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Niedernhuber M, Schroeder AC, Lercher C, Bruegger M, Prates de Matos NM, Noreika V, Lenggenhager B. An interhemispheric frontoparietal network supports hypnotic states. Cortex 2024; 177:180-193. [PMID: 38865762 DOI: 10.1016/j.cortex.2024.05.008] [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: 10/20/2023] [Revised: 02/22/2024] [Accepted: 05/13/2024] [Indexed: 06/14/2024]
Abstract
Understanding the neural substrate of altered conscious states is an important cultural, scientific, and clinical endeavour. Although hypnosis causes strong shifts in conscious perception and cognition, it remains largely unclear how hypnosis affects information processing in cortical networks. Here we manipulated the depth of hypnotic states to study information processing between cortical regions involved in attention and awareness. We used high-density Electroencephalography (EEG) to record resting-state cortical activity from 30 hypnosis experts during two hypnotic states with different depth. Each participant entered a light and a deep hypnotic state as well as two well-matched control states. Bridging top-down and lateralisation models of hypnosis, we found that interhemispheric frontoparietal connectivity distinguished hypnosis and control conditions, while no difference was found between the two hypnotic states. Using a graph-theoretic measure, we revealed that the amount of information passing through individual nodes (measured via betweenness centrality) is reduced during hypnosis relative to control states. Finally, we found that theta power was enhanced during hypnosis. Our result contributes to the current discussion around a role for theta power in bringing about hypnotic states, as well as other altered conscious states. Overall, our findings support the notion that altered top-down control in frontoparietal regions facilitates hypnosis by integrating information between cortical hemispheres.
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Affiliation(s)
- Maria Niedernhuber
- Department of Psychology, University of Cambridge, Downing Pl, Cambridge, United Kingdom; Department of Psychology, University of Zurich, Binzmuehlestrasse 14, Zurich, Switzerland.
| | | | - Céline Lercher
- Department of Psychology, University of Zurich, Binzmuehlestrasse 14, Zurich, Switzerland
| | - Mike Bruegger
- Center of Dental Medicine, University of Zurich, Plattenstrasse 11, Zurich, Switzerland
| | | | - Valdas Noreika
- Department of Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, Mile End Road, London, United Kingdom
| | - Bigna Lenggenhager
- Department of Psychology, University of Zurich, Binzmuehlestrasse 14, Zurich, Switzerland; Department of Psychology, University of Konstanzs, Universitätsstraße 10, Konstanz, Germany
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2
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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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3
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Jensen MP, Barrett TD. The Role of Electroencephalogram-Assessed Bandwidth Power in Response to Hypnotic Analgesia. Brain Sci 2024; 14:557. [PMID: 38928559 PMCID: PMC11201437 DOI: 10.3390/brainsci14060557] [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: 02/11/2024] [Revised: 05/24/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Abstract
Research supports the efficacy of therapeutic hypnosis for reducing acute and chronic pain. However, little is known about the mechanisms underlying these effects. This paper provides a review of the evidence regarding the role that electroencephalogram-assessed bandwidth power has in identifying who might benefit the most from hypnotic analgesia and how these effects occur. Findings are discussed in terms of the slow wave hypothesis, which posits that brain activity in slower bandwidths (e.g., theta and alpha) can facilitate hypnosis responsivity. Although the extant research is limited by small sample sizes, the findings from this research are generally consistent with the slow wave hypothesis. More research, including and especially studies with larger sample sizes, is needed to confirm these preliminary positive findings.
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Affiliation(s)
- Mark P. Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA 98195, USA;
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van Tilburg MAL, Monis EL, Braumann RE, Fleishman K, Lamm K. Hypnotherapy as a medical treatment: Evidence-based or pseudoscience? Complement Ther Clin Pract 2024; 55:101841. [PMID: 38387324 DOI: 10.1016/j.ctcp.2024.101841] [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: 09/15/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Hypnotherapy continues to be a controversial practice in medicine. It is surrounded by myth and misuses that instill doubts about its legitimacy and usefulness. PURPOSE In this paper, we will distinguish pseudoscientific claims from evidence-based uses of hypnotherapy. RESULTS The use and acceptability of hypnotherapy has varied over history. Pseudoscientific uses, based on outdated theories that it can access the unconscious mind, have delegitimized hypnotherapy. Modern theories that hypnosis uses common social, emotional, and cognitive processes combined with evidence-based methods have re-established the use of hypnotherapy in many physical and mental health disorders and symptoms. Currently it is a widely accepted and recommended treatment for irritable bowel syndrome, with evidence building for many other applications. CONCLUSION Hypnotherapy, as a pseudoscience, can become unethical and cause distress for the patient and their families. Hypnotherapy, as an evidence-based treatment, can be used as a powerful tool to treat physical and psychological symptoms related to medical ailments.
