New views of hypnotizability
Identifieur interne : 003134 ( Ncbi/Merge ); précédent : 003133; suivant : 003135New views of hypnotizability
Auteurs : Enrica L. SantarcangeloSource :
- Frontiers in Behavioral Neuroscience [ 1662-5153 ] ; 2014.
Url:
DOI: 10.3389/fnbeh.2014.00224
PubMed: 25009479
PubMed Central: 4067572
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<front><journal-meta><journal-id journal-id-type="nlm-ta">Front Behav Neurosci</journal-id><journal-id journal-id-type="iso-abbrev">Front Behav Neurosci</journal-id><journal-id journal-id-type="publisher-id">Front. Behav. Neurosci.</journal-id><journal-title-group><journal-title>Frontiers in Behavioral Neuroscience</journal-title></journal-title-group><issn pub-type="epub">1662-5153</issn><publisher><publisher-name>Frontiers Media S.A.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25009479</article-id><article-id pub-id-type="pmc">4067572</article-id><article-id pub-id-type="doi">10.3389/fnbeh.2014.00224</article-id><article-categories><subj-group subj-group-type="heading"><subject>Neuroscience</subject><subj-group><subject>Opinion Article</subject></subj-group></subj-group></article-categories><title-group><article-title>New views of hypnotizability</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Santarcangelo</surname><given-names>Enrica L.</given-names></name><xref ref-type="author-notes" rid="fn001"><sup>*</sup></xref><uri xlink:type="simple" xlink:href="http://community.frontiersin.org/people/u/108340"></uri></contrib></contrib-group><aff><institution>Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa</institution><country>Pisa, Italy</country></aff><author-notes><corresp id="fn001">*Correspondence: <email xlink:type="simple">enricals@dfb.unipi.it</email></corresp><fn fn-type="other" id="fn002"><p>This article was submitted to the journal Frontiers in Behavioral Neuroscience.</p></fn><fn fn-type="edited-by"><p>Edited by: Shigeyoshi Itohara, RIKEN Brain Science Institute, Japan</p></fn><fn fn-type="edited-by"><p>Reviewed by: Masao Ito, RIKEN Brain Science Institute, Japan; Akira Katoh, Tokai University, Japan</p></fn></author-notes><pub-date pub-type="epub"><day>24</day><month>6</month><year>2014</year></pub-date><pub-date pub-type="collection"><year>2014</year></pub-date><volume>8</volume><elocation-id>224</elocation-id><history><date date-type="received"><day>25</day><month>4</month><year>2014</year></date><date date-type="accepted"><day>04</day><month>6</month><year>2014</year></date></history><permissions><copyright-statement>Copyright © 2014 Santarcangelo.</copyright-statement><copyright-year>2014</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/3.0/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</license-p></license></permissions><kwd-group><kwd>hypnotizability</kwd><kwd>imagery</kwd><kwd>cerebellum</kwd><kwd>postural control</kwd><kwd>voluntariness</kwd><kwd>nitric oxide</kwd></kwd-group><counts><fig-count count="1"></fig-count><table-count count="1"></table-count><equation-count count="0"></equation-count><ref-count count="58"></ref-count><page-count count="5"></page-count><word-count count="4150"></word-count></counts></article-meta></front><body><sec sec-type="intro" id="s1"><title>Introduction</title><p>Hypnotizability, or hypnotic susceptibility (Green et al., <xref rid="B17" ref-type="bibr">2005</xref>), is a good predictor of the response to suggestions in and out of hypnosis (Meyer and Lynn, <xref rid="B39" ref-type="bibr">2011</xref>). It can be measured by scales (Sheehan and McConkey, <xref rid="B52" ref-type="bibr">1982</xref>) allowing to classify subjects as high (<italic>highs</italic>), medium (<italic>mediums</italic>), and low (<italic>lows</italic>) hypnotizable by indicating the individual ability to modify experience and behavior according to the suggestions' content and to feel that this occurs independently of will.