Comparison of Hypnotic Suggestion and Transcranial Direct-Current Stimulation Effects on Pain Perception and the Descending Pain Modulating System: A Crossover Randomized Clinical Trial
Objectives: This paper aims to determine if hypnotic analgesia suggestion and transcranial direct-current stimulation (tDCS) have a differential effect on pain perception. We hypothesized that transcranial direct-current stimulation would be more effective than hypnotic analgesia suggestion at chang...
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| Format: | Article |
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Frontiers Media S.A.
2019-06-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fnins.2019.00662/full |
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| author | Gerardo Beltran Serrano Gerardo Beltran Serrano Gerardo Beltran Serrano Gerardo Beltran Serrano Laura Pooch Rodrigues Bruno Schein Andressa Souza Iraci L. S. Torres Luciana da Conceição Antunes Felipe Fregni Felipe Fregni Wolnei Caumo Wolnei Caumo Wolnei Caumo Wolnei Caumo |
| author_facet | Gerardo Beltran Serrano Gerardo Beltran Serrano Gerardo Beltran Serrano Gerardo Beltran Serrano Laura Pooch Rodrigues Bruno Schein Andressa Souza Iraci L. S. Torres Luciana da Conceição Antunes Felipe Fregni Felipe Fregni Wolnei Caumo Wolnei Caumo Wolnei Caumo Wolnei Caumo |
| author_sort | Gerardo Beltran Serrano |
| collection | DOAJ |
| description | Objectives: This paper aims to determine if hypnotic analgesia suggestion and transcranial direct-current stimulation (tDCS) have a differential effect on pain perception. We hypothesized that transcranial direct-current stimulation would be more effective than hypnotic analgesia suggestion at changing the descending pain modulating system, whereas the hypnotic suggestion would have a greater effect in quantitative sensory testing.Design: This is a randomized, double blind and crossover trial.Settings: All stages of this clinical trial were performed at the Laboratory of Pain and Neuromodulation of the Hospital de Clínicas de Porto Alegre.Subjects: Were included 24 healthy females aged from 18 to 45 years old, with a high susceptibility to hypnosis, according to the Waterloo-Stanford Group Scale of Hypnotic Susceptibility, Form C (15).Methods: The subjects received a random and crossover transcranial direct-current stimulation over the dorsolateral prefrontal cortex (2 mA for 20 min) and hypnotic analgesia (20 min).Results: Only hypnotic suggestion produced changes that are statistically significant from pre- to post-intervention in the following outcomes measures: heat pain threshold, heat pain tolerance, cold pressure test, and serum brain-derivate-neurotrophic-factor. The analysis showed a significant main effect for treatment (F = 4.32; P = 0.04) when we compared the delta-(Δ) of conditioned pain modulation task between the transcranial direct-current stimulation and hypnotic suggestion groups. Also, the change in the brain-derivate-neurotrophic-factor was positively correlated with the conditioned pain modulation task.Conclusion: The results confirm a differential effect between hypnotic suggestion and transcranial direct-current stimulation on the pain measures. They suggest that the impact of the interventions has differential neural mechanisms, since the hypnotic suggestion improved pain perception, whereas the transcranial direct-current stimulation increased inhibition of the descending pain modulating system.Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT03744897.Perspective: These findings highlight the effect of hypnotic suggestion on contra-regulating mechanisms involved in pain perception, while the transcranial direct-current stimulation increased inhibition of the descending pain modulating system. They could help clinicians comprehend the mechanisms involved in hypnotic analgesia and transcranial direct-current stimulation and thus may contribute to pain and disability management. |
| first_indexed | 2024-12-22T03:14:13Z |
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| issn | 1662-453X |
| language | English |
| last_indexed | 2024-12-22T03:14:13Z |
| publishDate | 2019-06-01 |
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| series | Frontiers in Neuroscience |
| spelling | doaj.art-0447301baf9f478889a47e434538c7a72022-12-21T18:40:51ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2019-06-011310.3389/fnins.2019.00662465285Comparison of Hypnotic Suggestion and Transcranial Direct-Current Stimulation Effects on Pain Perception and the Descending Pain Modulating System: A Crossover Randomized Clinical TrialGerardo Beltran Serrano0Gerardo Beltran Serrano1Gerardo Beltran Serrano2Gerardo Beltran Serrano3Laura Pooch Rodrigues4Bruno Schein5Andressa Souza6Iraci L. S. Torres7Luciana da Conceição Antunes8Felipe Fregni9Felipe Fregni10Wolnei Caumo11Wolnei Caumo12Wolnei Caumo13Wolnei Caumo14Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, BrazilPain and Palliative Care Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, BrazilLaboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre, Porto Alegre, BrazilPsychology Department, Universidad Católica de Cuenca, Cuenca, EcuadorLaboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre, Porto Alegre, BrazilLaboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre, Porto Alegre, BrazilDepartment of Nutrition, Health Science Center, Universidade Federal de Santa Catarina (UFSC), Florianópolis, BrazilPostgraduate Program in Health and Human Development, La Salle