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Affiliation(s)
- Miranda A L van Tilburg
- Cape Fear Valley Health, Fayetteville NC, USA; Campbell University, Lillington, NC, USA; Marshall University, Huntington, WV, USA; University of North Carolina, Chapel Hill, NC, USA; University of Washington, Seattle, WA, USA.
| | - Elizabeth L Monis
- Cape Fear Valley Health, Fayetteville NC, USA; Campbell University, Lillington, NC, USA
| | - Ryan E Braumann
- Cape Fear Valley Health, Fayetteville NC, USA; Campbell University, Lillington, NC, USA
| | - Kenneth Fleishman
- Cape Fear Valley Health, Fayetteville NC, USA; Campbell University, Lillington, NC, USA
| | - Kevin Lamm
- Cape Fear Valley Health, Fayetteville NC, USA; Campbell University, Lillington, NC, USA
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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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6
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Slavin KV. Systems Neuroscience's 2022 Top Papers: An Editorial Summary. Brain Sci 2024; 14:315. [PMID: 38671967 PMCID: PMC11048697 DOI: 10.3390/brainsci14040315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 03/15/2024] [Indexed: 04/28/2024] Open
Abstract
Despite the seemingly endless-and sometimes overwhelming-flow of scientific information, there are always some articles that stand out from the crowd, either due to the depth of the covered topic, or due to their unique and unexpected findings [...].
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Affiliation(s)
- Konstantin V. Slavin
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL 60612, USA;
- Neurology Service, Jesse Brown Veterans Administration Hospital, Chicago, IL 60612, USA
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Catalano Chiuvé S, Momjian S, Wolff A, Corniola MV. Effectiveness and reliability of hypnosis in stereotaxy: a randomized study. Acta Neurochir (Wien) 2024; 166:112. [PMID: 38411747 PMCID: PMC10899299 DOI: 10.1007/s00701-024-05943-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/04/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Patients suffering from Parkinson's disease (PD) may experience pain during stereotactic frame (SF) fixation in deep brain stimulation (DBS). We assessed the role of hypnosis during the SF fixation in PD patients undergoing awake bilateral subthalamic nucleus (STN) DBS. METHODS N = 19 patients were included (N = 13 males, mean age 63 years; N = 10 allocated to the hypnosis and N = 9 allocated to the control groups). Patients were randomly assigned to the interventional (hypnosis and local anesthesia) or non-interventional (local anesthesia only) groups. The primary outcome was the pain perceived (the visual analogue scale (VAS)). Secondary outcomes were stress, anxiety, and depression, as measured by the perceived stress scale (PSS) and hospital anxiety and depression scale (HADS). Procedural distress was measured using the peritraumatic distress inventory (PDI-13). RESULTS In the hypnosis group, VASmean was 5.6 ± 2.1, versus 6.4 ± 1.2 in the control group (p = 0.31). Intervention and control groups reported similar VASmax scores (7.6 ± 2.1 versus 8.6 ± 1.6 (p = 0.28), respectively). Both groups had similar HADS scores (6.2 ± 4.3 versus 6.7 ± 1.92, p = 0.72 (HADSa) and 6.7 ± 4.2 versus 7.7 ± 3, p = 0.58 (HADSd)), so were the PSS scores (26.1 ± 6.3 versus 25.1 ± 7, p = 0.75). Evolutions of VASmean (R2 = 0.93, 95% CI [0.2245, 1.825], p = 0.03) and PDI-13 scores (R2 = 0.94, 95% CI [1.006, 6.279], p = 0.02) significantly differ over follow-up with patients in the hypnosis groups showing lower scores. CONCLUSION In this unblinded, randomized study, hypnosis does not influence pain, anxiety, and distress during awake SF fixation but modulates pain memory over time and may prevent the integration of awake painful procedures as a bad experience into the autobiographical memory of patients suffering from PD. A randomized controlled study with more data is necessary to confirm our findings.
