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| Personalized neurostimulation targets. Personalized L-DLPFC neurostimulation targets (blue) for all participants were used in comparison with the commonly used Beam F3 skull-based measurement coordinates (−35.5, 49.4, 32.4). Although shown here in Montreal Neurological Institute standard space for illustration purposes, individual targets were analyzed and identified in native subject space representing the greatest L-DLPFC-dACC functional connectivity.
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Hypnotizability, one’s ability to experience cognitive, emotional, behavioral and physical changes in response to suggestions in the context of hypnosis, is a stable neurobehavioral trait associated with improved treatment outcomes from hypnosis-based therapy. Increasing hypnotizability in people who are low-to-medium hypnotizable individuals could...
Context in source publication
Context 1
... L-DLPFC targets were generated for each participant using resting-state functional MRI (fMRI) hierarchical clustering to determine the anatomical location within the L-DLPFC that exhibited the greatest functional connectivity to the dACC (Fig. 4). The dACC region of interest (ROI) was based on a previous coordinatebased meta-analysis aimed at determining the areas of the brain most Nature Mental Health 31 . This general approach was previously reported in a clinical trial using the Stanford Accelerated Intelligent Neuromodulation Therapy for the treatment of depression 53 and ...
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Depression is the disorder with the greatest socioeconomic burdens. Its diagnosis is still based on an operational diagnosis derived from symptoms, and no objective diagnostic indicators exist. Thus, the present study aimed to develop an artificial intelligence (AI) model to aid in the diagnosis of depression from electroencephalography (EEG) data...
Citations
... However, results have shown that functional sites can be influenced by the processing of resting-state MRI data, leading to variability in stimulation site identification and raising questions about the stability of such methods. Furthermore, the effectiveness of interventions based on functional sites remains to be fully explored [39,40]. On the other hand, structural imaging studies have revealed a disrupted white matter microstructure as a potential pivotal clue in BD [41,42]. ...
Background
Traditional neuromodulation strategies show promise in enhancing cognitive abilities in bipolar disorder (BD) but remain suboptimal. This study introduces a novel multimodal neurostimulation (MNS) protocol to improve therapeutic outcomes.
Methods
The novel MNS protocol used individualized diffusion tensor imaging (DTI) data to identify fiber tracts between the dorsolateral prefrontal cortex and dorsal anterior cingulate cortex. The highest structural connectivity point is selected as the individualized stimulation site, which is then targeted using a combination of optimized transcranial alternating current stimulation (tACS) and robot-assisted navigated repetitive transcranial magnetic stimulation (rTMS). A double-blind randomized controlled trial was conducted to investigate the clinical efficacy of this innovative neuromodulation approach on cognitive abilities in stable-phase BD patients. One hundred BD patients were randomly assigned to four groups: group A (active tACS-active rTMS (MNS protocol)), group B (sham tACS-active rTMS), group C (active tACS-sham rTMS), and group D (sham tACS-sham rTMS). Participants underwent 15 sessions over 3 weeks. Cognitive assessments (THINC integrated tool) were conducted at baseline (week 0) and post-treatment (week 3).
Results
Sixty-six participants completed all 15 sessions. Group A (MNS protocol) showed superior improvements in Spotter CRT, TMT, and DSST scores compared to other groups at week 3. Only group A exhibited significant activation in the left frontal region post-MNS intervention. The novel MNS protocol was well tolerated, with no significant side effects observed.
Conclusions
The study indicates that DTI-guided multimodal neurostimulation mode significantly improves cognitive impairments and is safe for stable-phase BD patients.
Trial registration
ClinicalTrials.gov identifier: NCT05964777.
... Our proposed Bayesian predictive coding model hypothesis integrates concepts from cognitive neuroscience regarding how actions are controlled and monitored by the brain, including the role of expectations and feedback in shaping behavior. It aligns with literature that explores the use of hypnotherapy in functional stroke rehabilitation [3] and the underlying neural mechanisms that may be facilitated with non-invasive brain stimulation [27]. Research on portable brain imaging suggests its potential to monitor brain responses, shedding light on the interplay between 'bottom-up' sensory feedback and 'top-down' cognitive processes, which can be in conjunction with video-based motion analysis of the behaviour [28]. ...
