EEG concomitants of hypnotic susceptibility

EEG Correlates of Suggestion-Induced Stroop Interference Reduction in High-Suggestible Individuals: A Systematic Review and Meta-Analysis

Studies have explored the impact of suggestion on the Stroop effect, aiming to understand how effective suggestion is in modulating this phenomenon. The suggestion effect has been replicated in multiple studies, supporting its robustness, but lacks systematic evaluation. We conducted a systematic review and meta-analysis of relevant English-language studies from PubMed, Web of Science, PsycINFO, Scopus, and ScienceDirect since databases inception until January 2023. Quality of included studies was evaluated using the Joanna Briggs Institute (JBI) appraisal checklist, and potential publication biases were assessed. Subgroup analyses were also performed, and effect sizes were estimated using Hedges' g and analyzed using random effects model. The systematic review was comprised of 19 studies. For the meta-analysis, 14 studies examined the suggestion effect on Stroop interference effect (SIE), while six studies investigated suggestion effects on accuracy. Results have revealed significant overall effects of suggestion on Stroop performance in participants, as evidenced by SIE and accuracy. Subgroup analysis based on types of suggestion demonstrated a significant effect on SIE. Six EEG/ERP studies have also been discussed in the context of the review.

Linear and Nonlinear Quantitative EEG Analysis during Neutral Hypnosis following an Opened/Closed Eye Paradigm

Hypnotic susceptibility is a major factor influencing the study of the neural correlates of hypnosis using EEG. In this context, while its effects on the response to hypnotic suggestions are undisputed, less attention has been paid to “neutral hypnosis” (i.e., the hypnotic condition in absence of suggestions). Furthermore, although an influence of opened and closed eye condition onto hypnotizability has been reported, a systematic investigation is still missing. Here, we analyzed EEG signals from 34 healthy subjects with low (LS), medium (MS), and (HS) hypnotic susceptibility using power spectral measures (i.e., TPSD, PSD) and Lempel-Ziv-Complexity (i.e., LZC, fLZC). Indeed, LZC was found to be more suitable than other complexity measures for EEG analysis, while it has been never used in the study of hypnosis. Accordingly, for each measure, we investigated within-group differences between rest and neutral hypnosis, and between opened-eye/closed-eye conditions under both rest and neutral hypnosis. Then, we evaluated between-group differences for each experimental condition. We observed that, while power estimates did not reveal notable differences between groups, LZC and fLZC were able to distinguish between HS, MS, and LS. In particular, we found a left frontal difference between HS and LS during closed-eye rest. Moreover, we observed a symmetric pattern distinguishing HS and LS during closed-eye hypnosis. Our results suggest that LZC is better capable of discriminating subjects with different hypnotic susceptibility, as compared to standard power analysis.

Beyond imagination: Hypnotic visual hallucination induces greater lateralised brain activity than visual mental imagery

Hypnotic suggestions can produce a broad range of perceptual experiences, including hallucinations. Visual hypnotic hallucinations differ in many ways from regular mental images. For example, they are usually experienced as automatic, vivid, and real images, typically compromising the sense of reality. While both hypnotic hallucination and mental imagery are believed to mainly rely on the activation of the visual cortex via top-down mechanisms, it is unknown how they differ in the neural processes they engage. Here we used an adaptation paradigm to test and compare top-down processing between hypnotic hallucination, mental imagery, and visual perception in very highly hypnotisable individuals whose ability to hallucinate was assessed. By measuring the N170/VPP event-related complex and using multivariate decoding analysis, we found that hypnotic hallucination of faces involves greater top-down activation of sensory processing through lateralised neural mechanisms in the right hemisphere compared to mental imagery. Our findings suggest that the neural signatures that distinguish hypnotically hallucinated faces from imagined faces lie in the right brain hemisphere.

Analgesic hypnotic treatment in a post-stroke patient

In recent years, hypnotic suggestions have been used in several clinical conditions. This treatment is often used for anxiety treatment, somatization, and post-traumatic stress disorder. Hypnotic analgesia is one of the most clinically useful phenomena of hypnosis. The article describes the case of a patient who underwent hypnotic treatments for hypersensitivity and chronic pain. Results showed an improvement of pain control and a decrease of pain hypersensibility. In addition, during rehabilitative treatments, the patient reported a high level of compliance with the multidisciplinary team. These findings suggest that hypnosis could be a useful treatment for post-stroke pain management.

