotherapy for Procedural Pain and Distress in Children: A Scoping Review Protocol. PAIN MEDICINE (MALDEN, MASS.) 2021; 22:2818-2826. [PMID: 33528510 PMCID: PMC8665999 DOI: 10.1093/pm/pnab038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Inadequately treated pain and distress elicited by medical procedures can put children at higher risk of acute and chronic biopsychosocial sequelae. Children can benefit from hypnotherapy, a psychologically tailored intervention, as an adjunct to pharmacological agents to address the multiple components of pain and distress. Despite providing evidence on the effectiveness and potential superiority of hypnotherapy to other psychological interventions, research on hypnotherapy for pediatric procedural pain and distress has been predominantly limited to oncology and needle procedures. Plus, there is a lack of reporting of intervention manuals, factors influencing hypnotic responding, pain unpleasantness outcomes, theoretical frameworks, adverse events, as well as barriers and facilitators to the feasibility of delivering the intervention and study procedures. The proposed review aims to map the range and nature of the evidence on hypnotherapy for procedural pain and distress in children to identify gaps in literature and areas requiring further investigation. METHODS This review will follow the Arksey and O'Malley (2005) methodology and incorporate additional scoping review recommendations by the Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses. Relevant studies will be identified through searching published literature databases (PubMed, Cochrane Library, PsycINFO, Embase, CINAHL, Scopus and Web of Science) and grey literature in addition to hand-searching of reference lists and key journals. Two authors will independently screen titles and abstracts of search results followed by full-texts review against eligibility criteria. CONCLUSION Findings are anticipated to guide future research and inform the development of tailored hypnotic interventions in children.
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Affiliation(s)
- Daly Geagea
- Centre for Children’s Burns and Trauma Research, The University of Queensland, Brisbane, Australia
| | - Zephanie Tyack
- Centre for Children’s Burns and Trauma Research, The University of Queensland, Brisbane, Australia
| | - Roy Kimble
- Centre for Children’s Burns and Trauma Research, The University of Queensland, Brisbane, Australia
| | - Lars Eriksson
- Herston Health Sciences Library, The University of Queensland, Brisbane, Australia
| | - Vince Polito
- Department of Cognitive Science, Macquarie University, Sydney, Australia
| | - Bronwyn Griffin
- Centre for Children’s Burns and Trauma Research, The University of Queensland, Brisbane, Australia
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32
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Coogle J, Coogle B, Quezada J. Hypnosis in the Treatment of Pediatric Functional Neurological Disorder: The Magic Glove Technique. Pediatr Neurol 2021; 125:20-25. [PMID: 34624606 DOI: 10.1016/j.pediatrneurol.2021.08.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 08/27/2021] [Accepted: 08/29/2021] [Indexed: 10/20/2022]
Abstract
The treatment of functional neurological disorder (FND), previously referred to as conversion disorder, can be challenging. Despite these challenges and with increased understanding of this condition, new treatment options are emerging. One such treatment is hypnosis, which has a long history of use in the treatment of FND. Jean-Martin Charcot, considered by many to be the father of modern neurology, used therapeutic hypnosis as early as the 19th century. In this report, we discuss the novel use of a hypno-anesthetic technique (the magic glove) for treatment of FND presenting as diplegia. We illustrate the use of the technique with the case of a 9-year-old girl who suffered from chronic pain and lower extremity weakness secondary to FND. With the magic glove technique, she improved rapidly and was free of symptoms by her sixth month follow-up visit. We review the current literature on FND interventions and emphasize the need for continued research in this field.