</p><p>In the ordinary state of consciousness, <italic>highs</italic> and <italic>lows</italic> can be discriminated by the predictability of their electroencephalographic (EEG) dynamics, while the several studies performed through spectral analysis of EEG failed to indicate clear-cut discrimination criteria (Madeo et al., <xref rid="B34" ref-type="bibr">2013</xref>). Imaging studies (Hoeft et al., <xref rid="B21" ref-type="bibr">2012</xref>) have associated high hypnotizability with greater functional connectivity between the left dorsolateral prefrontal cortex, an executive-control region, and the salience network (dorsal anterior cingulate cortex, anterior insula, amygdala, ventral striatum) involved in detection and processing of relevant information (Figure <xref ref-type="fig" rid="F1">1</xref>). This is consistent with the evidence that <italic>highs</italic> tend to become deeply absorbed in any task of everyday life (Tellegen and Atkinson, <xref rid="B56" ref-type="bibr">1974</xref>; Kihlstrom et al., <xref rid="B28" ref-type="bibr">1989</xref>); nonetheless, the theory attributing the <italic>highs'</italic> peculiar ability of focusing attention on selected internal or external objects as the basis of hypnotic responding (Raz, <xref rid="B44" ref-type="bibr">2005</xref>; Szekely et al., <xref rid="B55" ref-type="bibr">2010</xref>) has been challenged by neuropsychological and genetic studies. The former have denied any association between various attentional abilities and hypnotisability (Varga et al., <xref rid="B57" ref-type="bibr">2011</xref>), have shown only higher arousal in <italic>highs</italic> (Castellani et al., <xref rid="B8" ref-type="bibr">2007</xref>) and have suggested that the <italic>highs</italic>' attention is more stable (less distractible) rather than more flexible than the <italic>lows</italic>' one (Jamieson and Sheehan, <xref rid="B24" ref-type="bibr">2004</xref>; Egner et al., <xref rid="B15" ref-type="bibr">2005</xref>); genetic studies (Presciuttini et al., <xref rid="B43" ref-type="bibr">2014</xref>) have refuted the hypothesis that reduced dopamine catabolism associated with polymorphism of the brain Catechol-O-Methil-Transferase (COMT) may be responsible for the <italic>highs'</italic> attentional abilities, as no difference between <italic>highs</italic> and <italic>lows</italic> has been found in COMT polymorphism (Szekely et al., <xref rid="B55" ref-type="bibr">2010</xref>). Nonetheless, theoretically, higher dopaminergic tone could be sustained in <italic>highs</italic> by other mechanisms such as different receptors density/distribution/sensitivity, dopamine production, and catabolism by the Mono-Amino-Oxidase system.</p><fig id="F1" position="float"><label>Figure 1</label><caption><p><bold>Schematic view of hypnotizability-related differences in the brain activity</bold>. <sup>*</sup>Structures and connections (arrows) possibly involved.</p></caption><graphic xlink:href="fnbeh-08-00224-g0001"></graphic></fig><p>Since the very beginning of my research activity I have focused my interest on the physiological correlates of hypnotisability rather than on its psychological factors possibly accounting for hypnotic responding (Killeen and Nash, <xref rid="B29" ref-type="bibr">2003</xref>; Dienes et al., <xref rid="B13" ref-type="bibr">2009</xref>; Lynn and Green, <xref rid="B33" ref-type="bibr">2011</xref>). In fact, I considered that the existence of a trait influencing only one aspect of behavior—the proneness to accept suggestions—would be a serious challenge to common sense, all the more that hypnotic performance was considered a consequence of peculiar attentional abilities (Raz, <xref rid="B44" ref-type="bibr">2005</xref>), attention modulates several sensorimotor processes (Woollacott and Shumway-Cook, <xref rid="B59" ref-type="bibr">2002</xref>; Ruff, <xref rid="B46" ref-type="bibr">2013</xref>), cognitive-emotional traits have been associated with peculiar morphological characteristics of cerebellar structures (Picerni et al., <xref rid="B42" ref-type="bibr">2013</xref>), and both the cerebellum and basal ganglia are often involved in non-motor functions (Stoodley, <xref rid="B54" ref-type="bibr">2012</xref>; Leisman and Melillo, <xref rid="B32" ref-type="bibr">2013</xref>; Keren-Happuch et al., <xref rid="B27" ref-type="bibr">2014</xref>).