The notion of consciousness is at the core of an ongoing debate on the existence and nature of hypnotic states. Previously, we have described changes in brain activity associated with hypnosis (Rainville, Hofbauer, Paus, Duncan, Bushnell, & Price, 1999). Here, we replicate and extend those findings using positron emission tomography (PET) in 10 normal volunteers. Immediately after each of 8 PET scans performed before (4 scans) and after (4 scans) the induction of hypnosis, subjects rated their perceived level of “mental relaxation” and “mental absorption,” two of the key dimensions describing the experience of being hypnotized. Regression analyses between regional cerebral blood flow (rCBF) and self-ratings confirm the hypothesized involvement of the anterior cingulate cortex (ACC), the thalamus, and the ponto-mesencephalic brainstem in the production of hypnotic states. Hypnotic relaxation further involved an increase in occipital rCBF that is consistent with our previous interpretation that hypnotic states are characterized by a decrease in cortical arousal and a reduction in cross-modality suppression (disinhibition). In contrast, increases in mental absorption during hypnosis were associated with rCBF increases in a distributed network of cortical and subcortical structures previously described as the brain's attentional system. These findings are discussed in support of a state theory of hypnosis in which the basic changes in phenomenal experience produced by hypnotic induction reflect, at least in part, the modulation of activity within brain areas critically involved in the regulation of consciousness.

The neural mechanisms underlying hypnotic states and responses to hypnotic suggestions remain largely unknown and, to date, have been studied only with indirect methods. Here, the effects of hypnosis and suggestions to alter pain perception were investigated in hypnotizable subjects by using positron emission tomography (PET) measures of regional cerebral blood flow (rCBF) and electroencephalographic (EEG) measures of brain electrical activity. The experimental conditions included a restful state (Baseline) followed by hypnotic relaxation alone (Hypnosis) and by hypnotic relaxation with suggestions for altered pain unpleasantness (Hypnosis-with-Suggestion). During each scan, the left hand was immersed in neutral (35°C) or painfully hot (47°C) water in the first two conditions and in painfully hot water in the last condition. Hypnosis was accompanied by significant increases in both occipital rCBF and delta EEG activity, which were highly correlated with each other ( r = 0.70, p < 0.0001). Peak increases in rCBF were also observed in the caudal part of the right anterior cingulate sulcus and bilaterally in the inferior frontal gyri. Hypnosis-related decreases in rCBF were found in the right inferior parietal lobule, the left precuneus, and the posterior cingulate gyrus. Hypnosis-with-suggestions produced additional widespread increases in rCBF in the frontal cortices predominantly on the left side. Moreover, the medial and lateral posterior parietal cortices showed suggestion-related increases overlapping partly with regions of hypnosis-related decreases. Results support a state theory of hypnosis in which occipital increases in rCBF and delta activity reflect the alteration of consciousness associated with decreased arousal and possible facilitation of visual imagery. Frontal increases in rCBF associated with suggestions for altered perception might reflect the verbal mediation of the suggestions, working memory, and top-down processes involved in the reinterpretation of the perceptual experience. These results provide a new description of the neurobiological basis of hypnosis, demonstrating specific patterns of cerebral activation associated with the hypnotic state and with the processing of hypnotic suggestions.

Judgments of the intensity of a stimulus are dependent on the level of central nervous system activity it generates. Generally, it is assumed that such judgments are based on activity along modality-specific pathways. Thus, visual intensity judgments would be based on unimodal visual activity. However, many neurons do not fit neatly within modality-specific categories, but can be influenced by more than one sensory modality. Often the “multisensory” effect is quite pronounced. If these multisensory neurons participate in such fundamental functions as perceived intensity, the presence of a nonvisual (i.e., auditory) cue may have a significant effect on the perceived intensity of a visual cue. The results of the present study were consistent with such a hypothesis. A brief, broad-band auditory stimulus was found to significantly enhance the perceived intensity of an LED. The effect was most pronounced at the lowest visual intensities, and was evident regardless of the location of the auditory cue. However, it was present only at the location of visual fixation. Yet, despite the significant influence of the auditory cue, and its differential effect at different visual intensities, a power function that maintains the proportionality among perceived visual intensities was retained.

During the last two decades there has been a proliferation of studies evaluating the psychophysical and neural attributes of heat-induced pain. Experiments using radiant and contact heat-induced pain have produced different observations thereby broadening our appreciation of the importance of acknowledging how a noxious heat stimulus is delivered; moreover manipulations of stimulus parameters have now provided a foundation for understanding the underlying neural mechanisms of heat-induced pain and their biological significance. The psychophysical attributes of heat-induced pain include highly reliable thresholds for most body regions, minimal adaptation to maintained noxious stimuli, an exquisite sensitivity to small changes in stimulus intensity, slow temporal summation for some types of heat-induced pain (i.e., second pain) but not for others (i.e., first pain), spatial summation---especially for suprathreshold noxious temperatures---and the perceived spread of pain well beyond the actual body area stimulated (i.e., radiation). The present body of information indicates that the pain system is optimally adapted for conveying precise information about intensity, and is less concerned with other stimulus features, such as spatial patterns or boundaries.