Hypnotizability-Related Asymmetries: A Review

Hypnotizability is a dispositional trait reflecting the individual ability to modify perception, memory and behavior according to imaginative suggestions. It is measured by validated scales that classify the general population in high (highs), medium (mediums) and low (lows) hypnotizable persons, predicts the individual proneness to respond to suggestions, and is particularly popular in the field of the cognitive control of pain and anxiety. Different hypnotizability levels, however, have been associated with specific brain morpho-functional characteristics and with peculiarities in the cognitive, sensorimotor and cardiovascular domains also in the ordinary state of consciousness and in the absence of specific suggestions. The present scoping review was undertaken to summarize the asymmetries observed in the phenomenology and physiological correlates of hypnosis and hypnotizability as possible indices of related hemispheric prevalence. It presents the findings of 137 papers published between 1974 and 2019. In summary, in the ordinary state of consciousness, behavioral, neurophysiological and neuroimaging investigations have revealed hypnotizability related asymmetries mainly consisting of pre-eminent left hemisphere information processing/activation in highs, and no asymmetries or opposite directions of them in lows. The described asymmetries are discussed in relation to the current theories of hypnotizability and hypnosis.

The Potential to Source a Patient's Imaginative Powers in Treating Cancer: Illustrated in Three Cases

BACKGROUND

The imaginative power of a human patient has the big advantage of sourcing his/her own depth leading to first-hand experiencing. Such experiences have a potential to make a deep impact that can be instrumental to the process of healing. Successful healing is almost inevitably linked to new recognitions and perceptions, changes in attitudes or changes in lifestyle. Therapists in charge may find that they cannot exert direct control over this process but nevertheless, there is a big inherent potential to such processes as a truly complementary approach to clinical oncology.

CASE REPORTS

Going by the characteristic of the matter, it seems impossible to conduct randomized trials; rather, we have to learn from the very individual experiences and try to find common traits. Hence, in this contribution, it is "just" three cases that are presented: patients with a pancreatic tumor, lung metastasis, and a colon carcinoma. Still, the same objectives of evaluation criteria as in any conventional clinical trial, namely overall survival and quality of life, are followed here. The presented cases are set against expected outcomes of the guideline-oriented therapy options.

CONCLUSION

Quality of life has improved in all three cases, expected overall survival extended in one case, the second is still to be verified. Certainly beneficially, however, is the ratio of effect to - in these cases - no negative side effects.

Neural mechanisms of hypnosis and meditation

Hypnosis has been an elusive concept for science for a long time. However, the explosive advances in neuroscience in the last few decades have provided a "bridge of understanding" between classical neurophysiological studies and psychophysiological studies. These studies have shed new light on the neural basis of the hypnotic experience. Furthermore, an ambitious new area of research is focusing on mapping the core processes of psychotherapy and the neurobiology/underlying them. Hypnosis research offers powerful techniques to isolate psychological processes in ways that allow their neural bases to be mapped. The Hypnotic Brain can serve as a way to tap neurocognitive questions and our cognitive assays can in turn shed new light on the neural bases of hypnosis. This cross-talk should enhance research and clinical applications. An increasing body of evidence provides insight in the neural mechanisms of the Meditative Brain. Discrete meditative styles are likely to target different neurodynamic patterns. Recent findings emphasize increased attentional resources activating the attentional and salience networks with coherent perception. Cognitive and emotional equanimity gives rise to an eudaimonic state, made of calm, resilience and stability, readiness to express compassion and empathy, a main goal of Buddhist practices. Structural changes in gray matter of key areas of the brain involved in learning processes suggest that these skills can be learned through practice. Hypnosis and Meditation represent two important, historical and influential landmarks of Western and Eastern civilization and culture respectively. Neuroscience has beginning to provide a better understanding of the mechanisms of both Hypnotic and Meditative Brain, outlining similarities but also differences between the two states and processes. It is important not to view either the Eastern or the Western system as superior to the other. Cross-fertilization of the ancient Eastern meditation techniques presented with Western modern clinical hypnosis will hopefully result in each enriching the other.

Brain Oscillations, Hypnosis, and Hypnotizability

In this article, we summarize the state-of-science knowledge regarding the associations between hypnosis and brain oscillations. Brain oscillations represent the combined electrical activity of neuronal assemblies, and are usually measured as specific frequencies representing slower (delta, theta, alpha) and faster (beta, gamma) oscillations. Hypnosis has been most closely linked to power in the theta band and changes in gamma activity. These oscillations are thought to play a critical role in both the recording and recall of declarative memory and emotional limbic circuits. Here we propose that it is this role that may be the mechanistic link between theta (and perhaps gamma) oscillations and hypnosis; specifically that theta oscillations may facilitate, and that changes in gamma activity observed with hypnosis may underlie, some hypnotic responses. If these hypotheses are supported, they have important implications for both understanding the effects of hypnosis, and for enhancing response to hypnotic treatments.

