Search Results (10)

Hypnotic phenomena exhibit significant inter-individual variability, with some individuals consistently demonstrating efficient responses to hypnotic suggestions, while others show limited susceptibility. Recent neurophysiological studies have added to a growing body of research that shows variability in hypnotic susceptibility is linked to distinct neural characteristics. Building on this foundation, our previous work identified that individuals with high and low hypnotic susceptibility can be differentiated based on the arrhythmic activity observed in resting-state electrophysiology (rs-EEG) outside of hypnosis. However, because previous work has largely focused on mean spectral characteristics, our understanding of the variability over time of these features, and how they relate to hypnotic susceptibility, is still limited. Here we address this gap using a time-resolved assessment of rhythmic alpha peaks and arrhythmic components of the EEG spectrum both prior to and following hypnotic induction. Using multivariate pattern classification, we investigated whether these neural features differ between individuals with high and low susceptibility to hypnosis. Specifically, we used multivariate pattern classification to investigate whether these non-stationary neural features could distinguish between individuals with high and low susceptibility to hypnosis before and after a hypnotic induction. Our analytical approach focused on time-resolved spectral decomposition to capture the intricate dynamics of neural oscillations and their non-oscillatory counterpart, as well as Lempel–Ziv complexity. Our results show that variations in the alpha center frequency are indicative of hypnotic susceptibility, but this discrimination is only evident during hypnosis. Highly hypnotic-susceptible individuals exhibit higher variability in alpha peak center frequency. These findings underscore how dynamic changes in neural states related to alpha peak frequency represent a central neurophysiological feature of hypnosis and hypnotic susceptibility. Full article

In this paper, we present the development and the validation of a novel index of nociception/anti-nociception (N/AN) based on skin impedance measurement in time and frequency domain with our prototype AnspecPro device. The primary objective of the study was to compare the Anspec-PRO device with two other commercial devices (Medasense, Medstorm). This comparison was designed to be conducted under the same conditions for the three devices. This was carried out during total intravenous anesthesia (TIVA) by investigating its outcomes related to noxious stimulus. In a carefully designed clinical protocol during general anesthesia from induction until emergence, we extract data for estimating individualized causal dynamic models between drug infusion and their monitored effect variables. Specifically, these are Propofol hypnotic drug to Bispectral index of hypnosis level and Remifentanil opioid drug to each of the three aforementioned devices. When compared, statistical analysis of the regions before and during the standardized stimulus shows consistent difference between regions for all devices and for all indices. These results suggest that the proposed methodology for data extraction and processing for AnspecPro delivers the same information as the two commercial devices. Full article

General anesthetics were first used over 170 years ago; however, the mechanisms of how general anesthetics induce loss of consciousness (LOC) remain unclear. Ciprofol, a novel intravenous anesthetic, has been developed by incorporating cyclopropyl into the chemical structure of propofol. This modification offers the benefits of rapid onset and minimal injection pain. Recent studies have revealed that the glutamatergic neurons of the lateral habenula (LHb) play a crucial role in modulating the LOC induced by propofol and sevoflurane. Nevertheless, the specific involvement of LHb in the anesthetic effects of ciprofol remains uncertain. Here, using targeted recombination in active populations (TRAP) combined with electroencephalogram/electromyography recordings and the righting reflex behavioral test, our study revealed that intravenous infusion of ciprofol for 1 h could lead to the induction of c-Fos expression in the LHb in mice. The combination of TRAP and gene ablation, aimed at selectively ablating ciprofol-activated neurons in the LHb, has been shown to facilitate the emergence of ciprofol anesthesia and decrease the proportion of delta waves during the emergence phase. Chemogenetic inhibition of these neurons produced a comparable effect, whereas chemogenetic activation resulted in the opposite outcome. Chemogenetic activation of ciprofol-activated neurons in the LHb delays the emergence of anesthesia and induces a deep hypnotic state during the emergence phase. Taken together, our findings suggest that LHb ciprofol-activated neurons modulate the state of consciousness and could potentially be targeted to manipulate consciousness during ciprofol anesthesia. Full article

Background and Objectives: Cerebral ischemia is one of the major preoperative complications. Dexmedetomidine is a well-known sedative–hypnotic agent that has potential organ-protective effects. We examine the miRNAs associated with preconditioning effects of dexmedetomidine in cerebral ischemia. Materials and Methods: Transient infarcts were induced in mice via reperfusion after temporary occlusion of one side of the middle cerebral artery. A subset of these mice was exposed to dexmedetomidine prior to cerebral infarction and miRNA profiling of the whole brain was performed. We administered dexmedetomidine and miRNA-323-5p mimic/inhibitor to oxygen–glucose deprivation/reoxygenation astrocytes. Additionally, we administered miR-323-5p mimic and inhibitor to mice via intracerebroventricular injection 2 h prior to induction of middle cerebral artery occlusion. Results: The infarct volume was significantly lower in the dexmedetomidine-preconditioned mice. Analysis of brain samples revealed an increased expression of five miRNAs and decreased expression of three miRNAs in the dexmedetomidine-pretreated group. The viability of cells significantly increased and expression of miR-323-5p was attenuated in the dexmedetomidine-treated oxygen–glucose deprivation/reoxygenation groups. Transfection with anti-miR-323-5p contributed to increased astrocyte viability. When miRNA-323-5p was injected intraventricularly, infarct volume was significantly reduced when preconditioned with the miR-323-5p inhibitor compared with mimic and negative control. Conclusions: Dexmedetomidine has a protective effect against transient neuronal ischemia–reperfusion injury and eight specific miRNAs were profiled. Also, miRNA-323-5p downregulation has a cell protective effect under ischemic conditions both in vivo and in vitro. Our findings suggest the potential of the miR-323-5p inhibitor as a therapeutic agent against cerebral infarction. Full article

