Deep Hypnosis Research Articles

Gamma power and beta envelope correlation are potential neural predictors of deep hypnosis

Hypnosis is a psychological intervention that is commonly used to enhance the effectiveness of therapeutic suggestions. Despite extensive fascination and study, the neural mechanisms behind hypnosis remain elusive. In the current study, we undertook a systematic exploration of these neural correlates. We first extracted well-studied neurophysiological features from EEG sensors and source-localized data using spectral analysis and two measures of functional connectivity: weighted phase lag index (wPLI) and power envelope correlation (PEC). Next, we developed classification models that predicted self-rated hypnotic experience based on the extracted feature sets. Our findings reveal that gamma power computed on sensor-level data and beta PEC computed between source-localized brain networks are the top predictors of hypnosis depth. Further, a SHapley Additive exPlanations (SHAP) analysis suggested reduced gamma power in the midline frontal area and increased beta PEC between interhemispheric Dorsal Attention Networks (DAN) contribute to the hypnotic experience. These results broaden our understanding of the neural correlates of deep hypnosis, highlighting potential targets for future research. Moreover, this study demonstrates the potential of using predictive models in understanding the neural underpinnings of self-reported hypnotic depth, offering a template for future investigations.

Real-time assessment of hypnotic depth, using an EEG-based brain-computer interface: a preliminary study

ObjectiveHypnosis can be an effective treatment for many conditions, and there have been attempts to develop instrumental approaches to continuously monitor hypnotic state level (“depth”). However, there is no method that addresses the individual variability of electrophysiological hypnotic correlates. We explore the possibility of using an EEG-based passive brain-computer interface (pBCI) for real-time, individualised estimation of the hypnosis deepening process.ResultsThe wakefulness and deep hypnosis intervals were manually defined and labelled in 27 electroencephalographic (EEG) recordings obtained from eight outpatients after hypnosis sessions. Spectral analysis showed that EEG correlates of deep hypnosis were relatively stable in each patient throughout the treatment but varied between patients. Data from each first session was used to train classification models to continuously assess deep hypnosis probability in subsequent sessions. Models trained using four frequency bands (1.5–45, 1.5–8, 1.5–14, and 4–15 Hz) showed accuracy mostly exceeding 85% in a 10-fold cross-validation. Real-time classification accuracy was also acceptable, so at least one of the four bands yielded results exceeding 74% in any session. The best results averaged across all sessions were obtained using 1.5–14 and 4–15 Hz, with an accuracy of 82%. The revealed issues are also discussed.

The Unbearableness of Being Light.

The Unbearableness of Being Light.

Emergence delirium in children is not related to intraoperative burst suppression \u2013 prospective, observational electrography study

BackgroundEmergence-delirium is the most frequent brain dysfunction in children recovering from general anaesthesia, though the pathophysiological background remains unclear. The presented study analysed an association between emergence delirium and intraoperative Burst Suppression activity in the electroencephalogram, a period of very deep hypnosis during general anaesthesia.MethodsIn this prospective, observational cohort study at the Charité - university hospital in Berlin / Germany children aged 0.5 to 8 years, undergoing planned surgery, were included between September 2015 and February 2017. Intraoperative bi-frontal electroencephalograms were recorded. Occurrence and duration of Burst Suppression periods were visually analysed. Emergence delirium was assessed using the Pediatric Assessment of Emergence Delirium Score.ResultsFrom 97 children being analysed within this study, 40 children developed emergence delirium, and 57 children did not. Overall 52% of the children displayed intraoperative Burst Suppression periods; however, occurrence and duration of Burst Suppression (Emergence delirium group 55% / 261 + 462 s vs. Non-emergence delirium group 49% / 318 + 531 s) did not differ significantly between both groups.ConclusionsOur data reveal no correlation between the occurrence and duration of intraoperative Burst Suppression activity and the incidence of emergence delirium. Burst Suppression occurrence is frequent; however, it does not seem to have an unfavourable impact on cerebral function at emergence from general anaesthesia in children.Trail registrationNCT02481999, June 25, 2015.

Pediatric Electroconvulsive Therapy: An Anesthesiologist's Perspective.