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Affiliation(s)
- Justin Coogle
- Child Neurology Resident at Children's Mercy, Kansas City, Missouri.
| | - Brianna Coogle
- Internal Medicine Resident at The University of Kansas Health System and The University of Kansas School of Medicine, Kansas City, Kansas
| | - Julio Quezada
- Division of Neurology, Department of Pediatrics, Children's Mercy Kansas City, University of Missouri, Kansas City, Missouri
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33
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De Benedittis G. Neural Mechanisms of Hypnosis and Meditation-Induced Analgesia: A Narrative Review. Int J Clin Exp Hypn 2021; 69:363-382. [PMID: 33960912 DOI: 10.1080/00207144.2021.1917294] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Meditation and hypnosis have both been found to attenuate pain; however, little is known about similarities and differences in the cognitive modulation of pain. Hypnotic and meditative states (e.g., mindfulness) reduce pain by sharing and overlapping multiple neuro-cognitive mechanisms, but they differ in many respects. While there are overlapping brain networks involved, the nature of these effects seems different. Both phenomena involve frontal modulation of pain-related areas. The role of the dorsolateral prefrontal cortex appears to depend, in hypnosis, on the type of suggestion given and, in meditation, on the level of practice. Whereas the anterior cingulate cortex seems to be a key node in both hypnosis and meditation, the dorsolateral prefrontal cortex appears to engage in hypnosis as a function of suggestion and, in meditation, as a function of proficiency.
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34
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Hiltunen S, Karevaara M, Virta M, Makkonen T, Kallio S, Paavilainen P. No evidence for theta power as a marker of hypnotic state in highly hypnotizable subjects. Heliyon 2021; 7:e06871. [PMID: 33997402 PMCID: PMC8102752 DOI: 10.1016/j.heliyon.2021.e06871] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/19/2020] [Accepted: 04/16/2021] [Indexed: 10/28/2022] Open
Abstract
EEG spectral-power density was analyzed in a group of nine highly hypnotizable subjects via ten frontal, central, parietal, and occipital electrodes under four conditions: 1) wake state, 2) neutral hypnosis, 3) hypnotic suggestion for altering perception of tones, and 4) post-hypnosis. Results indicate no theta-power changes between conditions, challenging previous findings that increased theta power is a marker of hypnosis. A decrease in gamma power under hypnotic suggestion and an almost significant decrease under neutral hypnosis were observed, compared to post-hypnosis. Anteroposterior power distribution remained stable over all conditions. The results are discussed and compared to earlier studies, which report heterogenous findings.
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Affiliation(s)
- Seppo Hiltunen
- Teaching and Learning Services, University Services, University of Helsinki, Finland.,Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Maria Karevaara
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Maarit Virta
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Tommi Makkonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland.,Cognitive Brain Research Unit, Department of Psychology and Logopedics, University of Helsinki, Finland
| | - Sakari Kallio
- Department of Cognitive Neuroscience and Philosophy, School of Bioscience, University of Skövde, Sweden.,Centre for Cognitive Neuroscience, University of Turku, Finland
| | - Petri Paavilainen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland.,Cognitive Brain Research Unit, Department of Psychology and Logopedics, University of Helsinki, Finland
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35
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Ouadfel A, El Sanharawi M, Tahiri Joutei Hassani R. [Contribution of respiratory relaxation techniques during intravitreal injections: A pilot study]. J Fr Ophtalmol 2021; 44:842-848. [PMID: 33840495 DOI: 10.1016/j.jfo.2020.09.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 08/27/2020] [Accepted: 09/03/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE To study the effects of breathing techniques for anxiety, perceived pain, and patient satisfaction while receiving intravitreal injections. METHOD This prospective, randomized clinical study included patients admitted for intravitreal anti-VEGF injections. They were randomized into two groups: a relaxation group who listened to a prerecorded relaxation breathing session before and during the injection, and a control group who received the injection without a relaxation session. Statistical analysis was then performed to assess the factors influencing satisfaction, anxiety, and perceived pain. RESULTS We included one-hundred four patients in total: 52 in the relaxation group versus 52 in the control group. The relaxation group had a greater decrease in anxiety than the control group (P=0.03) but similar levels of pain (P=0.86). In total, 80.76% of patients in the relaxation group expressed the wish to have a relaxation session during their next injection. Multivariate analysis showed that the patient's usual level of stress as well as the relaxation session affected the level of anxiety experienced before the injection. CONCLUSION Relaxation techniques before and during intravitreal injections decrease anxiety in patients without decreasing pain during IVT. Prerecorded relaxation breathing sessions are non-invasive, inexpensive, easy to set up, and reduce anxiety during intravitreal injections on an outpatient basis.