The relevance of formal hypnotic induction to the experience of trance and its neural correlates is not clear, in that hypnotizability, beliefs and expectation of hypnosis may play a major role. The aim of the study was assessing the EEG brain activity of participants with high (highs) or low hypnotizability scores (lows), aware of their hypnotizability level and informed that the session will include simple relaxation, formal hypnotic induction and neutral hypnosis. A total of 16 highs and 15 lows (according to the Stanford Hypnotic Susceptibility Scale, form A) were enrolled. Their EEGs were recorded during consecutive conditions of open/closed-eyes relaxation, hypnotic induction, neutral hypnosis and post hypnosis not interrupted by interviews. The studied variables were theta, alpha and gamma power spectral density (PSD), and the Determinism (DET) and Entropy (ENT) of the EEG signal Multidimensional Recurrence Plot (mRP). Highs reported significantly greater changes in their state of consciousness than lows across the session. The theta, alpha and gamma PSD did not exhibit condition-related changes in both groups. The Alpha PSD was larger in highs than in lows on midline sites, and the different sides/regions’ theta and gamma PSD were observed in the two groups independently from conditions. ENT showed no correlation with hypnotizability, while DET positively correlated with hypnotizability during hypnosis. In conclusion, the relevance of formal hypnotic induction to the experience of trance may be scarce in highs, as they are aware of their hypnotizability scores and expecting hypnosis. Cognitive processing varies throughout the session depending on the hypnotizability level. Full article

The purpose of the present study was to examine placebo and nocebo effects under hypnotic analgesia in lowly hypnotizable (LH) and highly hypnotizable (HH) subjects. A placebo and nocebo, obtained in a two-step intervention (verbal expectation and conditioning), were studied in 12 LH and 12 HH subjects under hypnosis. Visual analog scales (VASs) of pain intensity were recorded in response to short, painful electrical stimuli. VAS scores of placebo-produced analgesia differed significantly from nocebo-produced hyperalgesia in the LH subjects. Placebo intervention combined with hypnotic analgesia in LH subjects led to an analgesic degree similar to that achieved in the HH subjects. Yet, no difference was detected between the placebo and the nocebo effects on the HH subjects. Expectations for placebo and nocebo were significantly higher in the LH subjects than in the HH subjects. It seems that the HH subjects were more “tuned” to an inner trait that made them less susceptible to contextual cues, and therefore, more resistant to placebo/nocebo interventions. The ability to achieve hypnotic analgesia in LH subjects to the degree reached in the HH subjects under combined placebo intervention and hypnosis induction is of clinical significance. Combining placebo intervention with the induction of hypnotic analgesia could markedly improve analgesia, regardless of the patients’ hypnotic susceptibility. Full article

Background and Objectives: Phase lag entropy, an electroencephalographic monitor, evaluates the variety in temporal patterns of phase relationship between frontal and prefrontal brain region. Phase lag entropy can reflect the depth of anesthesia induced by propofol, but the association between sevoflurane and phase lag entropy has not been elucidated. This study examined the effect of sevoflurane on phase lag entropy during induction of general anesthesia. We also explored the pharmacodynamic model between end-tidal anesthetic concentration and electroencephalographic monitor. Materials and Methods: A total of 20 patients were enrolled. General anesthesia was produced by escalating the sevoflurane (1 vol% up to 8 vol%). The relationship between phase lag entropy and end-tidal anesthetic concentration was analyzed. A non-linear mixed-effects model was used to get the relationship of pharmacodynamics between the end-tidal sevoflurane concentration and phase lag entropy. Mean blood pressure, heart rate, and the modified observer’s assessment of alertness/sedation scale were also recorded during sevoflurane anesthesia. Results: As level of sedation increased, phase lag entropy decreased. A significant correlation was showed between phase lag entropy and end-tidal sevoflurane concentration (r = −0.759, p < 0.001). The correlation coefficient between the modified observer’s assessment of alertness/sedation scale and phase lag entropy was 0.731 (p < 0.001). The pharmacodynamic factors assessed by the sigmoid E_max model were E₀ = 84.9, E_max = 42, C_e50 = 1.81, γ = 4.78, and k_e0 = 0.692. The prediction probability of phase-lag entropy for measuring the modified observer’s assessment of alertness/sedation scale and end-tidal sevoflurane concentration were 0.764 and 0.789, respectively. With the increasing concentration of sevoflurane, mean blood pressure decreased, but heart rate did not change. Conclusions: The continuing escalation in end-tidal sevoflurane concentration caused a decline in phase lag entropy. Phase lag entropy can serve as an indicator of hypnotic depth in patients receiving sevoflurane anesthesia. Full article

