Virtual reality hypnosis prior to radiofrequency thermocoagulation for patients with chronic pain: an exploratory clinical trial.

Background: The management of chronic pain may involve an array of tools, including radiofrequency thermocoagulation (Rf-Tc) of sensory nerve terminals. Like many other invasive procedures, Rf-Tc can generate anxiety in a lot of patients, either during the expectation of the procedure or in the course of it. Virtual reality hypnosis (VRH) is a promising tool for managing anxiety and pain in several situations, but its anxiolytic property has not been investigated in participants with chronic pain and going through a Rf-Tc procedure. Objectives: The goal of this study was to evaluate the effectiveness of VRH for reducing self-assessed anxiety in participants with chronic pain, when received in preparation for Rf-Tc. Materials and methods: This prospective, controlled trial was conducted in the Interdisciplinary Algology Centre of the University Hospital of Liège (Belgium). Participants were assigned to two groups: VRH or control (usual care). Assessment was carried-out at 4 time points: T0 (one week before Rf-Tc); T1 (pre-intervention, on the day of Rf-Tc); T2 (immediately after the VRH intervention outside of the Rf-Tc room); and T3 (right after Rf-Tc). Medical, sociodemographic data, anxiety trait and immersive tendencies were collected at T0. Anxiety state and pain intensity were assessed at each time points. Satisfaction was examined at T3. Results: Forty-two participants were quasi-randomly assigned to the VRH or control group. No statistically significant interaction group by time was observed regarding all measured variables, including primary endpoint. However, a significant effect of time was found for anxiety and pain when considering both groups together, toward a progressive reduction. Conclusion: In the context of our study, there appears to be no significant effect of VRH at reducing anxiety in participants with chronic pain undergoing Rf-Tc. Anxiety decreases along the procedure, while pain is attenuated by the local anesthetic infiltration of the Rf site. Our results suggest that the presence of a caregiver throughout the procedure might explain the progressive decrease in anxiety. Future randomized controlled trials are needed to precisely study the effectiveness of the VRH tool, and the possibility of using it as a complementary approach for anxiety during invasive procedures.

Effect of virtual reality hypnosis on intraoperative sedation needs and functional recovery in knee arthroplasty: a prospective randomized clinical trial.

BACKGROUND AND OBJECTIVES: Perioperative psychological stress and pharmacological anxiolysis can negatively affect the quality of recovery after total knee arthroplasty. We aimed to assess whether hypnosis combined with virtual reality could reduce intraoperative pharmacological sedation and improve quality of recovery after total knee arthroplasty surgery. METHODS: In this prospective randomized clinical trial, 60 patients scheduled for total knee arthroplasty with spinal anesthesia were randomly divided into 2 groups of 30 patients each. Intraoperatively, intermittent boluses of midazolam 1 mg were administered at 5 min intervals at the patient's request, with a maximum driven by the clinical assessment of sedation depth. During surgery, patients received standard care (group control) or virtual reality hypnosis (group VRH). An unblinded observer recorded the total dose of midazolam administered during surgery, and changes in the Quality-of-Recovery 15-item score, comfort, fatigue, pain and anxiety before and 1, 3 and 7 days after surgery. RESULTS: Patients in the VRH group required a lower dose of midazolam (mg; median (range)) intraoperatively (group VRH: 0 (0-4) and group control: 2 (0-9), p<0.001). Quality-of-Recovery 15-item, anxiety, and pain were similar between groups. CONCLUSIONS: In total knee arthroplasty with spinal anesthesia, VRH reduces the requirement for intraoperative pharmacological sedation, without a change in the quality of recovery. TRIAL REGISTRATION NUMBER: NCT05707234.

A Group Intervention Combining Self-Hypnosis and Self-Care in Oncology: Implementation in Daily Life and Perceived Usefulness.