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Affiliation(s)
- Sabina Catalano Chiuvé
- Neurology Department, Neuropsychology Unit, Geneva University Hospitals, Geneva, Switzerland
| | - Shahan Momjian
- Faculty of Medicine, Université of Genève, Geneva, Suisse
- Neurosurgery Department, Geneva University Hospitals, Geneva, Switzerland
| | - Adriana Wolff
- Anesthesiology Department, Geneva University Hospitals, Geneva, Switzerland
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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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Obukhov NV, Naish PLN, Solnyshkina IE, Siourdaki TG, Martynov IA. Real-time assessment of hypnotic depth, using an EEG-based brain-computer interface: a preliminary study. BMC Res Notes 2023; 16:288. [PMID: 37875937 PMCID: PMC10599062 DOI: 10.1186/s13104-023-06553-2] [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: 05/26/2023] [Accepted: 10/02/2023] [Indexed: 10/26/2023] Open
Abstract
OBJECTIVE Hypnosis can be an effective treatment for many conditions, and there have been attempts to develop instrumental approaches to continuously monitor hypnotic state level ("depth"). However, there is no method that addresses the individual variability of electrophysiological hypnotic correlates. We explore the possibility of using an EEG-based passive brain-computer interface (pBCI) for real-time, individualised estimation of the hypnosis deepening process. RESULTS The wakefulness and deep hypnosis intervals were manually defined and labelled in 27 electroencephalographic (EEG) recordings obtained from eight outpatients after hypnosis sessions. Spectral analysis showed that EEG correlates of deep hypnosis were relatively stable in each patient throughout the treatment but varied between patients. Data from each first session was used to train classification models to continuously assess deep hypnosis probability in subsequent sessions. Models trained using four frequency bands (1.5-45, 1.5-8, 1.5-14, and 4-15 Hz) showed accuracy mostly exceeding 85% in a 10-fold cross-validation. Real-time classification accuracy was also acceptable, so at least one of the four bands yielded results exceeding 74% in any session. The best results averaged across all sessions were obtained using 1.5-14 and 4-15 Hz, with an accuracy of 82%. The revealed issues are also discussed.
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Affiliation(s)
- Nikita V Obukhov
- Research Department, The Association of Experts in the Field of Clinical Hypnosis, 40, Kamennoostrovsky Ave., 410, Saint Petersburg, 197022, Russian Federation.
- Department of Psychotherapy, Academician I.P. Pavlov First St. Petersburg State Medical University, 6-8, L. Tolstoy str, Saint Petersburg, 197022, Russian Federation.
| | - Peter L N Naish
- Department of Psychology, The Open University, Walton Hall, Milton Keynes, MK7 6AA, UK
| | - Irina E Solnyshkina
- Department of Psychotherapy, Academician I.P. Pavlov First St. Petersburg State Medical University, 6-8, L. Tolstoy str, Saint Petersburg, 197022, Russian Federation
| | - Tatiana G Siourdaki
- Research Department, The Association of Experts in the Field of Clinical Hypnosis, 40, Kamennoostrovsky Ave., 410, Saint Petersburg, 197022, Russian Federation
| | - Ilya A Martynov
- Research Department, The Association of Experts in the Field of Clinical Hypnosis, 40, Kamennoostrovsky Ave., 410, Saint Petersburg, 197022, Russian Federation
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Callara AL, Fontanelli L, Belcari I, Rho G, Greco A, Zelič Ž, Sebastiani L, Santarcangelo EL. Modulation of the heartbeat evoked cortical potential by hypnotizability and hypnosis. Psychophysiology 2023; 60:e14309. [PMID: 37070749 DOI: 10.1111/psyp.14309] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/07/2023] [Accepted: 03/22/2023] [Indexed: 04/19/2023]
Abstract
Hypnotizability is a psychophysiological trait measured by scales and associated with several differences, including interoceptive accuracy and the morpho-functional characteristics of interoception-related brain regions. The aim of the study was to assess whether the amplitude of the heartbeat evoked cortical potential (HEP), a correlate of interoceptive accuracy, differs in participants with low (lows) and high (highs) hypnotizability scores (assessed by the Stanford Hypnotic Susceptibility Scale, Form A) before and after the induction of hypnosis. ECG and EEG were monitored in 16 highs and 15 lows during an experimental session, including open eyes baseline (B), closed eyes relaxation (R), hypnotic induction (IND), neutral hypnosis (NH), and post session baseline (Post). No significant difference was observed between groups and conditions in autonomic variables. The HEP amplitude was lower in highs than in lows at the right parietal site, likely due to hypnotizability related differences in the functional connection between the right insula and parietal cortex. It increased in highs and decreased in lows across the session, possibly due to the highs' preeminently internally directed attention and to the lows' possible disengagement from the task. Since interoception is involved in several cognitive-emotional functions, its hypnotizability related differences may contribute to the variability of experience and behavior in daily life.