Proper planning and communication between psychiatry and anesthesiology teams is vital to conferring the greatest therapeutic benefit to children presenting for electroconvulsive therapy while minimizing risk. Anesthesia for the child undergoing electroconvulsive therapy should ideally provide deep hypnosis, ensure muscle relaxation to reduce injury, have minimal effect on seizure dynamics, and allow for rapid recovery to baseline neurologic and cardiopulmonary status. Unique factors for pediatric electroconvulsive therapy include the potential need for preoperative anxiolytic and inhalational induction of anesthesia, which must be weighed against the detrimental effects of anesthetic agents on the evoked seizure quality required for a successful treatment.

Does a hypnosis session reduce the required propofol dose during closed-loop anaesthesia induction?: A randomised controlled trial.

Hypnosis has a positive effect on peri-operative anxiety and pain. The objective of this study was to assess the impact of a formal deep hypnosis session on the consumption of propofol for anaesthetic induction using automated administration of propofol guided by the bispectral index (BIS) in a closed loop. A 1 : 1 randomised, usual-care-controlled, single-centre trial. Tertiary care centre in France from April 2014 to December 2015. Female adult patients scheduled for outpatient gynaecological surgery under general anaesthesia. Before surgery, patients were randomised to receive either a deep hypnosis session or routine care. Anaesthetic induction was performed automatically by propofol without opioids and was assisted by the BIS in a closed loop. The primary endpoint was the propofol dose required for anaesthesia induction, defined as a BIS less than 60 for at least 30 s. Data for 31 patients in the hypnosis group and 35 in the control group were analysed. There was no evidence of a difference in the mean required propofol dose for anaesthetic induction between the hypnosis and the control groups (2.06 mg kg (95% confidence interval [1.68 to 2.43]) versus 1.79 mg kg (95% CI [1.54 to 2.03]), P = 0.25, respectively). The current study, which was designed to determine the effect of a deep hypnosis session on anaesthesia induction using an automated tool for propofol administration, failed to detect a difference in the required dose of propofol. ClinicalTrials.gov, NCT02249364.

Effect of psychological projection on improving the quality of marriage of patients with breast cancer after chemotherapy

Objective To explore the psychological projection on improving the quality of marriage of patients with breast cancer after chemotherapy. Methods From January to December 2015, a total of 32 breast cancer patients with postoperative chemotherapy who admitted to Department of General Surgery Huai'nan North Hospital and Huai'nan Eastern Hospital were selected as the research object. Olson marital quality questionnaire was issued when patients firstly receiving chemotherapy in hospital, at the same time they were evaluated by the Rorschach Inkblot Test. In view of the negative projection in the patient's test, the intervention was carried out by painting projective therapy, sand plate therapy, deep hypnosis and cognitive behavioral therapy. The marital quality of patients were investigated again at 1 month after discharge or the second time receiving chemotherapy. The scores of Olson marital quality questionnaire were compared before and after the intervention. Results Before the intervention of psychological projection, the score of marital satisfaction, husband and wife communication and sexual life dimension in the Olson quality of marriage questionnaire were (33.3±5.6) , (30.9±5.5) and (28.2±4.2) respectively. The scores of each dimension after intervention were (36.1±4.6) , (34.2±4.3) , and (30.7±5.3) respectively. They were all improved in the Olson marital quality questionnaire, and the differences were statistically significant (t=2.19, 2.67, 2.09; P<0.05) . Conclusions The intervention of psychological projection can relieve the physical and psychological trauma caused by breast cancer in patients with postoperative chemotherapy of breast cancer and improve the quality of marriage. Key words: Breast neoplasms; Antineoplastic combined chemotherapy protocols; Marital quality; Psychological projection; Projection effect

Certain Bio-Cognitive and Quantum Views of Depression

Depression has been considered essentially a psycho-bio, social condition. In this paper, a hypnotic/quantum approach to understanding depression is attempted and parallel or co-thinking is designated as quantum thinking, one of the main sources of depressive cognitions. It is the flexibility of the quantum brain that accounts for cognitive distortions. Hypnosis may involve a spectrum of quantum consciousness and has great research value in uncovering non-biological depression. Like many of the alternate states of consciousness, hypnosis may be a neuro-quantum state. In the earlier part of the 2oth century, Frederic Myers recognised that the middle realm of the unconscious mind is the “hypnotic stratum” and is associated with deep hypnosis. The unconscious is increasingly allied with the quantum and it is time to revise the concept of the Freudian unconscious accordingly. The co-existence of a quantum mechanical body and brain is all the time more recognised now in parasciences. If consciousness is transmitted through rather than actually produced by the brain, depression may have a downward causation rather than an upward causation arguable in biological disorders like schizophrenia and bipolar disorder. Consciousness-based healing is warranted in the treatment of depression. Whether consciousness is the primary generator of clinical depression or it only contributes to the genesis of depression will continue to be a matter for debate in the foreseeable future.