Multicomponent mind-body interventions are increasingly studied in oncology to improve patients' quality of life (QOL). However, the respective usefulness of each of their components or their long-term use by the participants are rarely assessed. In this study, 95 women with different cancer diagnoses participated in a self-hypnosis and self-care group. Different questionnaires were administrated before (T1), right after (T2), 3 to 4 months after (T3), and 1 year after (T4) the intervention. After the intervention, 97.5% of the participants regularly practiced any kind of relaxation (vs. 50% at baseline), especially hypnosis. The different components of the intervention (i.e., being in a group, hypnosis exercises during the sessions and at home, self-care tasks, and discussions during the group sessions) were all considered to be very useful (M = 6.91-7.75/10). One year after the intervention, the 10 most used techniques were mainly concrete activities to take care of oneself. This intervention seems very relevant for women who had cancer. Our results allow a first reflection about the mechanisms of action of our intervention.Registration: ClinicalTrials.gov (NCT03144154). Registered on the 1st of May 2017.

Autonomic nervous system modulation during self-induced non-ordinary states of consciousness.

Self-induced cognitive trance (SICT) is a voluntary non-ordinary state of consciousness characterized by a lucid yet narrowed awareness of the external surroundings. It involves a hyper-focused immersive experience of flow, expanded inner imagery, modified somatosensory processing, and an altered perception of self and time. SICT is gaining attention due to its potential clinical applications. Similar states of non-ordinary state of consciousness, such as meditation, hypnosis, and psychedelic experiences, have been reported to induce changes in the autonomic nervous system. However, the functioning of the autonomic nervous system during SICT remains poorly understood. In this study, we aimed to investigate the impact of SICT on the cardiac and respiratory signals of 25 participants proficient in SICT. To accomplish this, we measured various metrics of heart rate variability (HRV) and respiration rate variability (RRV) in three conditions: resting state, SICT, and a mental imagery task. Subsequently, we employed a machine learning framework utilizing a linear discriminant analysis classifier and a cross-validation scheme to identify the features that exhibited the best discrimination between these three conditions. The results revealed that during SICT, participants experienced an increased heart rate and a decreased level of high-frequency (HF) HRV compared to the control conditions. Additionally, specific increases in respiratory amplitude, phase ratio, and RRV were observed during SICT in comparison to the other conditions. These findings suggest that SICT is associated with a reduction in parasympathetic activity, indicative of a hyperarousal state of the autonomic nervous system during SICT.

Altered Brain Connectivity and Network Topological Organization in a Non-ordinary State of Consciousness Induced by Hypnosis.

Hypnosis has been shown to be of clinical utility; however, its underlying neural mechanisms remain unclear. This study aims to investigate altered brain dynamics during the non-ordinary state of consciousness induced by hypnosis. We studied high-density EEG in 9 healthy participants during eyes-closed wakefulness and during hypnosis, induced by a muscle relaxation and eyes fixation procedure. Using hypotheses based on internal and external awareness brain networks, we assessed region-wise brain connectivity between six ROIs (right and left frontal, right and left parietal, upper and lower midline regions) at the scalp level and compared across conditions. Data-driven, graph-theory analyses were also carried out to characterize brain network topology in terms of brain network segregation and integration. During hypnosis, we observed (1) increased delta connectivity between left and right frontal, as well as between right frontal and parietal regions; (2) decreased connectivity for alpha (between right frontal and parietal and between upper and lower midline regions) and beta-2 bands (between upper midline and right frontal, frontal and parietal, also between upper and lower midline regions); and (3) increased network segregation (short-range connections) in delta and alpha bands, and increased integration (long-range connections) in beta-2 band. This higher network integration and segregation was measured bilaterally in frontal and right parietal electrodes, which were identified as central hub regions during hypnosis. This modified connectivity and increased network integration-segregation properties suggest a modification of the internal and external awareness brain networks that may reflect efficient cognitive-processing and lower incidences of mind-wandering during hypnosis.

A neurophenomenological approach to non-ordinary states of consciousness: hypnosis, meditation, and psychedelics.

No contemporary unifying framework has been provided for the study of non-ordinary states of consciousness (NSCs) despite increased interest in hypnosis, meditation, and psychedelics. NSCs induce shifts in experiential contents (what appears to the experiencer) and/or structure (how it appears). This can allow the investigation of the plastic and dynamic nature of experience from a multiscale perspective that includes mind, brain, body, and context. We propose a neurophenomenological (NP) approach to the study of NSCs which highlights their role as catalysts of transformation in clinical practice by refining our understanding of the relationships between experiential (subjective) and neural dynamics. We outline the ethical implications of the NP approach for standard conceptions of health and pathology as well as the crucial role of experience-based know-how in NSC-related research and application.