... In such situations, the inferior olive evaluates previous predictions made by the cerebellum against the latest ones to produce signals that facilitate cerebellar learning via action imagery [43] without real sensory data from motor action leading to automatic and unconscious control of motor action i.e. functional weakness or functional dystonia or functional seizures. Therefore, if the sense of agency or sense of control guiding the higher-level cerebral executive functions or the anticipated motor states influencing the cerebral sensorimotor regions are not functioning properly, it is suggested that the suggestion and imagery [6] (facilitated with non-invasive brain stimulation in low hypnotizable individuals [27]) for top-down facilitation be integrated with the bottom-up adjustment of prediction errors using humanmachine interfaces for recalibrationsee Fig. 2. ...
... Conversely, decreased connectivity in patients was found between the right hippocampus and right frontal regions, subcortical regions, and left putamen; the anterior cingulate cortex and right caudate; the right and left amygdala; and the left supramarginal gyrus and frontal regions. Recently, Stanford Hypnosis Integrated with Functional Connectivitytargeted Transcranial Stimulation (SHIFT) study [27] investigated enhancing hypnotizability using transcranial magnetic stimulation (TMS) on the left DLPFC, i.e., cold executive function [51]. Conducted as a double-blinded, randomized controlled trial with 80 fibromyalgia patients who were new to TMS, the research aimed to see if TMS could increase their susceptibility to hypnosis. ...
... However, while innovative, the "objective" measurement method could be questioned due to its reliance on the experimenters subjective rating when assessing a perceptive suggestion like taste hallucination. More recently, rTMS was delivered over the left DLPFC of patients with fibromyalgia syndrome (Faerman et al., 2024): authors reported a small effect of neurostimulation on hypnotizability as returned by the Hypnotic Induction Profile (HIP). ...
Non-Invasive Brain Stimulation (NIBS) stands as an advanced technology embraced by researchers and clinicians to influence thoughts, emotions, and behaviors. The prevalent NIBS methods include transcranial Direct Current Stimulation (tDCS) and Transcranial Magnetic Stimulation (TMS), both proficient in either exciting or depressing neural activities in specific cortical regions. Recently, NIBS has been integrated into hypnosis research with the goal of enhancing hypnotizability. Specifically, the limited existing studies have predominantly focused on the dorsolateral prefrontal cortex (DLPFC) due to its significant role in neutral hypnosis. Overall, these studies suggest the fascinating potential to alter hypnotizability and hypnotic phenomena, although the impact on responsiveness to suggestions remains modest. In contrast to psychological and pharmacological methods, NIBS enables alterations in hypnotic experiences that are independent of operators and noninvasive. This grants researchers the chance to employ a causal approach in investigating the brain-behavior relationship associated with suggestibility. The present paper evaluates existing NIBS studies in this domain, delving into the neurocognitive mechanisms at play and their potential implications for hypnosis research and practice.
... In such situations, the inferior olive evaluates previous predictions made by the cerebellum against the latest ones to produce signals that facilitate cerebellar learning via action imagery (Miall, 2024) without real motor action. Therefore, if the sense of control guiding the higher-level cerebral executive functions or the anticipated motor states influencing the cerebral sensorimotor regions are not functioning properly, it is suggested that the suggestion and motor imagery (Apelian et al., 2023) (non-invasive brain stimulation in low suggestibility individuals (Faerman et al., 2024)) for top-down facilitation be integrated with the bottom-up adjustment of prediction errors through the use of motor-imagery driven human-machine interfaces. ...
