Somatosensory event-related potential and autonomic activity to varying pain reduction cognitive strategies in hypnosis

Objectives: The issues of differential effects among cognitive strategies d uring hypnosis in the control of human pain are under active debate. This s tudy, which employs measures of pain perception, electrocortical and autono mic responses, was aimed at determining these pain-related modulations. Methods: Somatosensory event-related potentials (SERPs) to noxious stimuli under an odd-ball paradigm were recorded at the frontal, temporal and parie tal regions in 10 high, 9 mid, and 10 low hypnotizable right-handed young w omen, at waking baseline, varying cognitive strategies (deep relaxation, di ssociative imagery, focused analgesia) in hypnosis and placebo conditions. The phasic heart rate (HR) and skin conductance response were also recorded . The analysis was focused on the frequent standard trials of the odd-ball SER-Ps. Repeated measures analysis of variance was conducted to examine the experimental effects. Results: Focused analgesia induced the largest reduction in pain rating, mo re in the high than low hypnotizable subjects. In high hypnotizable subject s, the N2 amplitude was greater over frontal and temporal scalp sites than over parietal and central sites, whereas in moderately and low hypnotizable subjects, N2 was greater over temporal sites than over frontal, parietal, and central sites. These subjects also displayed a larger N2 peak over temp oral sites during focused analgesia than in the other conditions. The P3 am plitude was smaller under deep relaxation, dissociative imagery and focused analgesia in the high hypnotizable subjects. For these subjects, the small est P3 peaks were obtained for dissociated imagery and focused analgesia ov er frontal and temporal sites. In contrast, for the P3 peak, low hypnotizab le subjects failed to show significant condition effects. In all of the sub jects, the skin conductance and HR were smaller during hypnotic suggestions than in the waking state. Conclusions: The effect of pain modulation is limited to high hypnotizable subjects rather than low hypnotizable ones. Fligher frontal-temporal N2 and smaller posterior parietal P3 may indicate active inhibitory processes dur ing cognitive strategies in hypnotic analgesia. These inhibitory processes also regulate the autonomic activities in pain perception. (C) 2001 Elsevie r Science Ireland Ltd. All rights reserved.