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Affiliation(s)
- A Ouadfel
- Service de chirurgie ambulatoire, centre hospitalier d'Avranches-Granville, Granville, France; Service d'ophtalmologie, CHU d'Oujda, Université Mohammed-VI, Oujda, Maroc
| | - M El Sanharawi
- Service d'ophtalmologie, centre hospitalier intercommunal de Villeneuve Saint-Georges, Villeneuve-Saint-Georges, France; Unité de dépistage et de chirurgie ophtalmologique, centre hospitalier de Châteaudun, Châteaudun, France
| | - R Tahiri Joutei Hassani
- Service de chirurgie ambulatoire, centre hospitalier d'Avranches-Granville, Granville, France.
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36
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Oakley DA, Walsh E, Mehta MA, Halligan PW, Deeley Q. Direct verbal suggestibility: Measurement and significance. Conscious Cogn 2021; 89:103036. [DOI: 10.1016/j.concog.2020.103036] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 08/19/2020] [Accepted: 10/09/2020] [Indexed: 10/22/2022]
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37
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Corpus callosum size, hypnotic susceptibility and empathy in women with alleged mediumship: a controlled study. Explore (NY) 2021; 18:217-225. [PMID: 33478904 DOI: 10.1016/j.explore.2021.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/16/2020] [Accepted: 01/08/2021] [Indexed: 11/20/2022]
Abstract
AIM Evidence indicates that highly hypnotizable subjects may have larger area of the rostrum of the corpus callosum (CC). Mediumship can be defined as the alleged ability to communicate regularly with deceased personalities, and self-hypnosis is postulated as an underlying mechanism for this ability. Therefore, we aimed to investigate the CC area, hypnotic susceptibility, self-reported dissociation, and empathy in alleged mediums in comparison with healthy, non-medium controls. METHODS The study sample consisted of 16 Spiritist mediums (medium group (MG)) and 16 non-medium controls. Magnetic resonance imaging scans were performed to measure the CC areas (total and subdivisions). The Harvard Group Scale of Hypnotic Susceptibility was used to assess hypnotizability, and self-reported measures were used to investigate anomalous experiences, mental health using the Self-Reporting Questionnaire-SRQ, dissociative experiences using the Dissociative Experiences Scale, and empathy using the Interpersonal Reactivity Index. RESULTS No between-group differences were found in the total or subdivided CC areas or in hypnotizability, with both groups showing intermediate levels. The rostrum of the CC area and hypnotizability were not correlated. The MG presented with significantly more anomalous experiences, but the two groups had similar scores for dissociation, empathy, and mental health. CONCLUSION The normal CC areas found in the MG are in contrast with the abnormal results typically observed in subjects with psychotic and dissociative disorders. Although hypnotizability was not different between groups, further studies are needed to replicate these findings in other samples.
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Perri RL, Bianco V, Facco E, Di Russo F. Now You See One Letter, Now You See Meaningless Symbols: Perceptual and Semantic Hypnotic Suggestions Reduce Stroop Errors Through Different Neurocognitive Mechanisms. Front Neurosci 2021; 14:600083. [PMID: 33510612 PMCID: PMC7835729 DOI: 10.3389/fnins.2020.600083] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/30/2020] [Indexed: 01/09/2023] Open
Abstract
Compelling literature has suggested the possibility of adopting hypnotic suggestions to override the Stroop interference effect. However, most of these studies mainly reported behavioral data and were conducted on highly hypnotizable individuals. Thus, the question of the neural locus of the effects and their generalizability remains open. In the present study, we used the Stroop task in a within-subject design to test the neurocognitive effects of two hypnotic suggestions: the perceptual request to focus only on the central letter of the words and the semantic request to observe meaningless symbols. Behavioral results indicated that the two types of suggestions did not alter response time (RT), but both favored more accurate performance compared to the control condition. Both types of suggestions increased sensory awareness and reduced discriminative visual attention, but the perceptual request selectively engaged more executive control of the prefrontal cortex (PFC), and the semantic request selectively suppressed the temporal cortex activity devoted to graphemic analysis of the words. The present findings demonstrated that the perceptual and the semantic hypnotic suggestions reduced Stroop errors through common and specific top-down modulations of different neurocognitive processes but left the semantic activation unaltered. Finally, as we also recruited participants with a medium level of hypnotizability, the present data might be considered potentially representative of the majority of the population.
