Chronic low-back pain modulation is enhanced by hypnotic analgesic suggestion by recruiting an emotional network: a PET imaging study.
Fanny Nusbaum, Jérôme Redouté, Didier Le Bars, Pierre Volckmann, François Simon, Salem Hannoun, Gérard Ribes, Jacques Gaucher, Bernard Laurent, Dominique Sappey-Marinier
The International journal of clinical and experimental hypnosis January 2011 DOI: 10.1080/00207144.2011.522874 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Population | Patients with chronic low-back pain |
| Measures | visual analog scale |
| Key findings | Hypnosis activates an emotional pain modulation network distinct from the cognitive-sensory network seen in normal alertness, and indirect suggestion engages a broader emotional network than direct suggestion. Visual analog scale data indicate greater pain modulation with hypnosis. |
Abstract
This study aimed to characterize the neural networks involved in patients with chronic low-back pain during hypnoanalgesia. PET was performed in 2 states of consciousness, normal alertness and hypnosis. Two groups of patients received direct or indirect analgesic suggestion. The normal alertness state showed activations in a cognitive-sensory pain modulation network, including frontotemporal cortex, insula, somatosensory cortex, and cerebellum. The hypnotic state activated an emotional pain modulation network, including frontotemporal cortex, insula, caudate, accumbens, lenticular nuclei, and anterior cingulate cortex (ACC). Direct suggestion activated cognitive processes via frontal, prefrontal, and orbitofrontal cortices, while indirect suggestion activated a widespread and more emotional network including frontal cortex, anterior insula, inferior parietal lobule, lenticular nucleus, and ACC. Confirmed by visual analog scale data, these results suggest that chronic pain modulation is greater with hypnosis, which enhances both activated networks.