70. Laser-evoked potentials (LEPs) in chronic pain conditions during hypnotic analgesia

Hypnotic analgesia represents one of the most effective nonpharmacological methods for pain control. Hypnosis and distraction from pain might share similar mechanisms, implying that brain responses to painful stimulation should be similarly reduced in both situations. Literature data are conflicting, showing increase, reduction or no change in Event-Related Brain Potentials amplitudes during hypnosis compared to control conditions. Here we investigate effects of hypnosis and distraction during laser-evoked potentials (LEPs) in patients with chronic painful diseases. 9 patients with chronic pain were studied with LEPs on the dominant hand during resting state, medium and deep hypnosis (techniques for analgesia), and focused attention on article reading. Pain induced by LEPs was assessed with Numerical Rating Scale (NRS) and we analyzed N2/P2 complex amplitude change during the three conditions. Patients under hypnosis showed significant N2/P2 amplitudes decrease compared to resting state and distraction. Hypnosis is a physiological modified state of consciousness that may differ either from mental relaxation or distraction from pain. N2/P2 amplitude reduction may depend on different brain networks activation, in particular frontolimbic pathways, which could modify noxious stimuli input processing during hypnotic analgesia. Our results indicate that different brain mechanisms might act in hypnosis and distraction during pain processing.

Out-of-Body Experience Induced by Hypnotic Suggestions: An Exploratory Neurophenomenological Study

The main objective of this study was to compare the neurophenomenology of the Out-of-Body-Experience (OBE) state induced by hypnotic suggestion on a group of five selected participants with other states of consciousness, specifically the state of imagined OBE and hypnosis. From a phenomenological point of view, a comparison of the OBE state with that of deep hypnosis, measured by using the Phenomenology of Consciousness Inventory, gave higher scores of Self-Awareness, Memory, Rationality, Voluntary Control and Imagery for the OBE.From a neurophysiological perspective, the major difference – with respect to all other control conditions – was an increase in the power spectrum density and a decrease of coherence of the delta band when participants were required to answer questions posed by the hypnotist during their OBE state, suggesting that this could be the neurophysiological marker of this special state of consciousness.

Relationship of bispectral index to minimum alveolar concentration during isoflurane, sevoflurane or desflurane anaesthesia

To determine bispectral index (BIS) values produced by equipotent concentrations of commonly used volatile anaesthetics. Female patients undergoing thyroidectomy were randomly assigned to receive isoflurane, sevoflurane or desflurane anaesthesia. After induction, anaesthesia was maintained by the volatile agent at 1 minimum alveolar concentration and supplemented with remifentanil infusion. BIS values were recorded during 1 h surgical anaesthesia after a 15 min equilibrium phase. Time-averaged BIS value during the study period was significantly lower in the desflurane group (n = 29) than the sevoflurane group (n = 27) (37.0 ± 4.9 vs 41.5 ± 5.9). Duration of deep hypnosis (BIS < 40) was significantly longer in the desflurane group than the sevoflurane group (40.2 ± 20.7 vs 24.3 ± 22.5 min). There were no significant differences in any parameter between the isoflurane group (n = 27) and any other group. Desflurane produces a greater hypnotic effect than sevoflurane during equipotent anaesthesia. Management of volatile anaesthesia using predetermined minimum alveolar concentration targets can lead to an unnecessarily long duration of deep hypnosis.

A right hemisphere safety backup at work: Hypotheses for deep hypnosis, post-traumatic stress disorder, and dissociation identity disorder

