The relationship between transliminality, hypnotic and imaginative suggestibility, and other personality traits.

To our knowledge, no study has directly examined the link between hypnotic response and the personality trait of transliminality (which is underpinned, for example, by magical ideation, mystical experience, fantasy proneness, absorption, hyperaesthesia). In order to further understand the correlates of suggestibility, the aim of the current project was to investigate whether transliminality is associated with hypnotic and imaginative suggestibility (considering: objective response, subjective response and involuntariness). Another aim was to assess the contribution of transliminality as a predictor of suggestibility when a range of previously studied personality trait measures were considered. Participants completed: the Revised Transliminality Scale, Tellegen Absorption Scale, Creative Experiences Questionnaire, and the Dissociative Experiences Scale II. To avoid context effects, where knowledge or measurement of one trait or ability might influence measurement of another, a separate standalone study was conducted where hypnotic and imaginative (without hypnosis) suggestibility screenings were carried out in-person in small groups using the modified Carleton University Responsiveness to Suggestion Scale. The merging of these two datasets enabled the analyses. Transliminality was weakly correlated with the imaginative suggestibility subjective response measure (r = 0.19). Likewise, weak correlations were found between transliminality and the hypnotic suggestibility response measures (objective, r = 0.21, subjective, r = 0.23, involuntariness, r = 0.24). The multiple regressions (forward selection) reflected the pattern of correlations, with no model for any of the variables, retaining more than a single significant predictor. In summary, this study combination, avoiding context effects, shows transliminality to be a weak predictor of response to suggestion.

Behavioral Therapy Approaches for the Management of Low Back Pain: An Up-To-Date Systematic Review.

Low back pain is one of the most common causes for seeking medical treatment and it is estimated that one in two people will experience low back pain at some point during their lifetimes. Management of low back pain includes pharmacological and non-pharmacological approaches. Non-pharmaceutical treatments include interventions such as acupuncture, spinal manipulation, and psychotherapy. The latter is especially important as patients who suffer from low back pain often have impaired quality of life and also suffer from depression. Depressive symptoms can appear because back pain limits patients' ability to work and engage in their usual social activities. The aim of this systematic review was to overview the behavioral approaches that can be used in the management of patients with low back pain. Approaches such as electromyography (EMG) biofeedback, cognitive behavioral therapy, and mindfulness-based stress reduction are discussed as non-pharmacological options in the management of low back pain.

Brain Activation Patterns Characterizing Different Phases of Motor Action: Execution, Choice and Ideation.

Motor behaviour is controlled by a large set of interacting neural structures, subserving the different components involved in hierarchical motor processes. Few studies have investigated the neural substrate of higher-order motor ideation, i.e. the mental operation of conceiving a movement. The aim of this functional magnetic resonance imaging study was to segregate the neural structures involved in motor ideation from those involved in movement choice and execution. An index finger movement paradigm was adopted, including three different conditions: performing a pre-specified movement, choosing and executing a movement and ideating a movement of choice. The tasks involved either the right or left hand, in separate runs. Neuroimaging results were obtained by comparing the different experimental conditions and computing conjunction maps of the right and left hands for each contrast. Pre-specified movement execution was supported by bilateral fronto-parietal motor regions, the cerebellum and putamen. Choosing and executing finger movement involved mainly left fronto-temporal areas and the anterior cingulate. Motor ideation activated almost exclusively left hemisphere regions, including the inferior, middle and superior frontal regions, middle temporal and middle occipital gyri. These findings show that motor ideation is controlled by a cortical network mainly involved in abstract thinking, cognitive and motor control, semantic and visual imagery processes.

Structural and functional correlates of hypnotic depth and suggestibility.

This study explores whether self-reported depth of hypnosis and hypnotic suggestibility are associated with individual differences in neuroanatomy and/or levels of functional connectivity. Twenty-nine people varying in suggestibility were recruited and underwent structural, and after a hypnotic induction, functional magnetic resonance imaging at rest. We used voxel-based morphometry to assess the correlation of grey matter (GM) and white matter (WM) against the independent variables: depth of hypnosis, level of relaxation and hypnotic suggestibility. Functional networks identified with independent components analysis were regressed with the independent variables. Hypnotic depth ratings were positively correlated with GM volume in the frontal cortex and the anterior cingulate cortex (ACC). Hypnotic suggestibility was positively correlated with GM volume in the left temporal-occipital cortex. Relaxation ratings did not correlate significantly with GM volume and none of the independent variables correlated with regional WM volume measures. Self-reported deeper levels of hypnosis were associated with less connectivity within the anterior default mode network. Taken together, the results suggest that the greater GM volume in the medial frontal cortex and ACC, and lower connectivity in the DMN during hypnosis facilitate experiences of greater hypnotic depth. The patterns of results suggest that hypnotic depth and hypnotic suggestibility should not be considered synonyms.

