Chronic pain concerns one in four adults in Belgium. Fibromyalgia is an example of chronic pain and is characterized by diffused and migrant musculo-tendinous pain localized in the limbs and at an axial level. The technological improvement in neuroimaging allowed to improve, at a cerebral level, the identification of the structural and the functional characteristics of this clinical entity. Studies indicated a modification in cerebral morphometry showing an alteration of white and grey matter in the anterior cingulate cortex, orbitofrontal lateral cortex, cerebellum, basal ganglia, insula, secondary somatosensory cortex, thalamus, amygdala, putamen, superior temporal gyrus and periaqueductal grey matter. At a functional level, studies show un alteration in the connectivity of the default mode network, an atrophy of zones implicated in nociception and an increased activation of zone implicated in response to a nociceptive stimulus. Nowadays, researchers are interested in finding out the beneficial effects of non-pharmacological techniques to improve de well-being of patients with chronic pain. Hypnosis is one of these techniques that has already proven to be successful in decreasing pain and improving global quality of life. Nevertheless, to our knowledge, no study has been conducted to understand the impact of hypnosis upon the cerebral functioning of these patients. Therefore, the aim of this study is to understand the impact of a 6 months self-hypnosis/self-care learning program upon the structural and functional functioning of the brain by means of functional magnetic resonance imagery (fMRI) and electroencephalography (EEG).
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
60
Learning phase of self-hypnosis/self-care.
Hospital University of Liège
Liège, Belgium
RECRUITINGChange in pain description
The impact of self-hypnosis/self-care on pain description will be assessed by means of a Visual Analogue Scale (VAS). Scale ranging from 0 (no pain) to 10 (worst pain).
Time frame: Day 0 (first meeting with the doctor), up to 5 months (before the intervention), up to 12 months (after the intervention)
Change in sleep difficulties
The impact of self-hypnosis/self-care upon the severity of insomnia will be assessed by means of the "Insomnia Severity Index" (Morin et al., 2001). Scale ranging from 0 (none) to 4 (very severe).
Time frame: Day 0 (first meeting with the doctor), up to 5 months (before the intervention), up to 12 months (after the intervention)
Change in anxiety
The impact of self-hypnosis/self-care on anxiety will be assessed by means of the subtest "anxiety" of the Hospital Anxiety and Depression Scale (HADS, Zigmond \& Snaith, 1983). Scale ranging from 0 (never) to 4 (always).
Time frame: Day 0 (first meeting with the doctor), up to 5 months (before the intervention), up to 12 months (after the intervention)
Change in depression
The impact of self-hypnosis/self-care on depression will be assessed by means of the subtest "anxiety" of the Hospital Anxiety and Depression Scale (HADS, Zigmond \& Snaith, 1983). Scale ranging from 0 (never) to 4 (always).
Time frame: Day 0 (first meeting with the doctor), up to 5 months (before the intervention), up to 12 months (after the intervention)
Change in pain disability
The impact of self-hypnosis/self-care on pain disability will be assessed by means of the "Pain Disability Index" (PDI, Tait et al., 1990). Scale ranging from 0 (no difficulties) to 10 (a lot of difficulties).
Time frame: Day 0 (first meeting with the doctor), up to 5 months (before the intervention), up to 12 months (after the intervention)
Change in attitudes and beliefs about pain
The impact of self-hypnosis/self-care on the attitudes and beliefs about pain will be assessed my means of the "Survey of Pain Attitudes" (SOPA, Jensen \& Karoly, 1987). Scale ranging from 0 (totally wrong) to 10 (totally right).
Time frame: Day 0 (first meeting with the doctor), up to 5 months (before the intervention), up to 12 months (after the intervention)
Change in quality of life
The impact of self-hypnosis/self-care on the quality of life will be assessed by means of the "Short Form-36"(SF-36; Ware et al., 1988). Each item is balanced to obtain a score between 0 (worst quality) to 100 (maximum quality).
Time frame: Day 0 (first meeting with the doctor), up to 5 months (before the intervention), up to 12 months (after the intervention)
Change in locus of control
The impact of self-hypnosis/self-care on the locus of control will be assessed my means og the "Multidimensional Health Locus of Control" (MHLC, Wallston et al., 1978). Scale ranging from 1 (no agreement) to 4 (agreement).
Time frame: Day 0 (first meeting with the doctor), up to 5 months (before the intervention), up to 12 months (after the intervention)
Change of the impact of pain
The impact of self-hypnosis/self-care on the impact of pain in individual's life, quality of social support and general activity, will be assessed my means of the "Multidimensional Pain Index" (PDI, Kerns et al., 1985). Scale ranging from 0 (none) to 6 (a lot).
Time frame: Day 0 (first meeting with the doctor), up to 5 months (before the intervention), up to 12 months (after the intervention)
Change in generic health
The impact of self-hypnosis/self-care on generic health will be assessed by the "EuroQol 5 Dimensions" questionnaire (EQ-5D, Health Policy, 1990). Scale ranging from 1 (no problems) to 3 (extreme problems).
Time frame: Day 0 (first meeting with the doctor), up to 5 months (before the intervention), up to 12 months (after the intervention)
Change in health status
The impact of Self-hypnosis/self-care on global health status will be assessed by means of a Visual Analogue Scale (VAS). Scale ranging from 0 (worst health status) to 100 (best health status).
Time frame: Day 0 (first meeting with the doctor), up to 5 months (before the intervention), up to 12 months (after the intervention)
Change in physical activity
The impact of self-hypnosis/self-care on the physical activity will be assessed by means of the International Physical Activity Questionnaire (Craig et al., 2003). Participants have to describe the amount of low to intense physical activity they did over a period of 7 days.
Time frame: Day 0 (first meeting with the doctor), up to 5 months (before the intervention), up to 12 months (after the intervention)
Motivation to change
The impact of self-hypnosis/self-care on the motivation to change will be assessed by means of the "University of Rhode Island Change Assessment" (URICA, DiClemente et al., 1990). Scale ranging from 1 (no agreement) to 5 (agreement).
Time frame: Day 0 (first meeting with the doctor), up to 5 months (before the intervention), up to 12 months (after the intervention)
Impact on return-to-work
For participants who continued to work at time of inclusion, the "Work Design Questionnaire" (WDQ, Morgeson \& Hymphrey, 2006) will be administered. Scale ranging from 0 (not at all) to 5 (exactly).
Time frame: Day 0 (first meeting with the doctor), up to 5 months (before the intervention), up to 12 months (after the intervention)
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