Problem theory points to an a priori relation between six key problems of living, to which people have adapted through evolution. Children are guided through the problems one by one, learning to switch between them automatically and unawares. The first problem of raising hope of certainty (about the environment), is dealt with in the right hemisphere (RH). The second of raising hope of freedom (or power to control), is dealt with in the left hemisphere (LH). Here adventurousness and ignoring the goodness of outcomes potentially create recklessness. When uncertainty rises the RH activates a backup with an override that substitutes immobility, takes over sensory inputs, but allows obedience to parental commands, and a cut-out that stops new work on the freedom problem. Support for the use of the backup by infants is found in the immobility that precedes the crying in strange conditions, and in childhood EEGs. The hypothesis that the backup is active in deep hypnosis imposes accord on findings that appear contradictory. For example it accounts for why observations during deep hypnosis emphasize the activity of the RH, but observations of responsive people not under hypnosis emphasize the activity of the LH. The hypothesis that the backup is active in post-traumatic stress disorder (PTSD) is supported by (a) fMRI observations that could reflect the cut-out, in that part of the precuneus has low metabolism, (b) the recall of motionlessness at the time of the trauma, (c) an argument that playing dead as a defence against predators is illogical, (d) the ease of hypnosis. With dissociative identity disorder (DID), the theory is consistent with up to six alters that have executive control and one trauma identity state where childhood traumas are re-experienced. Support for the cut-out affecting the trauma identity state comes from suppression of part of the precuneus and other parts of the parietal lobe when the trauma identity state is salient and a general script about a trauma is listened to. Support also comes from the ease of hypnosis. The cut-out acts independently of the override. It is linked to low metabolism at the same point in the left precuneus by evidence from all three conditions, hypnosis, PTSD and DID. The concept of dissociation is not required with any of the hypotheses.

Hospital Stay and Mortality Are Increased in Patients Having a “Triple Low” of Low Blood Pressure, Low Bispectral Index, and Low Minimum Alveolar Concentration of Volatile Anesthesia

Sessler, Daniel I.; Sigl, Jeffrey C.; Kelley, Scott D.; Chamoun, Nassib G.; Manberg, Paul J.; Saager, Leif; Kurz, Andrea; Greenwald, ScottAuthor Information

Dexmedetomidine overdosage: An unusual presentation

We present a case of dexmedetomidine toxicity in a 3-year-old child. The case report describes the features and outlines the treatment strategy adopted. The child presented with bradypnoea, bradycardia, hypotension, deep hypnosis and miosis. He was successfully managed with oxygen, saline boluses and adrenaline infusion. He became haemodynamically stable with adrenaline infusion. He started responding to painful stimuli in 3 h and became oriented in 7 h. Dexmedetomidine, a selective α2 adrenoceptor agonist, is claimed to have a wide safety margin. This case report highlights the fact that dexmedetomidine administered in a toxic dose may be life-threatening may present with miosis and adrenaline infusion may be a useful supportive treatment.

Hospital Stay and Mortality Are Increased in Patients Having a “Triple Low” of Low Blood Pressure, Low Bispectral Index, and Low Minimum Alveolar Concentration of Volatile Anesthesia

Low mean arterial pressure (MAP) and deep hypnosis have been associated with complications and mortality. The normal response to high minimum alveolar concentration (MAC) fraction of anesthetics is hypotension and low Bispectral Index (BIS) scores. Low MAP and/or BIS at lower MAC fractions may represent anesthetic sensitivity. The authors sought to characterize the effect of the triple low state (low MAP and low BIS during a low MAC fraction) on duration of hospitalization and 30-day all-cause mortality. Mean intraoperative MAP, BIS, and MAC were determined for 24,120 noncardiac surgery patients at the Cleveland Clinic, Cleveland, Ohio. The hazard ratios associated with combinations of MAP, BIS, and MAC values greater or less than a reference value were determined. The authors also evaluated the association between cumulative triple low minutes, and excess length-of-stay and 30-day mortality. Means (±SD) defining the reference, low, and high states were 87 ± 5 mmHg (MAP), 46 ± 4 (BIS), and 0.56 ± 0.11 (MAC). Triple lows were associated with prolonged length of stay (hazard ratio 1.5, 95% CI 1.3-1.7). Thirty-day mortality was doubled in double low combinations and quadrupled in the triple low group. Triple low duration ≥60 min quadrupled 30-day mortality compared with ≤15 min. Excess length of stay increased progressively from ≤15 min to ≥60 min of triple low. The occurrence of low MAP during low MAC fraction was a strong and highly significant predictor for mortality. When these occurrences were combined with low BIS, mortality risk was even greater. The values defining the triple low state were well within the range that many anesthesiologists tolerate routinely.