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Affiliation(s)
- Rinaldo Livio Perri
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico,”Rome, Italy
| | - Valentina Bianco
- IRCCS Fondazione Santa Lucia, Rome, Italy
- Laboratory of Cognitive Neuroscience, Department of Languages and Literatures, Communication, Education and Society, University of Udine, Udine, Italy
| | - Enrico Facco
- Studium Patavinum, Department of Neurosciences, University of Padova, Padua, Italy
- Inst. F. Granone—Italian Center of Clinical and Experimental Hypnosis, Turin, Italy
| | - Francesco Di Russo
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico,”Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
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Sakly EH, Grissa MH, Zoghlami S, Khayati A, Zokkar N. Assessment of Hypnosis Knowledge Among Dentists: A Cross-Sectional Study. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | - Sabri Zoghlami
- Quebec School of Professional Training in Hypnosis (EFPHQ Tunisia), Tunisia
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Descroix V. Medical hypnosis and surgery, towards a new hermeneutic of care. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2020. [DOI: 10.1051/mbcb/2020059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hypnosis-induced modulation of corticospinal excitability during motor imagery. Sci Rep 2020; 10:16882. [PMID: 33037277 PMCID: PMC7547693 DOI: 10.1038/s41598-020-74020-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 07/23/2020] [Indexed: 11/08/2022] Open
Abstract
Hypnosis can be considered an altered state of consciousness in which individuals produce movements under suggestion without apparent voluntary control. Despite its application in contexts implying motor control, evidence for the neurophysiological mechanisms underlying hypnosis is scarce. Inter-individual differences in hypnotic susceptibility suggest that sensorimotor strategies may manifest in a hypnotic state. We tested by means of transcranial magnetic stimulation applied over the primary motor cortex whether motor system activation during a motor imagery task differs in the awake and in the hypnotic state. To capture individual differences, 30 healthy volunteers were classified as high or low hypnotizable (Highs and Lows) according to ad-hoc validated scales measuring hypnotic susceptibility and personality questionnaires. Corticospinal activation during motor imagery in the hypnotic state was greater in the Highs than the Lows. Intrinsic motivation in task performance and level of persuasion modulated corticospinal activation in the Highs. Corticospinal system activation under hypnosis may have practical implications that merit research in areas where hypnosis can be applied to improve motor performance, such as loss of motor abilities and sports.
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Grégoire C, Faymonville ME, Vanhaudenhuyse A, Jerusalem G, Willems S, Bragard I. Randomized controlled trial of a group intervention combining self-hypnosis and self-care: secondary results on self-esteem, emotional distress and regulation, and mindfulness in post-treatment cancer patients. Qual Life Res 2020; 30:425-436. [PMID: 33025372 PMCID: PMC7886776 DOI: 10.1007/s11136-020-02655-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2020] [Indexed: 01/06/2023]
Abstract
PURPOSE Cancer patients often report low self-esteem and high emotional distress. Two factors seem particularly linked to these symptoms: emotion regulation strategies and mindfulness. The interest of hypnosis and self-care to relieve these symptoms is not well documented. Our randomized controlled trial aimed at assessing the effect of a group intervention combining self-hypnosis and self-care on self-esteem, emotional distress, emotion regulation, and mindfulness abilities of post-treatment cancer patients, as well as investigating the links between these variables. METHODS One hundred and four patients who had suffered from cancer were randomized into the intervention group (N = 52) and the wait-list control group (N = 52). They had to answer questionnaires before (T1) and after the intervention (T2). Nine men were excluded from the analyses, leading to a final sample of 95 women with cancer. Group-by-time changes were assessed with MANOVA, and associations with self-esteem and emotional distress were investigated with hierarchical linear regression models. RESULTS Participants in the intervention group (mean age = 51.65; SD = 12.54) reported better self-esteem, lower emotional distress, a decreased use of maladaptive emotion regulation strategies, and more mindfulness abilities after the intervention, compared to the WLCG. This increase in mindfulness explained 33% of the improvement of self-esteem and 41.6% of the decrease of emotional distress in the intervention group. Self-esteem and emotional distress also predicted each other. CONCLUSION Our study showed the efficacy of our hypnosis-based intervention to improve all the investigated variables. Mindfulness predicted the improvement of self-esteem and emotional distress. The primary impact of our intervention on mindfulness abilities seems to explain, at least in part, its efficacy. Registration: ClinicalTrials.gov (NCT03144154). Retrospectively registered on the 1st of May, 2017.
