title: Chronic low-back pain modulation is enhanced by hypnotic analgesic suggestion by recruiting an emotional network: a PET imaging study.
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.
authors.affiliation: University of Lyon II, Laboratoire Santé-Individu-Société, 5 avenue Pierre Mendès France – Bâtiment K – 69500 Bron, France. f.nusbaum@wanadoo.fr
authors.forename: Fanny
authors.initials: F
authors.lastname: Nusbaum
authors.forename: Jérome
authors.initials: J
authors.lastname: Redouté
authors.forename: Didier
authors.initials: D
authors.lastname: Le Bars
authors.forename: Pierre
authors.initials: P
authors.lastname: Volckmann
authors.forename: François
authors.initials: F
authors.lastname: Simon
authors.forename: Salem
authors.initials: S
authors.lastname: Hannoun
authors.forename: Gérard
authors.initials: G
authors.lastname: Ribes
authors.forename: Jacques
authors.initials: J
authors.lastname: Gaucher
authors.forename: Bernard
authors.initials: B
authors.lastname: Laurent
authors.forename: Dominique
authors.initials: D
authors.lastname: Sappey-Marinier
mesh_terms: D000328:Adult; D001143:Arousal / Q000502:physiology; D001921:Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001931:Brain Mapping; D004644:Emotions / Q000502:physiology*; D006801:Humans; D006991:Hypnosis, Anesthetic / Q000379:methods*; D007091:Image Processing, Computer-Assisted; D017116:Low Back Pain / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009415:Nerve Net / Q000000981:diagnostic imaging* / Q000503:physiopathology; D010101:Oxygen Consumption / Q000502:physiology; D010147:Pain Measurement; D049268:Positron-Emission Tomography; D013404:Suggestion