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Affiliation(s)
- Alejandro Luis Callara
- Department of Information Engineering, University of Pisa, Pisa, Italy
- Research Center "E. Piaggio", University of Pisa, Pisa, Italy
| | - Lorenzo Fontanelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Iacopo Belcari
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Gianluca Rho
- Department of Information Engineering, University of Pisa, Pisa, Italy
| | - Alberto Greco
- Department of Information Engineering, University of Pisa, Pisa, Italy
- Research Center "E. Piaggio", University of Pisa, Pisa, Italy
| | - Žan Zelič
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Laura Sebastiani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Enrica L Santarcangelo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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12
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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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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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14
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Wolf TG, Schläppi S, Benz CI, Campus G. Efficacy of Hypnosis on Dental Anxiety and Phobia: A Systematic Review and Meta-Analysis. Brain Sci 2022; 12:brainsci12050521. [PMID: 35624907 PMCID: PMC9138388 DOI: 10.3390/brainsci12050521] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/12/2022] [Accepted: 04/15/2022] [Indexed: 02/04/2023] Open
Abstract
Hypnosis is a commonly used therapy option in dentistry and medicine for fear and pain reduction. Nevertheless, it is viewed very critically, as there is still insufficient evidence for a treatment effect. Specific phobia of dental treatment and dental anxiety are prevalent conditions that can cause an oral health impairment. This paper critically reviews 19 clinical trials aimed at reducing dental anxiety and fear avoidance in adults, published in peer-reviewed journals between 1979 and 2021. The search identified 257 papers; 223 were selected after removing duplicates. A total of 188 articles were excluded after title and abstract evaluation; 35 full text articles were assessed for eligibility. Another 10 papers were discharged after full text evaluation, as these were case reports and questionnaires. Six papers were discharged due to the lack of a comparable scale to measure dental anxiety. The following treatment techniques were reviewed: various forms of cognitive-behavioral therapy (CBT), relaxation training, benzodiazepine premedication, self-hypnosis by audio therapy, hypnotherapy, hypnosis, and nitrous oxide sedation. CBT delivered in a variety of formats, including one-session treatment, showed the most evidence for the efficacy of reducing anxiety. A wide heterogeneity of methods allowed only the inclusion of five studies to the performed meta-analysis, showing contrasting results for the application of hypnosis. The main reason for this issue is the great variety in methods used, making a distinct assessment of hypnotic interventions difficult. However, the results of the systematic review are promising in that hypnosis can also be regarded as powerful and successful method for anxiety reduction, while there are also studies with a small or even slightly negative effect. Therefore, further research is needed. Within the limitations of the current study, a more consistent use of methods to examine anxiety for hypnosis research is recommended.
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Affiliation(s)
- Thomas Gerhard Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland; (S.S.); (G.C.)
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, D-55131 Mainz, Germany
- Correspondence: ; Tel.: +41-31-632-25-80
| | - Sina Schläppi
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland; (S.S.); (G.C.)
| | - Carla Irene Benz
- Department of Prosthodontics and Dental Technology, Faculty of Health, Witten-Herdecke University, D-58455 Witten, Germany;
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland; (S.S.); (G.C.)
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, I-07100 Sassari, Italy
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