Mechanisms of hypnosis: toward the development of a biopsychosocial model

Evidence supports the efficacy of hypnotic treatments, but there remain many unresolved questions regarding how hypnosis produces its beneficial effects. Most theoretical models focus more or less on biological, psychological, and social factors. This scoping review summarizes the empirical findings regarding the associations between specific factors in each of these domains and response to hypnosis. The findings indicate that (a) no single factor appears primary, (b) different factors may contribute more or less to outcomes in different subsets of individuals or for different conditions, and (c) comprehensive models of hypnosis that incorporate factors from all 3 domains may ultimately prove to be more useful than more restrictive models that focus on just 1 or a very few factors.

Baseline brain activity predicts response to neuromodulatory pain treatment

OBJECTIVES

The objective of this study was to examine the associations between baseline electroencephalogram (EEG)-assessed brain oscillations and subsequent response to four neuromodulatory treatments. Based on available research, we hypothesized that baseline theta oscillations would prospectively predict response to hypnotic analgesia. Analyses involving other oscillations and the other treatments (meditation, neurofeedback, and both active and sham transcranial direct current stimulation) were viewed as exploratory, given the lack of previous research examining brain oscillations as predictors of response to these other treatments.

DESIGN

Randomized controlled study of single sessions of four neuromodulatory pain treatments and a control procedure.

METHODS

Thirty individuals with spinal cord injury and chronic pain had their EEG recorded before each session of four active treatments (hypnosis, meditation, EEG biofeedback, transcranial direct current stimulation) and a control procedure (sham transcranial direct stimulation).

RESULTS

As hypothesized, more presession theta power was associated with greater response to hypnotic analgesia. In exploratory analyses, we found that less baseline alpha power predicted pain reduction with meditation.

CONCLUSIONS

The findings support the idea that different patients respond to different pain treatments and that between-person treatment response differences are related to brain states as measured by EEG. The results have implications for the possibility of enhancing pain treatment response by either 1) better patient/treatment matching or 2) influencing brain activity before treatment is initiated in order to prepare patients to respond. Research is needed to replicate and confirm the findings in additional samples of individuals with chronic pain.

Neurophysiological correlates of dissociative symptoms

OBJECTIVE

Dissociation is a mental process with psychological and somatoform manifestations, which is closely related to hypnotic suggestibility and essentially shows the ability to obtain distance from reality. An increased tendency to dissociate is a frequently reported characteristic of patients with functional neurological symptoms and syndromes (FNSS), which account for a substantial part of all neurological admissions. This review aims to investigate what heart rate variability (HRV), EEG and neuroimaging data (MRI) reveal about the nature of dissociation and related conditions.

METHODS

Studies reporting HRV, EEG and neuroimaging data related to hypnosis, dissociation and FNSS were identified by searching the electronic databases Pubmed and ScienceDirect.

RESULTS

The majority of the identified studies concerned the physiological characteristics of hypnosis; relatively few investigations on dissociation related FNSS were identified. General findings were increased parasympathetic functioning during hypnosis (as measured by HRV), and lower HRV in patients with FNSS. The large variety of EEG and functional MRI investigations with diverse results challenges definite conclusions, but evidence suggests that subcortical as well as (pre)frontal regions serve emotion regulation in dissociative conditions. Functional connectivity analyses suggest the presence of altered brain networks in patients with FNSS, in which limbic areas have an increased influence on motor preparatory regions.

CONCLUSIONS

HRV, EEG and (functional) MRI are sensitive methods to detect physiological changes related to dissociation and dissociative disorders such as FNSS, and can possibly provide more information about their aetiology. The use of such measures could eventually provide biomarkers for earlier identification of patients at risk and appropriate treatment of dissociative conditions.

The impacts of hypnotic susceptibility on chaotic dynamics of EEG signals during standard tasks of Waterloo-Stanford Group Scale

Chaotic features of hypnotic EEG (electroencephalograph), recorded during standard tasks of Waterloo-Stanford Group Scale of hypnotic susceptibility (WSGS), were used to investigate the underlying dynamic of tasks and analyse the effect of hypnotic depth and concentration on EEG signals. Results demonstrate: (1) More efficiency of Higuchi dimension in comparison with Correlation dimension to distinguish subjects from different hypnotizable groups, (2) Channels with significantly different chaotic features among people from various hypnotizability levels in tasks, (3) High level of consistency among discriminating channels of tasks with function of brain's lobes, (4) Most affectability of medium hypnotizable subjects and (5) Rise in fractal dimensions due to increase in hypnosis depth.