Virtual reality hypnosis in the management of pain: Self-reported and neurophysiological measures in healthy subjects.

BACKGROUND: Virtual reality hypnosis (VRH) has emerged as a new and promising option for pain management. Nonetheless, neural dynamics of pain modulation during VRH have not been investigated yet. The aim of this study was to measure the effects of VRH on pain, combining neurophysiological and self-reported measurements. METHODS: Eighteen healthy subjects underwent noxious electrical stimulations in both normal wakefulness and VRH conditions. Dissociation, absorption, time perception, anxiety, pain intensity and unpleasantness, heart rate variability and breathing were reported for each condition. EEG signals were analysed using event-related potentials (ERP) and time-frequency response (TFR) time-locked to stimuli. Neurophysiological features were correlated with self-reported data. RESULTS: VRH condition was associated with lower pain and higher dissociation. VRH significantly decreased amplitudes of N100 and P200 ERP components, reduced EEG power between 1 and 5 Hz from 100 to 560 ms, and increased EEG power from 5 to 11 Hz from 340 to 800 ms. These findings were observed at frontal, central and posterior electrodes. Heart rate variability was significantly higher and breathing frequency reduced with VRH. Correlations were found between the self-reported level of pain and ERP components. CONCLUSION: VRH modulates cerebral pain processes and body physiology, leading to reduced pain levels. These findings offer a first insight on the analgesic mechanisms of VRH and suggest that VRH is an effective approach to reduce experimental pain. SIGNIFICANCE: VRH decreases experimental pain perception, increases subject level of dissociation and modulates cerebral pain processing mechanisms. Pain can be managed with analgesic medication but also through complementary interventions. Among these, hypnosis and virtual reality (VR) are known to reduce pain for patients and healthy individuals. In recent years, an innovative technique combining hypnosis and VR has been proposed to help patients in managing pain. However, to our knowledge, no study has focused on the underlying mechanisms of this VR/hypnosis combination. We showed that VR combined with hypnosis decreases experimental pain, increases dissociation and influences EEG modulation.

Psycho-oncology interventions focusing on fatigue and sleep disturbances.

PURPOSE OF REVIEW: Cancer-related fatigue (CRF) and sleep disturbances are common symptoms among patients with cancer. They are often conceptualized as a part of a larger symptom cluster, also comprising pain and emotional distress. Despite their prevalence and long-lasting effects, CRF and sleep disturbances are still poorly addressed in clinical settings. Specific interventions are needed to manage these symptoms. RECENT FINDINGS: In addition to conventional pharmacological therapies, other kinds of interventions are increasingly being developed in oncology. This review will discuss three categories of interventions for patients with cancer and their interest in alleviating CRF and sleep disturbances: physical exercises (e.g., aerobic, resistance training, running, free weights), psychological interventions (e.g., cognitive-behavioural therapy, psychoeducational interventions), and mind-body interventions (e.g., yoga, mindfulness, hypnosis). The multicomponent aspect of these interventions seems particularly important to address these symptoms. SUMMARY: The findings detailed in this review will allow the scientific community, as well as health professionals working in oncology settings, to be informed about new nonpharmacological therapeutic options to help patients to manage their symptoms. It could eventually help to improve existing interventions for these patients.

Randomized, Controlled Trial of an Intervention Combining Self-Care and Self-Hypnosis on Fatigue, Sleep, and Emotional Distress in Posttreatment Cancer Patients: 1-Year Follow-Up.

Cancer can provoke fatigue, sleep disturbances, and emotional distress. Hypnosis interventions have shown positive short-term effects on these symptoms. However, less is known about their long-term effects. This study assessed the short- and long-term effects of a group intervention combining self-care and self-hypnosis on these symptoms in posttreatment cancer patients. Ninety-five female cancer survivors were randomized to either a hypnosis group intervention or wait-list control. Results showed significant decreases in fatigue, sleep difficulties and emotional distress after intervention for the hypnosis group intervention in comparison to the wait-list control. Most of these positive effects were maintained at 1-year follow-up. Most participants received the hypnosis group intervention approximately 10.65 months after diagnosis, and it is possible that delivering the intervention earlier after diagnosis could have achieved a more robust impact. Further studies are needed to replicate these results in comparison to an active control condition and investigate the best time postdiagnosis for initiating the intervention.