</p><p>My intuition was correct. Indeed, I have found hypnotizability-related differences (Carli et al., <xref rid="B6" ref-type="bibr">2006</xref>, <xref rid="B5" ref-type="bibr">2008</xref>; Santarcangelo et al., <xref rid="B49" ref-type="bibr">2008</xref>, <xref rid="B48" ref-type="bibr">2010</xref>; Menzocchi et al., <xref rid="B37" ref-type="bibr">2010</xref>, <xref rid="B38" ref-type="bibr">2012</xref>; Castellani et al., <xref rid="B7" ref-type="bibr">2011</xref>; Scattina et al., <xref rid="B50" ref-type="bibr">2012</xref>) in many aspects of sensori-motor integration in both the absence (Table <xref ref-type="table" rid="T1">1</xref>) (Collins and De Luca, <xref rid="B9" ref-type="bibr">1993</xref>; Caratelli et al., <xref rid="B2" ref-type="bibr">2010</xref>; Mecacci et al., <xref rid="B36" ref-type="bibr">2013</xref>) and the presence of suggestions. I have chosen the differences in postural control induced by imagined sensory alteration (Carli et al., <xref rid="B6" ref-type="bibr">2006</xref>; Santarcangelo et al., <xref rid="B48" ref-type="bibr">2010</xref>; Scattina et al., <xref rid="B50" ref-type="bibr">2012</xref>) as the object of this article. I will also show that my physiological approach to the field of hypnotizability allows to suggest that the involuntariness reported by <italic>highs</italic> in their response to sensory suggestions is physiologically sustained and, thus, “real” rather than only subjectively experienced (Santarcangelo et al., <xref rid="B48" ref-type="bibr">2010</xref>).</p><table-wrap id="T1" position="float"><label>Table 1</label><caption><p><bold>Sensori-motor integration in not hypnotized <italic>highs</italic> not receiving any suggestion</bold>.</p></caption><table frame="hsides" rules="groups"><tbody><tr><td align="left" rowspan="1" colspan="1"><bold>SPINAL REFLEXES DURING LONG LASTING RELAXATION (Carli et al., <xref rid="B5" ref-type="bibr">2008</xref>)</bold></td></tr><tr><td align="left" rowspan="1" colspan="1">Habituation of the <italic>soleus</italic> muscle H reflex</td></tr><tr><td align="left" rowspan="1" colspan="1">Reduction of the F wave frequency of occurrence (right hand <italic>abductor digiti minimi</italic><xref ref-type="table-fn" rid="TN1"><sup>*</sup></xref>)</td></tr><tr><td align="left" rowspan="1" colspan="1"><bold>POSTURAL CONTROL<xref ref-type="table-fn" rid="TN1"><sup>*</sup></xref></bold></td></tr><tr><td align="left" rowspan="1" colspan="1">Greater independence of peripheral information (Santarcangelo et al., <xref rid="B49" ref-type="bibr">2008</xref>)</td></tr><tr><td align="left" rowspan="1" colspan="1">Larger range of body sway not associated with peripherally-induced correction (Santarcangelo et al., <xref rid="B49" ref-type="bibr">2008</xref>)</td></tr><tr><td align="left" rowspan="1" colspan="1">Postural behavior similar to <italic>lows</italic> in highly demanding postural tasks (Caratelli et al., <xref rid="B2" ref-type="bibr">2010</xref>; Mecacci et al., <xref rid="B36" ref-type="bibr">2013</xref>)</td></tr><tr><td align="left" rowspan="1" colspan="1"><bold>WALKING DIRECTION DURING BLINDFOLDED LOCOMOTION (Menzocchi et al., <xref rid="B2" ref-type="bibr">2010</xref>)</bold></td></tr><tr><td align="left" rowspan="1" colspan="1">Larger variability in basal conditions</td></tr><tr><td align="left" rowspan="1" colspan="1">Scarce influence of tonic head rotation</td></tr><tr><td align="left" rowspan="1" colspan="1"><bold>HAPTIC EXPLORATION</bold></td></tr><tr><td align="left" rowspan="1" colspan="1">More accurate angle reproduction (Menzocchi et al., <xref rid="B38" ref-type="bibr">2012</xref>)</td></tr><tr><td align="left" rowspan="1" colspan="1">More frequent visual recognition of meaningless objects (Castellani et al., <xref rid="B7" ref-type="bibr">2011</xref>)</td></tr></tbody></table><table-wrap-foot><fn id="TN1"><label>*</label><p><italic>Stabilogram diffusion analysis (Collins and De Luca, <xref rid="B9" ref-type="bibr">1993</xref>) revealed different internal models for postural control in highs and lows during suppression of vision and alteration of the leg proprioceptive information (Santarcangelo et al., <xref rid="B49" ref-type="bibr">2008</xref>). Nonetheless, highs were not less efficient than lows in maintaining balance when postural conditions were highly demanding and required higher engagement of sensory feed-back mechanisms, as occurs on see-saw platforms (Caratelli et al., <xref rid="B2" ref-type="bibr">2010</xref>) and in one legged stance (Mecacci et al., <xref rid="B36" ref-type="bibr">2013</xref>)</italic>.