Functional neurological disorder (FND) is a complex condition that involves a disruption in the brain's ability to properly integrate sensory input and prior expectations, leading to motor dysfunction in functional motor disorders (FMD). This study investigates the role of sensory attenuation and the sense of agency in FMD, focusing on how these mechanisms can be leveraged for therapeutic interventions. Sensory attenuation, the brain's ability to predict and reduce the intensity of self-generated sensory inputs, is impaired in FMD, leading to a reduced sense of agency. This impairment disrupts motor control and contributes to the perception of involuntary movements.We propose using a bipedal reaching virtual reality (VR) task combined with a haptic ankle device to explore and potentially rehabilitate these impairments. In this task, foot positions are represented by VR objects, with initial weighting favoring the unaffected limb. This weighting gradually shifts to the affected limb as its involvement increases under operant conditioning. The task occasionally introduces perturbations to probe motor-related processing and feedback correction, providing a sensitive measure of visuomotor control. Additionally, we incorporate neuroimaging techniques, specifically functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG), to monitor brain activity and assess the effectiveness of these interventions. This approach aims to enhance understanding of the neural mechanisms underlying FND and develop targeted therapies that improve motor control by leveraging the interplay between sensory attenuation and amplification.Our findings could provide valuable insights into the treatment of FND, emphasizing the importance of feedback modulation and the integration of modern technologies like VR and haptic feedback in therapeutic interventions. This research has the potential to significantly improve the prognosis and quality of life for individuals with FND.
... However, results have shown that functional targets can be influenced by the processing of resting-state MRI data, leading to variability in target identification and raising questions about the stability of such methods. Furthermore, the effectiveness of interventions based on functional targets remains to be fully explored 39,40 . On the other hand. ...
Background: Traditional neuromodulation strategies for enhancing cognitive abilities in bipolar disorder (BD) patients have shown promise, yet there remains a need for novel intervention modalities to improve therapeutic outcomes.
Methods: This study introduces a novel multi-modal neuro-stimulaton (MNS) protocol using individualized DTI data to identify fiber tracts between the DLPFC and dACC. The highest structural connectivity point is selected as the individualized stimulation target, which is targeted using a combination of optimized tACS and robot-assisted navigated rTMS. A double-blind randomized controlled trial (Trial registration number: NCT05964777) was conducted to investigate the clinical efficacy of this innovative neuromodulation approach on cognitive abilities in BD patients. One hundred BD patients were randomly assigned to four groups: Group A (Active tACS-Active rTMS (MNS Protocol)), Group B (Sham tACS-Active rTMS), Group C (Active tACS-Sham rTMS ), and Group D (Sham tACS-Sham rTMS). Participants underwent 15 sessions over three weeks. Cognitive assessments (THINC integrated tool) were conducted at baseline (Week 0), post-treatment (Week 3), and follow-up (Week 8).
Results: Sixty-six participants completed all 15 sessions. Group A (MNS Protocol) showed superior improvements in Spotter CRT, TMT, and DSST scores compared to other groups at Week 3, with sustained cognitive enhancement in Spotter CRT at Week 8 (P < 0.01). Only Group A exhibited significant activation in the left frontal region post-MNS intervention. The novel MNS protocol was well tolerated, with no significant side effects observed.
Conclusions: DTI-guided multimodal neuro-stimulation mode significantly improves cognitive impairments and is safe for BD patients.
... The level of hypnotizability is related to the level in which the subject responds to the hypnotic suggestions (Rainville and Price, 2003;Vanhaudenhuyse et al., 2014), with two thirds of the world population showing to be potentially hypnotizable (Heap et al., 2004). A high level of hypnotizability seems to be associated with increased functional connectivity between the left dorsolateral prefrontal cortex and the dorsal anterior cingulate cortex (Faerman et al., 2024). Electroencephalography (EEG) data have shown that hypnotic state increases the theta band (drowsiness), with changes in the gamma band (problem solving, concentration) of brain oscillations (Vanhaudenhuyse et al., 2014;Jensen et al., 2015). ...
Anxiety is the most common form of mental health disorder, affecting millions of people worldwide. Psychosocial interventions such as mindfulness and cognitive behavioral therapy (CBT) have been suggested as an effective treatment in the management of general anxiety and anxiety disorders, with emerging evidence also suggesting the effectiveness of hypnosis. Moreover, anxiety has shown to be linked to the onset and development of several cardiovascular diseases (CVD), which are the leading cause of global death. In this paper, we review the current literature to examine the role that anxiety has on the onset and development of CVD and summarize the current knowledge on the role that hypnosis and hypnotherapy have in reducing anxiety, also explaining how this can impact the cardiovascular system and the prevention of CVD. Review of the evidence suggests that hypnosis and hypnotherapy are effective in treating anxiety and may positively affect the heart and the cardiovascular system, reducing sympathetic activation and increasing parasympathetic tone, potentially preventing the onset of CVD related to increased sympathetic activation. However, further studies are required to further understand how hypnosis and hypnotherapy affect the cardiovascular system through investigation of the neurophysiological components of the hypnotic state and of the mind-body relationship. Healthcare systems should embed mental health screening in patients at risk of developing CVD as part of the clinical pathway and consider the role that hypnosis and hypnotherapy may play in the management of CVD.