Hypnosis, Meditation, and Self-Induced Cognitive Trance to Improve Post-treatment Oncological Patients' Quality of Life: Study Protocol.

INTRODUCTION: A symptom cluster is very common among oncological patients: cancer-related fatigue (CRF), emotional distress, sleep difficulties, pain, and cognitive difficulties. Clinical applications of interventions based on non-ordinary states of consciousness, mostly hypnosis and meditation, are starting to be investigated in oncology settings. They revealed encouraging results in terms of improvements of these symptoms. However, these studies often focused on breast cancer patients, with methodological limitations (e.g., small sample size, no control group, and no follow-up). Another non-ordinary state of consciousness may also have therapeutic applications in oncology: self-induced cognitive trance (SICT). It seems to differ from hypnosis and meditation, as it involves the body more directly. Thus, investigating its clinical applications, along with hypnosis and meditation interventions, could improve available therapeutic options in oncology. This article details the study protocol of a preference-based longitudinal controlled superiority trial aiming to assess the effectiveness of 3 group interventions (hypnosis, meditation, and SICT) to improve oncological patients' quality of life, and more specifically CRF, emotional distress, sleep, pain, and cognitive difficulties (primary outcomes). METHODS AND ANALYSIS: A power analysis required a total sample of 160 patients. Main inclusion criteria are: cancer diagnosis, active treatments completed for less than a year, no practice of hypnosis, meditation, or SICT, and presence of at least one of these four symptoms: fatigue, sleep difficulties, depression, or anxiety. Each participant will choose the intervention in which they want to participate (hypnosis, mindful self-compassion meditation, SICT, or no intervention-control group). To test the effectiveness of the interventions, data will be collected by questionnaires and neurobiological measures and directly from the medical record at four time points: before inclusion in the study (baseline); immediately after the intervention; and at 3- and 12-month follow-up. The longitudinal data in each group will then be measured. DISCUSSION: In addition to standard cancer therapies, there is a growing interest from patients in complementary approaches, such as hypnosis, meditation, and SICT. The results of this study will be useful to increase knowledge about short- and long-term effectiveness of 3 group interventions for CRF, emotional distress, sleep, pain, and cognitive difficulties in patients with different cancers. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov/ (NCT04873661). Retrospectively registered on the 29th of April 2021. url: https://clinicaltrials.gov/ct2/show/NCT04873661.

Hypnosis to manage musculoskeletal and neuropathic chronic pain: A systematic review and meta-analysis.

This systematic review and meta-analysis aims to identify and quantify the current available evidence of hypnosis efficacy to manage pain in patients with chronic musculoskeletal and neuropathic pain. Randomized Control Trials (RCTs) with hypnosis and/or self-hypnosis treatment used to manage musculoskeletal and/or neuropathic chronic pain in adults and assessing pain intensity were included. Reviews, meta-analyses, non-randomized clinical trials, case reports and meeting abstracts were excluded. Five databases, up until May 13th 2021, were used to search for RCTs using hypnosis to manage chronic musculoskeletal and/or neuropathic pain. The protocol is registered on PROSPERO register (CRD42020180298) and no specific funding was received for this review. The risk of bias asessement was conducted according to the revised Cochrane risk of bias tool for randomized control trials (RoB 2.0). Nine eligible RCTs including a total of 530 participants were considered. The main analyses showed a moderate decrease in pain intensity (Hedge's g: -0.42; p = 0.025 after intervention, Hedge's g: -0.37; p = 0.027 after short-term follow-up) and pain interference (Hedge's g: -0.39; p = 0.029) following hypnosis compared to control interventions. A significant moderate to large effect size of hypnosis compared to controls was found for at 8 sessions or more (Hedge's g: -0.555; p = 0.034), compared to a small and not statistically significant effect for fewer than 8 sessions (Hedge's g: -0.299; p = 0.19). These findings suggest that a hypnosis treatment lasting a minimum of 8 sessions could offer an effective complementary approach to manage chronic musculoskeletal and neuropathic pain. Future research is needed to delineate the relevance of hypnosis in practice and its most efficient prescription.