Neuro-hypnotism: prospects for hypnosis and neuroscience

The neurophysiological substrates of hypnosis have been subject to speculation since the phenomenon got its name. Until recently, much of this research has been geared toward understanding hypnosis itself, including the biological bases of individual differences in hypnotizability, state-dependent changes in cortical activity occurring with the induction of hypnosis, and the neural correlates of response to particular hypnotic suggestions (especially the clinically useful hypnotic analgesia). More recently, hypnosis has begun to be employed as a method for manipulating subjects' mental states, both cognitive and affective, to provide information about the neural substrates of experience, thought, and action. This instrumental use of hypnosis is particularly well-suited for identifying the neural correlates of conscious and unconscious perception and memory, and of voluntary and involuntary action.

Fractal analysis of EEG upon auditory stimulation during waking and hypnosis in healthy volunteers

The authors tested fluctuation analyses (DFA) of EEGs upon auditory stimulation in waking and hypnotic states as related to topography and hypnotizability. They administered the Hypnotic Induction Profile (HIP), Dissociation Experience Scale, and Tellegen Absorption Scale to 10 healthy volunteers and measured subjects' EEGs while the subjects listened to sounds, either selecting or ignoring tones of different decibels, in waking and hypnotic states. DFA scaling exponents were closest to 0.5 when subjects reported the tones in the hypnotic state. Different DFA values at C3 showed significant positive correlations with the HIP eye-roll sign. Adding to the literature supporting the state theory of hypnosis, the DFA values at F3 and C3 showed significant differences between waking and hypnotic states. Application of auditory stimuli is useful for understanding neurophysiological characteristics of hypnosis using DFA.

Waking EEG spectral power and coherence differences between high and low hypnotizable subjects

EEG spectral power and coherence were analyzed under waking baseline condition in 19 high (HH) and 12 low (LH) hypnotizable subjects. In HH subjects, the theta1 and theta2 spectral power was higher than in LH. The major new finding of this study is that coherence between distributed brain regions was sharply elevated in HH subjects within the theta and alpha frequency bands. In contrast, spectral power and coherence of beta2 and gamma1 bands were higher in LH subjects as compared to HH subjects. However, the long distance coherence between frontal and posterior areas within beta-gamma frequency ranges was higher in HH subjects. It might be supposed that HH subjects are engaged in imaginal mental activity whereas LH ones are mainly engaged in linguistic activity. The neurophysiological basis of the obtained EEG differences is discussed.

The sociocognitive and dissociation theories of hypnosis: toward a rapprochement

In this introductory article to a special issue on the sociocognitive perspective of hypnosis, the authors contrast two influential hypnosis theories-the sociocognitive and dissociation perspectives-and argue that recent developments in sociocognitive theory (i.e., response set theory) and in the broader field of cognitive psychology pertaining to nonconscious information processing and goal-directed action make possible a rapprochement between theoretical accounts that have vied for attention and empirical support.

EEG correlates of virtual reality hypnosis

The study investigated hypnosis-related electroencephalographic (EEG) coherence and power spectra changes in high and low hypnotizables (Stanford Hypnotic Clinical Scale) induced by a virtual reality hypnosis (VRH) induction system. In this study, the EEG from 17 participants (Mean age = 21.35, SD = 1.58) were compared based on their hypnotizability score. The EEG recording associated with a 2-minute, eyes-closed baseline state was compared to the EEG during a hypnosis-related state. This novel induction system was able to produce EEG findings consistent with previous hypnosis literature. Interactions of significance were found with EEG beta coherence. The high susceptibility group (n = 7) showed decreased coherence, while the low susceptibility group (n = 10) demonstrated an increase in coherence between medial frontal and lateral left prefrontal sites. Methodological and efficacy issues are discussed.

Fractal analysis of EEG in hypnosis and its relationship with hypnotizability

Fractal analysis was applied to study the trends of EEG signals in the hypnotic condition. The subjects were 19 psychiatric outpatients. Hypnotizability was measured with the Hypnotic Induction Profile (HIP). Fifty-four sets of EEG data were analyzed by detrended fluctuation analysis (DFA), a well-established fractal analysis technique. The scaling exponents, which are the results of fractal analysis, are reduced toward white noise during the hypnotic condition, which differentiates the hypnotic condition from the waking condition. Further, the decrease in the scaling exponents during hypnosis was solely associated with the eye-roll sign within specific cortical areas (F3, C4, and O1/2) closely related to eye movements and attention. In conclusion, the present study has found that the application of the fractal analysis technique can demonstrate the electrophysiological correlations with hypnotic influence on cerebral activity.