University, Canoas, BrazilDepartment of Nutrition, Health Science Center, Universidade Federal de Santa Catarina (UFSC), Florianópolis, BrazilBerenson-Allen Center for Noninvasive Brain Stimulation, Harvard Medical School, Boston, MA, United StatesDepartment of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United StatesPost-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, BrazilPain and Palliative Care Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, BrazilLaboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre, Porto Alegre, BrazilDepartment of Pharmacology, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, BrazilObjectives: This paper aims to determine if hypnotic analgesia suggestion and transcranial direct-current stimulation (tDCS) have a differential effect on pain perception. We hypothesized that transcranial direct-current stimulation would be more effective than hypnotic analgesia suggestion at changing the descending pain modulating system, whereas the hypnotic suggestion would have a greater effect in quantitative sensory testing.Design: This is a randomized, double blind and crossover trial.Settings: All stages of this clinical trial were performed at the Laboratory of Pain and Neuromodulation of the Hospital de Clínicas de Porto Alegre.Subjects: Were included 24 healthy females aged from 18 to 45 years old, with a high susceptibility to hypnosis, according to the Waterloo-Stanford Group Scale of Hypnotic Susceptibility, Form C (15).Methods: The subjects received a random and crossover transcranial direct-current stimulation over the dorsolateral prefrontal cortex (2 mA for 20 min) and hypnotic analgesia (20 min).Results: Only hypnotic suggestion produced changes that are statistically significant from pre- to post-intervention in the following outcomes measures: heat pain threshold, heat pain tolerance, cold pressure test, and serum brain-derivate-neurotrophic-factor. The analysis showed a significant main effect for treatment (F = 4.32; P = 0.04) when we compared the delta-(Δ) of conditioned pain modulation task between the transcranial direct-current stimulation and hypnotic suggestion groups. Also, the change in the brain-derivate-neurotrophic-factor was positively correlated with the conditioned pain modulation task.Conclusion: The results confirm a differential effect between hypnotic suggestion and transcranial direct-current stimulation on the pain measures. They suggest that the impact of the interventions has differential neural mechanisms, since the hypnotic suggestion improved pain perception, whereas the transcranial direct-current stimulation increased inhibition of the descending pain modulating system.Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT03744897.Perspective: These findings highlight the effect of hypnotic suggestion on contra-regulating mechanisms involved in pain perception, while the transcranial direct-current stimulation increased inhibition of the descending pain modulating system. They could help clinicians comprehend the mechanisms involved in hypnotic analgesia and transcranial direct-current stimulation and thus may contribute to pain and disability management.https://www.frontiersin.org/article/10.3389/fnins.2019.00662/fullhypnotic analgesiatranscranial direct-current stimulationpain thresholdconditioned pain modulationbrain-derivate-neurotrophic-factorpain |
| spellingShingle | Gerardo Beltran Serrano Gerardo Beltran Serrano Gerardo Beltran Serrano Gerardo Beltran Serrano Laura Pooch Rodrigues Bruno Schein Andressa Souza Iraci L. S. Torres Luciana da Conceição Antunes Felipe Fregni Felipe Fregni Wolnei Caumo Wolnei Caumo Wolnei Caumo Wolnei Caumo Comparison of Hypnotic Suggestion and Transcranial Direct-Current Stimulation Effects on Pain Perception and the Descending Pain Modulating System: A Crossover Randomized Clinical Trial Frontiers in Neuroscience hypnotic analgesia transcranial direct-current stimulation pain threshold conditioned pain modulation brain-derivate-neurotrophic-factor pain |
| title | Comparison of Hypnotic Suggestion and Transcranial Direct-Current Stimulation Effects on Pain Perception and the Descending Pain Modulating System: A Crossover Randomized Clinical Trial |
| title_full | Comparison of Hypnotic Suggestion and Transcranial Direct-Current Stimulation Effects on Pain Perception and the Descending Pain Modulating System: A Crossover Randomized Clinical Trial |
| title_fullStr | Comparison of Hypnotic Suggestion and Transcranial Direct-Current Stimulation Effects on Pain Perception and the Descending Pain Modulating System: A Crossover Randomized Clinical Trial |
| title_full_unstemmed | Comparison of Hypnotic Suggestion and Transcranial Direct-Current Stimulation Effects on Pain Perception and the Descending Pain Modulating System: A Crossover Randomized Clinical Trial |
| title_short | Comparison of Hypnotic Suggestion and Transcranial Direct-Current Stimulation Effects on Pain Perception and the Descending Pain Modulating System: A Crossover Randomized Clinical Trial |
| title_sort | comparison of hypnotic suggestion and transcranial direct current stimulation effects on pain perception and the descending pain modulating system a crossover randomized clinical trial |
| topic | hypnotic analgesia transcranial direct-current stimulation pain threshold conditioned pain modulation brain-derivate-neurotrophic-factor pain |
| url | https://www.frontiersin.org/article/10.3389/fnins.2019.00662/full |
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