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Affiliation(s)
- C Grégoire
- Faculty of Psychology, Speech Therapy and Educational Sciences, and Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium.
| | - M-E Faymonville
- Interdisciplinary Algology Centre, CHU Liège, and Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium
| | - A Vanhaudenhuyse
- Interdisciplinary Algology Centre, CHU Liège, and Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium
| | - G Jerusalem
- Medical Oncology Department, CHU Liège and University of Liège, Liège, Belgium
| | - S Willems
- Faculty of Psychology, Speech Therapy and Educational Sciences, University of Liège, Liège, Belgium
| | - I Bragard
- Haute Ecole Libre Mosane (HELMo), Liège, Belgium
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De Schrijver L, Sermeus L, Maes S, Camerlynck H, Morrison S. Regional anesthesia combined with virtual reality hypnosis for extended orthopedic surgery: two case reports. ACTA ANAESTHESIOLOGICA BELGICA 2020. [DOI: 10.56126/71.3.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background : Virtual reality hypnosis is a combination of visual immersion in a virtual reality environment and clinical hypnosis. It can be used in addition to conventional techniques, for sedation and pain management during wound care. Patients undergoing painful and long-lasting procedures under regional anesthesia could also benefit, from this technique alleviating the need for sedative-hypnotic medication.
Case presentation : Two patients with relative contra- indications for general anesthesia underwent lengthy orthopedic surgery of the upper limbs under regional anesthesia with additional virtual reality hypnosis. Written informed consent was obtained from both patients before surgery. A 69-year-old man, with a previous medical history of severe symptomatic aortic valve stenosis (ѳ 0.69cm2, max/mean gradient of 91/58mmHg) sustained a proximal humerus fracture-dislocation and was scheduled to undergo shoulder hemi-arthroplasty. Anesthesia was provided with ultrasound-guided continuous interscalene block at the C5-C6 level (11mL levobupivacaine 0.5%) combined with a single-shot superficial cervical plexus block (6mL levobupivacaine 0.5%). The second case was a 56-year-old man suffering from rheumatoid arthritis with severe restrictive lung function due to interstitial lung disease and bilateral bronchiectasis. He received a unilateral elbow prosthesis.
Continuous infra-clavicular brachial plexus block, per- formed under ultrasound guidance was provided (20 mL mepivacaine 1.5%). Both patients required prolonged immobilization on the operating table. We used virtual reality hypnosis to induce sedation and improve comfort without using medication. This was provided by headphones and head-mounted goggles, showing computer generated images of underwater scenes (Aqua module, Oncomfort ™). Both surgeries were uneventful during which time cardiorespiratory stability was maintained. Patients were comfortable during and satisfied after surgery. No sedative drugs were given before nor during the procedures.
Conclusion : Non-pharmacological sedation can be achieved with virtual reality hypnosis. When com- bined with regional anesthesia, this technique provides satisfactory sedation when pharmacological methods may be hazardous.
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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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Picart T, Guyotat J, Pardey Bracho GF. Letter to the editor regarding anesthesia management for low-grade glioma awake surgery: a European low-grade glioma network survey. Acta Neurochir (Wien) 2020; 162:1721-1722. [PMID: 32383015 DOI: 10.1007/s00701-020-04370-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 04/22/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Thiébaud Picart
- Department of Neurosurgery, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, 59 boulevard Pinel, 69667, Bron, France.
- Faculty of Medicine Lyon Est, Claude Bernard Lyon I University, 69373, Lyon Cedex 08, France.