Neuroimaging resolution of the altered state hypothesis.

A controversy in the field of hypnosis has centered on the question of whether there is a uniquely hypnotic state of consciousness and, if so, whether it is causally related to responsiveness to suggestion. Evidence from brain imaging studies has been used to support claims for various altered state hypotheses, without resolving the debate. The designs of many neuroimaging studies confound the induction of hypnosis with the suggestions that can be given in or out of hypnosis, thus rendering them incapable of resolving the controversy. Brain imaging studies that do not have this confound support the hypothesis that hypnotic inductions produce changes in brain activity, but also indicate that these changes are not required for the experience of hypnotic suggestions or their neural correlates. The data remain equivocal as to whether there is a causal relation between the changes in brain activity produced by hypnotic inductions and those produced by other suggestions. It also remains uncertain whether the changes in activation produced by hypnotic inductions reflect a uniquely hypnotic state as opposed to more mundane processes.

Suggested visual hallucination without hypnosis enhances activity in visual areas of the brain.

This functional Magnetic Resonance Imaging (fMRI) study investigated high and low suggestible people responding to two visual hallucination suggestions with and without a hypnotic induction. Participants in the study were asked to see color while looking at a grey image, and to see shades of grey while looking at a color image. High suggestible participants reported successful alterations in color perception in both tasks, both in and out of hypnosis, and showed a small benefit if hypnosis was induced. Low suggestible people could not perform the tasks successfully with or without the hypnotic induction. The fMRI results supported the self report data, and changes in brain activity were found in a number of visual areas. The results indicate that a hypnotic induction, although having the potential to enhance the ability of high suggestible people, is not necessary for the effective alteration of color perception by suggestion.

Visuo-spatial imagery impairment in posterior cortical atrophy: a cognitive and SPECT study.

This study investigated the cognitive profile and the cerebral perfusion pattern in a highly educated 70 year old gentleman with posterior cortical atrophy (PCA). Visuo-perceptual abilities, spatial memory, spatial representation and navigation, visuo-spatial mental imagery, semantic and episodic-autobiographical memory were assessed. Regional cerebral blood flow (rCBF) was imaged with SPECT. Cognitive testing showed visual-perceptual impairment, apperceptive visual and landmark agnosia, topographical disorientation with way-finding deficits, impaired map learning and poor mental image generation. Semantic memory was normal, while episodic-autobiographical memory was impaired. Reduced rCBF was found mainly in the right hemisphere, in the precentral gyrus, posterior cingulate and middle temporal gyri, cuneus and precuneus, in the left superior temporal and lingual gyri and in the parahippocampus bilaterally. Hypoperfusion in occipito-parietal regions was associated with visuo-spatial deficits, whereas deficits in visuo-spatial mental imagery might reflect dysfunction related to hypoperfusion in the parahippocampus and precuneus, structures which are responsible for spatial and imagery processing. Dissociating performance between preserved semantic memory and poor episodic-autobiographical recall is consistent with a pattern of normal perfusion in frontal and anterior temporal regions but abnormal rCBF in the parahippocampi. The present findings indicate that PCA involves visuo-spatial imagery deficits and provide further validation to current neuro-cognitive models of spatial representation and topographical disorientation.

Hypnotic induction decreases anterior default mode activity.

The 'default mode' network refers to cortical areas that are active in the absence of goal-directed activity. In previous studies, decreased activity in the 'default mode' has always been associated with increased activation in task-relevant areas. We show that the induction of hypnosis can reduce anterior default mode activity during rest without increasing activity in other cortical regions. We assessed brain activation patterns of high and low suggestible people while resting in the fMRI scanner and while engaged in visual tasks, in and out of hypnosis. High suggestible participants in hypnosis showed decreased brain activity in the anterior parts of the default mode circuit. In low suggestible people, hypnotic induction produced no detectable changes in these regions, but instead deactivated areas involved in alertness. The findings indicate that hypnotic induction creates a distinctive and unique pattern of brain activation in highly suggestible subjects.