... However, while innovative, the "objective" measurement method could be questioned due to its reliance on the experimenters subjective rating when assessing a perceptive suggestion like taste hallucination. More recently, rTMS was delivered over the left DLPFC of patients with fibromyalgia syndrome (Faerman et al., 2024): authors reported a small effect of neurostimulation on hypnotizability as returned by the Hypnotic Induction Profile (HIP). ...
Memory recall is subject to errors that can lead to the formation of false memories. Several factors affect memory processes, such as attention deficits or emotional distress. Additionally, cardiovascular diseases may lead to cognitive decline and memory loss, also increasing the occurrence of false events recall. Hypnosis has proved to affect the autonomic nervous system, positively impacting the cardiovascular response. Hypnosis has also been suggested as a tool to enhance memory and autobiographical events recall in both healthy and unhealthy individuals; however, this approach has led to several controversies. Particularly, the employment of hypnosis in autobiographical recall (hypnotic regression) has been accused of favoring the creation of false memories, leading to therapeutic fallacy. In this paper, we review the current literature on the mechanisms behind the creation of false memories and the role played by hypnosis in memory enhancement and false memory recall. The evidence here collected suggests that cardiovascular diseases affect brain health contributing to cognitive decline and memory impairments, also increasing the occurrence of false memories. Hypnosis induces an increase in parasympathetic activity and a decrease in sympathetic activity, suggesting a potential role in preventing some cardiovascular diseases, such as hypertension, which in turn may improve brain health. Additionally, hypnosis has been shown to have some effectiveness in enhancing memory functions, although contradictory findings reported by several studies make it difficult to draw proper conclusions. Hypnotic regression and guided imagery should be used with caution as they may unintentionally lead to false memory recall. Nevertheless, further studies are required to better understand the effects of hypnosis on the brain and the heart and how it can be used to enhance memory, especially in people with cognitive decline.
Question
Dyspnoea persisting despite treatments of underlying causes requires symptomatic approaches. Medical hypnosis could provide relief without the untoward effects of pharmacological approaches. We addressed this question through experimentally induced dyspnoea in healthy humans (inspiratory threshold loading –excessive inspiratory effort– and carbon dioxide stimulation –air hunger–)
Material and Methods
20 volunteers (10 women, 21–40) were studied on 4 separate days. The order of the visits was randomised in two steps, firstly “inspiratory threshold loading first” versus “carbon dioxide first” group (n=10 in each group), secondly “medical hypnosis first” versus “visual distraction first” subgroup (n=5 in each subgroup). Each visit comprised three 5-minutes periods (reference, intervention, washout) during which participants used visual analog scales to rate dyspnoea's sensory and affective dimensions and after which they completed the Multidimensional Dyspnea Profile.
Results
Medical hypnosis reduced both dimensions of dyspnoea significantly more than visual distraction (inspiratory threshold loading: sensory reduction after 5 min 34% of full VAS versus 8% –p=0.0042–; affective reduction 17.6% versus 2.4% –p=0.044–; carbon dioxide; sensory reduction after 5 min 36.9% versus 3% –p=0.0015–; affective reduction 29.1% versus 8.7% –p=0.0023–). The Multidimensional Dyspnea Profile showed more marked sensory effects during inspiratory threshold loading and more marked affective effects during carbon dioxide stimulation.
Answer to the question
Medical hypnosis was more effective than visual distraction at attenuating the sensory and affective dimensions of experimentally induced dyspnoea. This provides a strong rationale for clinical studies of hypnosis in persistent dyspnoea patients.