- Department of Cancer Cell Plasticity - INSERM U1052, Cancer Research Center of Lyon, 28 rue Laennec, 69008, Lyon, France.
| | - Jacques Guyotat
- Department of Neurosurgery, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, 59 boulevard Pinel, 69667, Bron, France
| | - Gilda F Pardey Bracho
- Department of Anesthesia and Critical Care, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, 59 boulevard Pinel, 69667, Bron, France
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Rousseaux F, Bicego A, Ledoux D, Massion P, Nyssen AS, Faymonville ME, Laureys S, Vanhaudenhuyse A. Hypnosis Associated with 3D Immersive Virtual Reality Technology in the Management of Pain: A Review of the Literature. J Pain Res 2020; 13:1129-1138. [PMID: 32547176 PMCID: PMC7247604 DOI: 10.2147/jpr.s231737] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 02/19/2020] [Indexed: 12/21/2022] Open
Abstract
Hypnosis is well documented in the literature in the management of acute and chronic pain. Virtual reality (VR) is currently gaining credibility in the same fields as hypnosis for medical applications. Lately, the combination of hypnosis and VR was considered. The aim of this scoping review is to understand the current studied contexts and effects of virtual reality hypnosis (VRH) for the management of pain. We searched on PubMed, Taylor & Francis Online, and ProQuest databases with the following terms: “virtual reality,” “3D,” “hypnosis,” and “pain”. We included 8 studies that combined hypnosis and VR. All articles are in English. Two included healthy volunteers and six are clinical studies. Short-term results indicated significant decreases in pain intensity, pain unpleasantness, time spent thinking about pain, anxiety, and levels of opioids. However, results are not consistent for all patients all the days. VR alone seems to reduce pain independently of the hypnotizability level. One study claimed that VR and hypnosis could alter each other’s effects and another argued that VR did not inhibit the hypnotic process and may even facilitate it by employing visual imagery. We cannot affirm that VR added value to hypnosis when they are combined. These trials and case series gave us indications about the possible applications of VRH in different contexts. Additional randomized clinical trials on VRH in the future will have to test this technique in clinical practice and help define guidelines for VRH utilization in pain management.
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Affiliation(s)
- Floriane Rousseaux
- Laboratory of Cognitive Ergonomics and Work Intervention, University of Liège, Liège, Belgium.,Algology Department, University Hospital of Liège, Liège, Belgium.,Sensation & Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium
| | - Aminata Bicego
- Laboratory of Cognitive Ergonomics and Work Intervention, University of Liège, Liège, Belgium.,Algology Department, University Hospital of Liège, Liège, Belgium.,Sensation & Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium
| | - Didier Ledoux
- Sensation & Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium.,Intensive Care Units, University Hospital of Liège, Liège, Belgium
| | - Paul Massion
- Intensive Care Units, University Hospital of Liège, Liège, Belgium
| | - Anne-Sophie Nyssen
- Laboratory of Cognitive Ergonomics and Work Intervention, University of Liège, Liège, Belgium.,Sensation & Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium
| | | | | | - Audrey Vanhaudenhuyse
- Algology Department, University Hospital of Liège, Liège, Belgium.,Sensation & Perception Research Group, GIGA Consciousness, University of Liège, Liège, Belgium
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Integrative Medicine in Interventional Oncology: A Virtuous Alliance. ACTA ACUST UNITED AC 2020; 56:medicina56010035. [PMID: 31963617 PMCID: PMC7022725 DOI: 10.3390/medicina56010035] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 01/11/2020] [Accepted: 01/13/2020] [Indexed: 12/16/2022]
Abstract
This review aimed to identify the potential role of integrative medicine in interventional oncology. The music therapy; stress management techniques; guided imagery, including virtual reality; clinical hypnosis; and digital sedation may all be efficient on anxiety and pain during procedures performed in interventional oncology. Beyond pharmacological sedation, the implementation of integrative medicine to interventional oncology may, therefore, improve the support and care of cancer patients, which may further create a virtuous alliance.