Neurophysiology of hypnosis in chronic pain: A review of recent literature.

Chronic pain is a complex phenomenon which includes biological, psychological, and socio-professional factors that undermine patients' everyday life. Currently, only few patients significantly benefit from pharmacological treatments and many have to stop them because of negative side effects. Moreover, no medication or treatment addresses all aspects of chronic pain at once (i.e., sensations, emotions, behaviors, and cognitions), positioning chronic pain as an important public health issue and thus contributing to high health-care costs. Consequently, patients and health-care providers are increasingly turning to complementary non-pharmacological techniques such as hypnosis. Clinical research has demonstrated a decrease of pain perception, pain interference, depression and anxiety, and an increase in global quality of life when patients with chronic pain have benefited from hypnosis learning. Neuroimaging studies offer a possible explanation of these results by focusing on neural processes of pain modulation in chronic pain patients' brain. Studies conducted with chronic pain patients showed a modulation of pain matrix activity during hypnosis with a specific involvement of the anterior cingulate cortex (related to emotional and cognitive processing of pain). Therefore, hypnosis seems to act upon regions underlying emotion and cognition, with an influence on pain perception and emotional regulation. In this review, we propose to carry out a review of the recent literature on hypnosis in chronic pain management. A better understanding of the beneficial effects of hypnosis on chronic pain and its neurophysiology should enable more systematic use of this technique in the management of this complex health problem.

Virtual reality and hypnosis for anxiety and pain management in intensive care units: A prospective randomised trial among cardiac surgery patients.

BACKGROUND: Virtual reality and hypnosis are little studied in complex contexts, such as intensive care, where patients need significant physical and psychological assistance. OBJECTIVES: To compare and combine hypnosis and virtual reality benefits on anxiety and pain on patients before and after cardiac surgery. DESIGN: Prospective randomised controlled clinical trial. SETTING: The study was conducted in the University Hospital of Liege (Belgium) from October 2018 to January 2020. PATIENTS: One hundred patients (66 ±â€Š11.5 years; 24 women, 76 men) were included. Participants were adults undergoing cardiac surgery. Exclusion criteria: psychiatric diseases, claustrophobia, acrophobia, hearing loss, visual impairment, extreme fatigue, confusion surgery cancelled. INTERVENTIONS: Patients were randomly assigned to four arms (control; hypnosis; virtual reality; virtual reality hypnosis) and had 20 min of one of the techniques the day before and the day after surgery. MAIN OUTCOMES MEASURES: Anxiety, pain, fatigue, relaxation, physiological parameters, and opioid use were evaluated before and after each session. RESULTS: The main results did not show any significant differences between the groups. In all groups, anxiety decreased and pain increased from baseline to the postoperative day. Relaxation increased in all groups in the pre-operative (P < 0.0001) and postoperative period (P = 0.03). There were no significant differences for fatigue, physiological measures, or opioid use. CONCLUSION: As there were no significant differences between groups for the measured variables, we cannot affirm that one technique is better than another. Additional studies are required to compare and evaluate the cost-effectiveness of these techniques for critical care patients and caregivers. TRIAL REGISTRATION: ClinicalTrials.gov: NCT03820700. https://clinicaltrials.gov/ct2/show/NCT03820700. Retrospectively registered on 29 January 2019.

Hypnotherapy in Treatment of Mastocytosis: A Prospective Study.

Mastocytosis is an orphan disease associated with many systemic symptoms, chronic handicap, and potentially marked social consequences despite improved therapies. In this study, the authors aimed to measure the effect of 2 hypnosis sessions on mastocytosis symptoms in a clinical setting. Questionnaires (pain, flushes, energy, digestive symptoms, quality of life, perceived symptom severity, and global impression of change) were completed pre- and posthypnosis intervention. Data from 20 patients were analyzed (mean age: 53.3 years, 75% female). Compared to baseline assessment, patients exhibited a significant improvement immediately after the first and second hypnosis sessions with regard to the number of days with abdominal pain, abdominal pain intensity and fatigue (p = .03 and p = .005; p = .05 and p = .02; p = .034, and p = .039, respectively). Perceived severity of symptoms was significantly improved throughout the study (p = .0075). Long-term improvement in global impression of change was observed in half the responders (8/16). Patients with mastocytosis had an improvement in disabling symptoms with the impact of hypnotic intervention persisting at 1 month. Several patients experienced long-term improvement.

