title: Cognitive modulation of psychophysical, respiratory and autonomic responses to cold pressor test.
abstract: In healthy subjects with high hypnotisability (highs) under hypnosis, subjectively effective suggestions for analgesia abolish the increases in blood pressure associated with cold pressor test (cpt) by reducing the peripheral vascular resistance. The aim of the present study was to investigate the effects of the suggestions of analgesia on the responses to cpt in healthy highs (n = 22) and in low hypnotisable participants (lows, n = 22) out of hypnosis. Cpt was administered without (CPT) and with suggestions for analgesia (CPT+AN). Psychophysical (pain intensity, pain threshold, cpt duration (time of immersion) and pain tolerance, defined as the difference between cpt duration and pain threshold), respiratory (amplitude and frequency) and autonomic variables (tonic skin conductance, mean RR interval (RR = 1/heart rate), blood pressure, skin blood flow) were studied. The suggestions for analgesia increased cpt duration and RR in both groups, but decreased pain intensity and enhanced pain threshold only in highs; in both groups they did not modulate systolic blood pressure, tonic skin conductance and skin blood flow; thus, increased parasympathetic activity appears responsible for the heart rate reduction induced by suggestions in both groups. In conclusion, our findings show that suggestions modulate pain experience differentially in highs and lows, and are partially effective also in lows. We hypothesize that the mechanisms responsible for the efficacy of suggestions in healthy lows may be involved also in their efficacy in chronic pain patients with low hypnotisability.
authors.affiliation: Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
authors.forename: Enrica L
authors.initials: EL
authors.lastname: Santarcangelo
authors.forename: Giulia
authors.initials: G
authors.lastname: Paoletti
authors.forename: Iacopo
authors.initials: I
authors.lastname: Chiavacci
authors.forename: Carlo
authors.initials: C
authors.lastname: Palombo
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Carli
authors.forename: Maurizio
authors.initials: M
authors.lastname: Varanini
mesh_terms: D000698:Analgesia / Q000379:methods* / Q000523:psychology*; D001794:Blood Pressure / Q000502:physiology; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D010147:Pain Measurement; D012867:Skin / Q000098:blood supply; D055815:Young Adult