The intraprocedural immobilization of selected subsets of patients undergoing pars plana vitrectomy (PPV) requires the performance of general anesthesia (GA), which entails the intraoperative use of hypnotics and titration of opioids. The Adequacy of Anesthesia (AoA) concept of GA guidance optimizes the intraoperative dosage of hypnotics and opioids. Pre-emptive analgesia (PA) is added to GA to minimize intraoperative opioid (IO) usage. The current additional analysis evaluated the advantages of PA using either COX-3 inhibitors or regional techniques when added to AoA-guided GA on the rate of presence of postoperative nausea and vomiting (PONV), oculo-emetic (OER), and oculo-cardiac reflex (OCR) in patients undergoing PPV. A total of 176 patients undergoing PPV were randomly allocated into 5 groups: (1) Group GA, including patients who received general anesthesia alone; (2) Group T, including patients who received preventive topical analgesia by triple instillation of 2% proparacaine 15 min before induction of GA; (3) Group PBB, including patients who received PBB; (4) Group M, including patients who received PA using a single dose of 1 g of metamizole; (5) Group P, including patients who received PA using a single dose of 1 g of acetaminophen. The incidence rates of PONV, OCR, and OER were studied as a secondary outcome. Despite the group allocation, intraoperative AoA-guided GA resulted in an overall incidence of PONV in 9%, OCR in 12%, and OER in none of the patients. No statistically significant differences were found between groups regarding the incidence of OCR. PA using COX-3 inhibitors, as compared to that of the T group, resulted in less overall PONV (p < 0.05). Conclusions: PA using regional techniques in patients undergoing PPV proved to have no advantage when AoA-guided GA was utilised. We recommend using intraoperative AoA-guided GA to reduce the presence of OCR, and the addition of PA using COX-3 inhibitors to reduce the rate of PONV. Full article

Introduction: Sleeplessness is the most common sleep disorder. In this study, the hypnotic effect of macerated (HAME) and soxhlet (HASE) extract of Lagenaria vulgaris (fruit and seed) and Cucurbita pepo (fruit) were studied in mice. Methods: Extracts and fractions were administered intra-peritoneally (i.p.) in mice 30 min before the sodium pentobarbital (30 mg/kg, i.p.). Moreover, the influence of flumazenil or naloxone on the hypnotic effects of the extract and its toxic effects were evaluated. Results: The HAME and HASE of C. pepo prolonged the pentobarbital-induced sleep duration at dose of 200 mg/kg. The HAME of L. vulgaris (fruit) at dose of 200 mg/kg increased the sleeping time. The HAME and HASE of L. vulgaris (seed) increased sleep duration at doses of 50 and 100 mg/kg. Besides, flumazenil (2 mg/kg) reversed the effects of both diazepam (P < 0.001 vs. diazepam group), 200 mg/kg of HAME of C. pepo and 50 mg/kg of HAME and HASE of L. vulgaris (seed). All fractions especially ethyl-acetate fraction (EAF) of L. vulgaris (seed) increased the sleep duration. Naloxone reversed the hypnotic effect of HAME and HASE of L. vulgaris (seed). The extracts showed no neurotoxic effects on PC12 and L929 cell lines. Conclusion: The results showed that L. vulgaris (seed and fruit) and C. pepo potentiated pentobarbital hypnosis without toxic influence. The hypnotic effects of L. vulgaris seed was greater than its fruit and C. pepo. The GABA and opioid receptors may play role in the sleep-induction of L. vulgaris seed. Full article

Increasing numbers of licensed health professionals who care for children have been trained in clinical hypnosis. The evidence base for the safety and efficacy of this therapeutic approach in a wide variety of conditions is also growing. Pediatricians and other health professionals who have received training may wish to apply these skills in appropriate clinical scenarios but still may be unsure of the practical matters of how to incorporate this skill-set into day to day practice. Moreover, the practical application of such skills will take very different forms depending on the practice setting, types of acute or chronic conditions, patient and family preferences, and the developmental stages of the child or teen. This article reviews the application of pediatric clinical hypnosis skills by describing the use of hypnotic language outside of formal trance induction, by describing natural trance states that occur in children and teens in healthcare settings, and by describing the process of planning a clinical hypnosis encounter. It is assumed that this article does not constitute training in hypnosis or qualify its readers for the application of such skills; rather, it may serve as a practical guide for those professionals who have been so trained, and may serve to inform other professionals what to expect when referring a patient for hypnotherapy. The reader is referred to specific training opportunities and organizations. Full article