Complementary treatment comparison for chronic pain management: A randomized longitudinal study.

BACKGROUND: In chronic pain, it seems that the effect of cognitive-behavioral therapy (CBT) is boosted when it is combined with hypnosis. The aim of this study was to assess the efficacy of self-hypnosis combined with self-care (i.e., a type of CBT) compared to music/self-care, self-care and psychoeducation/CBT and to evaluate their long-term effects. METHODS: An open label randomized clinical trial enrolled patients with chronic pain and was carried out at the University Hospital of Liège (Belgium). Patients were randomized into four groups: self-hypnosis/self-care, music/self-care, self-care, psychoeducation/CBT (7 monthly sessions of 2 hours). Two follow-up sessions were delivered at 6- and 12-month. Levels of pain, fatigue intensity, anxiety, depression, insomnia severity, disability, health locus of control, mental and physical quality of life and attitudes (control, disability, harm, emotion, medical cure, medication, solicitude) towards pain were assessed before and after the treatments, and at follow-up. RESULTS: 203 patients were randomized: 52 in self-hypnosis/self-care, 59 in music/self-care, 47 in self-care, and 45 in psychoeducation/CBT. No group effect was found. A significant time effect was showed. Directly after the treatment, all groups decreased in pain attitudes and physical quality of life. Perceived control increased. At 6-month, all patients kept their levels of physical quality of life and perceived control, and showed decrease in pain intensity, harm, emotion and medical cure. At 12-month, scores that had change previously remained ameliorated, a decrease in insomnia severity and an increase in internal locus of control were observed. CONCLUSIONS: The present findings are encouraging as they display long-term beneficial effects of complementary biopsychosocial-based treatments in chronic pain. It seems that patients continued to apply the learnt strategies as improvements were observed one year after the treatments had ended.

Exploratory Controlled Study of the Impact of a Hypnosis-Based Intervention on the Couple's Communication and Coping in the Context of Cancer.

Emotional distress, communication, and dyadic coping difficulties are common among cancer patients and their partners. Hypnosis-based interventions can improve emotional distress in patients. We designed a group intervention combining self-hypnosis and self-care techniques. We hypothesized an effect of the intervention on emotional distress, conjugal communication, and dyadic coping, considered in patients and their partners. Our exploratory controlled study included 55 women with cancer and 55 partners. Participants completed questionnaires before and after the intervention, which was delivered to patients only. No significant effect of the intervention was revealed for patients or partners. Positive correlations between patients' and partners' communication and dyadic coping were revealed. However, to address couples' or partners' difficulties, interventions specifically designed for couples or partners must be tested.

Hypnosis Associated with 3D Immersive Virtual Reality Technology in the Management of Pain: A Review of the Literature.

Hypnosis is well documented in the literature in the management of acute and chronic pain. Virtual reality (VR) is currently gaining credibility in the same fields as hypnosis for medical applications. Lately, the combination of hypnosis and VR was considered. The aim of this scoping review is to understand the current studied contexts and effects of virtual reality hypnosis (VRH) for the management of pain. We searched on PubMed, Taylor & Francis Online, and ProQuest databases with the following terms: "virtual reality," "3D," "hypnosis," and "pain". We included 8 studies that combined hypnosis and VR. All articles are in English. Two included healthy volunteers and six are clinical studies. Short-term results indicated significant decreases in pain intensity, pain unpleasantness, time spent thinking about pain, anxiety, and levels of opioids. However, results are not consistent for all patients all the days. VR alone seems to reduce pain independently of the hypnotizability level. One study claimed that VR and hypnosis could alter each other's effects and another argued that VR did not inhibit the hypnotic process and may even facilitate it by employing visual imagery. We cannot affirm that VR added value to hypnosis when they are combined. These trials and case series gave us indications about the possible applications of VRH in different contexts. Additional randomized clinical trials on VRH in the future will have to test this technique in clinical practice and help define guidelines for VRH utilization in pain management.