Cognitive and neuronal processes involved in sequential generation of general and specific mental images.

Mental image generation is a complex process mediated by dynamically interrelated components, e.g. image generation and image enrichment of details. This study investigated the cognitive and neural correlates of sequential image generation. An event-related fMRI experiment was carried out in which general and specific images had to be generated sequentially in two different positions. Participants had to generate either a general image first and then a specific one or a specific image first and then a general one, in response to the same word-stimulus. Generation times showed that specific images took shorter to be produced if they had been preceded by the generation of a general image. The fMRI results showed that position of generation and type of image was associated with different patterns of neurofunctional change. When an image was generated as first, areas of activation were found in the parahippocampal, fusiform and occipital regions. These are areas associated with memory retrieval and visual processing. When an image was generated as second, significant activations were found in superior temporal and precuneus areas, brain structures that are involved in the storage of visual memory for object shapes and imagery, respectively. The generation of a general image was supported by frontal areas and by the precuneus. The generation of a specific image involved frontal and thalamic areas (structures associated with visual processing of details) and the posterior cingulate cortex. When shifting from a specific image to a general one, a higher level of activity was found in the middle frontal gyrus involved in global visuo-spatial processing, suggesting that the generation of specific images required the retrieval of an object's global shape. Altogether, these data suggest that the sequential generation of different types of image is associated with discrete processes but also shares common cognitive and neural components.

Left mediotemporal structures mediate the retrieval of episodic autobiographical mental images.

The aim of this functional magnetic resonance imaging (fMRI) study was to investigate the neuroanatomical substrates associated with the process of mental generation of specific (i.e., exemplar) and episodic autobiographical (i.e., an image of a unique life episode connected with an object) images. The fMRI paradigm in this experiment included a non-image generation baseline and two activation conditions requiring the generation of either specific or episodic autobiographical images. Image generation times and brain activation were recorded. Behavioral results showed that generating specific mental images took significantly less than generating episodic autobiographical images. Individuals generated specific images that were well distinct from the episodic autobiographical ones, semantic in nature without an episodic reference. Episodic autobiographical images did not show a significant bias towards preferential retrieval from any particular life period but were retrieved from across the entire life span. Conjunction analysis of the fMRI data showed that the two image generation conditions significantly activated a common set of neural structures, including mediofrontal areas. This shared pattern of activation might be the result of an underlying similar format and characteristics (e.g., richness in details) between the two types of images and might reflect the involvement of similar cognitive processes. Distinct patterns of significant activation were also present. Activation in the right parietal regions, cuneus, precuneus and left temporal regions was associated solely with the generation of specific images. Regions more specifically devoted to episodic memory retrieval and imagery, such as the left parahippocampal gyrus and precuneus, and the posterior cingulate cortex bilaterally, were significantly activated exclusively by the generation of episodic autobiographical images.

Different neuronal pathways support the generation of general and specific mental images.

The aim of this functional magnetic resonance imaging (fMRI) study was to investigate the neural correlates associated with the generation of general (i.e., prototypical) and specific (i.e., exemplar) visual mental images from concrete nouns. The fMRI paradigm included a non-imagery baseline, and two activation conditions requiring the generation of either general or specific images. Image generation times and brain activation were recorded. Analysis of the behavioral results showed that generating general images took less than the specific ones. The comparison of each activation condition with the baseline showed significant increase in brain activation in left frontal areas in both kinds of images, with the additional involvement of the posterior cingulate cortex during the generation of specific images. When the two activation conditions were contrasted with each other and masked for their respective comparison with baseline, significant activation was found in right frontal areas for general mental images, whereas a significant increase in activation in the left superior frontal region and the right thalamus was detected during the generation of specific mental images. These findings suggest that general and specific mental images are generated with the support of two different neural pathways. The generation of general images seems to involve brain areas associated with the formation of global gestalt-like images (areas in the right hemisphere), while the generation of specific mental images appears to require additional support from areas involved in the retrieval of visual details (i.e., the right thalamus).