Fractal dimension of electroencephalogram for assessment of hypnosis state of patient during anaesthesia

Depth of Anaesthesia (DoA) measurement and control is a demanding task that must be done to avoid intraoperative awareness and explicit recall of pain during surgery. Conventional methods of assessing DoA involve monitoring of physiological parameters, which are not found reliable, as patient awareness during surgery with anaesthetic agents has been reported. Electroencephalogram (EEG) is found to be a reliable means to determine the real anaesthetic state of a patient during surgery. Balanced anaesthesia is the fusion of four different components: hypnosis, analgesia, amnesia and neuromuscular blockade. The accurate control of anaesthesia is possible only with the accurate assessment of the different components of anaesthesia. The major component of balanced anaesthesia is hypnosis, which gives the level of unconsciousness of the patient during surgery. In the present study, efforts were made to calculate and validate an EEG-based parameter which is able to predict the awake and anaesthetic sleep state of the patient. In the present study, the EEG of 60 patients were recorded during normal awake state and while under anaesthesia. Analysis of the EEG signals was performed by non-linear quantifiers. Higuchi’s Fractal Dimension (HFD) has been calculated for this recorded EEG waveform for all patients in both states. It was found that HFD is able to predict the awake/sleep state of the patient quite accurately. Validation of the study was done by monitoring BIS in parallel and concluded that the HFD of the EEG goes down as the patient moves into deep hypnosis state.

EEG-Stadien im Steady State von Xenon-Narkosen

Einleitung: Xenon ist als Inhalationsanästhetikum in Deutschland und in anderen Ländern der Europäischen Union seit 2005 bzw. seit 2007 zugelassen. Es sollte untersucht werden, welche Hypnosetiefe, gemessen am Elektroenzephalogramm (EEG), im Steady State von Xenon-Narkosen erreicht wird.

Deep Hypnosis as a Sign of “Imbalance” in Balanced Anesthesia

Deep Hypnosis as a Sign of “Imbalance” in Balanced Anesthesia

Assessing the depth of hypnosis of xenon anaesthesia with the EEG / Bestimmung der Hypnosetiefe bei Xenon-Narkosen mit dem EEG

Xenon was approved as an inhaled anaesthetic in Germany in 2005 and in other countries of the European Union in 2007. Owing to its low blood/gas partition coefficient, xenons effects on the central nervous system show a fast onset and offset and, even after long xenon anaesthetics, the wake-up times are very short. The aim of this study was to examine which electroencephalogram (EEG) stages are reached during xenon application and whether these stages can be identified by an automatic EEG classification. Therefore, EEG recordings were performed during xenon anaesthetics (EEG monitor: Narcotrend®). A total of 300 EEG epochs were assessed visually with regard to the EEG stages. These epochs were also classified automatically by the EEG monitor Narcotrend® using multivariate algorithms. There was a high correlation between visual and automatic classification (Spearman's rank correlation coefficient r=0.957, prediction probability Pk=0.949). Furthermore, it was observed that very deep stages of hypnosis were reached which are characterised by EEG activity in the low frequency range (delta waves). The burst suppression pattern was not seen. In deep hypnosis, in contrast to the xenon EEG, the propofol EEG was characterised by a marked superimposed higher frequency activity. To ensure an optimised dosage for the single patient, anaesthetic machines for xenon should be combined with EEG monitoring. To date, only a few anaesthetic machines for xenon are available. Because of the high price of xenon, new and further developments of machines focus on optimizing xenon consumption.

Hypnotic depth and the incidence of emergence agitation and negative postoperative behavioral changes

Emergence agitation (EA) and negative postoperative behavioral changes (NPOBC) are common in children, although the etiology remains unclear. We investigated whether longer times under deep hypnosis as measured by Bispectral Index (BIS) monitoring would positively correlate with a greater incidence of EA in the PACU and a greater occurrence of NPOBC in children after discharge. We enrolled 400 children, 1-12 years old, scheduled for dental procedures under general anesthesia. All children were induced with high concentration sevoflurane, and BIS monitoring was continuous from induction through recovery in the PACU. A BIS reading <45 was considered deep hypnosis. The presence of EA was assessed in the PACU using the Pediatric Anesthesia Emergence Delirium scale. NPOBC were assessed using the Post-Hospital Behavior Questionnaire, completed by parents 3-5 days postoperatively. Data were analyzed using logistic regression, with a P < 0.05 considered statistically significant. The incidence of EA was 27% (99/369), and the incidence of NPOBC was 8.8% (28/318). No significant differences in the incidence of EA or NPOBC were seen with respect to length of time under deep hypnosis as measured by a BIS value of <45. Our data revealed no significant correlation between the length of time under deep hypnosis (BIS < 45) and the incidence of EA or NPOBC. Within this population, these behavioral disturbances do not appear to be related to the length of time under a deep hypnotic state as measured by the BIS.