Psychobiology of altered states of consciousness

The article reviews the current knowledge regarding altered states of consciousness (ASC) (a) occurring spontaneously, (b) evoked by physical and physiological stimulation, (c) induced by psychological means, and (d) caused by diseases. The emphasis is laid on psychological and neurobiological approaches. The phenomenological analysis of the multiple ASC resulted in 4 dimensions by which they can be characterized: activation, awareness span, self-awareness, and sensory dynamics. The neurophysiological approach revealed that the different states of consciousness are mainly brought about by a compromised brain structure, transient changes in brain dynamics (disconnectivity), and neurochemical and metabolic processes. Besides these severe alterations, environmental stimuli, mental practices, and techniques of self-control can also temporarily alter brain functioning and conscious experience.

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

OBJECTIVE

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

STUDY DESIGN

Retrospective and descriptive study of feasibility.

PATIENTS AND METHODS

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

RESULTS

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

CONCLUSION

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

The science of meditation and the state of hypnosis

Two aspects of Buddhist meditation--concentration and mindfulness--are discussed in relationship to hypnosis. Mindfulness training facilitates the investigation of subjective responses to hypnosis. Concentration practice leads to altered states similar to those in hypnosis, both phenomenologically and neurologically. The similarities and differences between hypnosis and meditation are used to shed light on perennial questions: (1) Does hypnosis involve an altered state of consciousness? (2) Does a hypnotic induction increase suggestibility? I conclude that a model for hypnosis should include altered states as well as capacity for imaginative involvement and expectations.

Hypnotic susceptibility scales: are the mean scores increasing?

The Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C), developed and named 37 years ago, is arguably the "gold standard" of hypnotic susceptibility scales. However, it has been the impression of several researchers that means obtained on the SHSS:C are higher now than in previous years. The authors comprehensively review studies using the SHSS:C over a 4-decade period. The findings demonstrate a significant linear trend between year and SHSS:C scores, with higher obtained means in more recent work. The authors also report a similar analysis of research with the Harvard Group Scale of Hypnotic Susceptibility, Form A. Although the mechanisms underlying this trend can only be speculated upon at present, these findings underscore the importance of using local control groups in research on hypnotizability.

Psychophysiological correlates of hypnosis and hypnotic susceptibility

This article reviews and summarizes electroencephalographic (EEG)-based research on physiological and cognitive indicators of hypnotic responding and hypnotic susceptibility, with special attention to the author's programmatic research in this area. Evidence that differences in attention levels may account for hypnotic depth and individual differences in hypnotizability is provided with traditional EEG rhythms, event-related potentials, and 40-Hz EEG activity. The alteration of stimulus perception may be a secondary effect with respect to allocation of attentional resources. In both nonhypnosis and hypnosis conditions, high hypnotizables appeared to show greater task-related EEG hemispheric shifts than did low hypnotizables. Findings concerning cognitive and physiological correlates of hypnotic analgesia are discussed with respect to hemispheric functioning in the apparent control of focused and sustained attention. The conclusion is that although a definitive EEG-based signature for hypnosis and hypnotizability is not yet established, there are a number of promising leads.

Cortical event-related potentials show the structure of hypnotic suggestions is crucial

Electroencephalographic cortical event-related potentials (ERPs) are affected by information processing strategies and are particularly appropriate for the examination of hypnotic alterations in perception. The effects of positive obstructive and negative obliterating instructions on visual and auditory P300 ERPs were tested. Twenty participants, stringently selected for hypnotizability, were requested to perform identical tasks during waking and alert hypnotic conditions. High hypnotizables showed greater ERP amplitudes while experiencing negative hallucinations and lower ERP amplitudes while experiencing positive obstructive hallucinations, in contrast to low hypnotizables and their own waking imagination-only conditions. The data show that when participants are carefully selected for hypnotizability and responses are time locked to events, rather robust physiological markers of hypnosis emerge. These reflect alterations in consciousness that correspond to participants' subjective experiences of perceptual alteration. Accounting for suggestion type reveals remarkable consistency of findings among dozens of researchers.

Dissociation in hypnosis and frontal executive function

In a career of many searching conceptual insights, Kenneth Bowers drew an important distinction between 2 different dissociative theories of hypnosis: dissociated experience and dissociated control. We contrast these 2 views and discuss how a dissociated control theory can be integrated with current conceptions of frontal executive function. Then we use this frontal elaboration of the dissociated control theory to sketch out a provisional understanding of memory function associated with hypnosis and hypnotic suggestibility, with particular emphasis on unsuggested effects.