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Cornelis FH, Monard E, Moulin MA, Vignaud E, Laveissiere F, Ben Ammar M, Nouri-Neuville M, Barral M, Lombart B. Sedation and analgesia in interventional radiology: Where do we stand, where are we heading and why does it matter? Diagn Interv Imaging 2019; 100:753-762. [PMID: 31706790 DOI: 10.1016/j.diii.2019.10.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 10/13/2019] [Accepted: 10/20/2019] [Indexed: 11/28/2022]
Abstract
The aims of this review were to describe the rationale and the techniques of sedation in interventional radiology, and to compile the safety and efficacy results available so far in the literature. A systematic MEDLINE/PubMed literature search was performed. Preliminary results from several studies demonstrated the feasibility, the efficacy and the safety of using sedative techniques in interventional radiology. Beyond pharmacological sedation and clinical hypnosis, digital sedation could reduce the anxiety and pain associated with interventional radiology procedures.
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Affiliation(s)
- F H Cornelis
- Department of Radiology, Tenon Hospital, Sorbonne University, AP-HP, 75020 Paris, France.
| | - E Monard
- Department of Radiology, Tenon Hospital, Sorbonne University, AP-HP, 75020 Paris, France
| | - M-A Moulin
- Department of Radiology, Tenon Hospital, Sorbonne University, AP-HP, 75020 Paris, France
| | - E Vignaud
- Department of Radiology, Tenon Hospital, Sorbonne University, AP-HP, 75020 Paris, France
| | - F Laveissiere
- Department of Radiology, Tenon Hospital, Sorbonne University, AP-HP, 75020 Paris, France
| | - M Ben Ammar
- Department of Radiology, Tenon Hospital, Sorbonne University, AP-HP, 75020 Paris, France
| | - M Nouri-Neuville
- Department of Radiology, Tenon Hospital, Sorbonne University, AP-HP, 75020 Paris, France
| | - M Barral
- Department of Radiology, Tenon Hospital, Sorbonne University, AP-HP, 75020 Paris, France
| | - B Lombart
- Saint Antoine Hospital, Sorbonne université, AP-HP, 75011 Paris, France
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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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Jaouen M, Parent V, Codet M, Gerard V, Chatellier-Miras A, Chaize C, De Crouy Chanel O, Jegoux F. Neck Surgery with Hypnosis: An Evaluation Based Upon Patient's Self Assessment. Ann Otol Rhinol Laryngol 2019; 129:256-264. [PMID: 31658815 DOI: 10.1177/0003489419882445] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Surgery with hypnosis avoids the use of general anesthesia (GA). It also shortens hospitalization and promotes outpatient surgery. The objective of this study has been to assess the satisfaction of operated patients. No previous study has focused on patient satisfaction in a prospective design. METHODS In this prospective, non-randomized, observational study, all patients operated with hypnosis between 2009 and 2017 in the Ear, Nose, and Throat department of a tertiary care hospital were selected. All patients were asked to fill a questionnaire based on a previously validated questionnaire incremented with complementary questions. Questionnaires were completed immediately after surgery for 31 patients and after 6 months for 20 patients. Global Satisfaction Index (GSI) was self-assessed on a scale ranging from 1 to 10. Patients were asked; whether they felt comfortable during the operation, whether hypnosis helped them, whether the experience matched their expectations, whether they would revisit or recommend it to someone else and whether they considered to have been sufficiently informed before the procedure. The data was analyzed using a linear regression model with P < .05 considered as statistically significant. RESULTS During the inclusion period, no patient required conversion to GA. A total of 48 questionnaires were evaluated. The median of the GSI was 8/10. GSI significantly correlated with patient comfort (P < 0.0001) and quality of preoperative information (P = .002). The percentage of patients who found hypnosis helpful correlated with the duration of surgery (P = .04). The probability for a patient to consider hypnosis as an experience matching their expectation increased with surgical team experience OR 0.55 (0.3-0.9). CONCLUSION This study reveals that patients' global satisfaction after hypnosis is high. This is significantly related to the quality of preoperative information and to the experience of the surgical team. It also suggests that patients are more likely to benefit from hypnosis if the surgery is longer.
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Affiliation(s)
- Marie Jaouen
- Rennes University Medical Center, Rennes, France
| | | | - Maxime Codet
- Rennes University Medical Center, Rennes, France
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