Effects of an intervention combining self-care and self-hypnosis on fatigue and associated symptoms in post-treatment cancer patients: A randomized-controlled trial.

OBJECTIVE: Cancer has a lot of consequences such as fatigue, sleep disturbances, emotional distress, cognitive impairment and reduced physical activity. Some hypnosis-based psychological interventions showed positive effects on fatigue, sleep and emotional distress, but generally focused on breast cancer patients. Our study aimed at assessing the effects of a group intervention combining self-care and self-hypnosis on quality of life of cancer patients. METHODS: Our longitudinal randomized-controlled trial assessed the benefits of the intervention first on fatigue and secondly on associated symptoms (sleep, emotional distress, cognitive impairment and reduced physical activity) of post-treatment cancer patients, and investigated predictors of the evolution of fatigue. All variables were measured with questionnaires and an actigraph (for sleep and physical activity). RESULTS: Ninety five women with different cancers were included in our study. Group-by-time effects were showed for fatigue, sleep, emotional distress and cognitive functioning: symptoms have improved in the intervention group compared to wait-list control group. Three predictors of the evolution of fatigue were revealed: depression, anxiety and worry. CONCLUSIONS: Our group intervention had benefits for post-treatment cancer patients' quality of life. Impacting emotional distress could be important in order to decrease fatigue. Further studies are needed to replicate our results. This intervention could be easily implemented to improve quality of life of cancer patients. Registration: ClinicalTrials.gov (NCT03144154). Retrospectively registered on the 1st of May, 2017.

Can hypnosis and virtual reality reduce anxiety, pain and fatigue among patients who undergo cardiac surgery: a randomised controlled trial.

BACKGROUND: Different non-pharmacological techniques, including hypnosis and virtual reality (VR) are currently used as complementary tools in the treatment of anxiety, acute and chronic pain. A new technique called virtual reality hypnosis (VRH), which encompasses a combination of both tools, is regularly used although its benefits and underlying mechanisms remain unknown to date. With the goal to improve our understanding of VRH combination effects, it is necessary to conduct randomised and controlled research trials in order to understand their clinical interest and potential benefits. METHODS: Patients (n = 100) undergoing cardiac surgery at the Liège University Hospital will be randomly assigned to one of four conditions (control, hypnosis, VR or VRH). Each patient will receive two sessions of one of the techniques: one the day before the surgery and one the day after. Physiological assessments will be made on the monitor and patients will rate their levels of anxiety, fatigue, pain, absorption and dissociation. DISCUSSION: This study will help to expand knowledge on the application of virtual reality, hypnosis and VRH in the specific context of cardiac and intensive care procedures, and the influence of these non-pharmacological techniques on patient's anxiety, fatigue, pain and phenomenological experience. TRIAL REGISTRATION: ClinicalTrials.gov: NCT03820700. Date registered on 29 January 2019. Study recruitment date: October 6, 2018. Study anticipated completion date: December 28, 2020.

Neurophenomenology of near-death experience memory in hypnotic recall: a within-subject EEG study.

The neurobiological basis of near-death experiences (NDEs) is unknown, but a few studies attempted to investigate it by reproducing in laboratory settings phenomenological experiences that seem to closely resemble NDEs. So far, no study has induced NDE-like features via hypnotic modulation while simultaneously measuring changes in brain activity using high-density EEG. Five volunteers who previously had experienced a pleasant NDE were invited to re-experience the NDE memory and another pleasant autobiographical memory (dating to the same time period), in normal consciousness and with hypnosis. We compared the hypnosis-induced subjective experience with the one of the genuine experience memory. Continuous high-density EEG was recorded throughout. At a phenomenological level, we succeeded in recreating NDE-like features without any adverse effects. Absorption and dissociation levels were reported as higher during all hypnosis conditions as compared to normal consciousness conditions, suggesting that our hypnosis-based protocol increased the felt subjective experience in the recall of both memories. The recall of a NDE phenomenology was related to an increase of alpha activity in frontal and posterior regions. This study provides a proof-of-concept methodology for studying the phenomenon, enabling to prospectively explore the NDE-like features and associated EEG changes in controlled settings.