</p></fn></table-wrap-foot></table-wrap><sec><title>Postural effects of imagined sensory alteration</title><p>The experience of involuntariness in hypnotic responding has been attributed by neo-dissociative theories to dissociation between experience or executive control and behavior, and by socio-cognitive theories to deep absorption in mental images associated with high expectancy of behavior congruent with the suggestions content (Lynn and Green, <xref rid="B33" ref-type="bibr">2011</xref>).</p><p>Different cortical activities have been observed during active, passive and hypnotically-induced movements (Kosslyn et al., <xref rid="B31" ref-type="bibr">2001</xref>; Blakemore et al., <xref rid="B1" ref-type="bibr">2003</xref>; Cardena et al., <xref rid="B3" ref-type="bibr">2012</xref>), and the observed activation of the inferior parietal cortex has been assumed as responsible for perceived involuntariness (Blakemore et al., <xref rid="B1" ref-type="bibr">2003</xref>), whereas physiological automaticity in hypnotic responding has never been demonstrated. I have approached this topic through a number of postural studies (Carli et al., <xref rid="B6" ref-type="bibr">2006</xref>; Santarcangelo et al., <xref rid="B48" ref-type="bibr">2010</xref>; Scattina et al., <xref rid="B50" ref-type="bibr">2012</xref>).</p><p>It is well-known that imagined and physically- induced perceptions as well as imagined and real voluntary movements activate the same neural circuits, although to different extent (Jeannerod, <xref rid="B25" ref-type="bibr">2001</xref>; Kosslyn et al., <xref rid="B31" ref-type="bibr">2001</xref>; Moulton and Kosslyn, <xref rid="B40" ref-type="bibr">2009</xref>; Munzert et al., <xref rid="B41" ref-type="bibr">2009</xref>; Hétu et al., <xref rid="B20" ref-type="bibr">2013</xref>). Several observations suggest a more effective activation of these circuits in <italic>highs</italic>.</p><p>In fact, only <italic>highs</italic> exhibited a backward body displacement (as expected on the basis of the inertia law) while standing and receiving the instruction to imagine that a carpet was under their feet and was being abruptly pulled forward (Carli et al., <xref rid="B6" ref-type="bibr">2006</xref>). In this study, the expected behavior was not explicitly described by the suggestion script; in addition, participants reported not to have predicted their movement on the basis of pertaining physical laws and to have experienced their backward sway as involuntary. Thus, it appeared unlikely that their movement was triggered by absorption/expectation, as suggested by Kirsch and Lynn (<xref rid="B30" ref-type="bibr">1999</xref>), but we did not have any objective evidence of involuntariness.</p><p>In another study, during imagery of procedural leg pain (Scattina et al., <xref rid="B50" ref-type="bibr">2012</xref>), that is while imagining that “the surgeon is taking out some pebbles from the left calf, he is using tweezers, he cannot avoid tearing away small pieces of flesh… unfortunately there is no anesthetic…,” only highs exhibited a postural response (larger and faster body sway with respect to rest, displacement of the Center of Pressure (CoP) toward the site opposite to the imagined nociceptive stimulation) congruent with the suggestion administered and reported it as involuntary. Covariate analysis showed that their body displacement was not completely accounted for by the vividness of imagery, absorption in the task and perceived pain intensity; in fact, the CoP displacement toward the opposite side was independent of all these factors. Thus, again our findings challenged the hypothesis that absorption/expectation may be sufficient to account for the observed motor response. Nonetheless, participants may have been aware that pain in one leg induces a displacement toward the other leg and/or remember similar real situations, thus again we had no evidence of involuntariness.</p></sec><sec><title>The vestibulo-spinal reflex: a probe for involuntariness</title><p>We designed an experiment to assess whether the perception of involuntariness may be sustained by physiological automaticity (Santarcangelo et al., <xref rid="B48" ref-type="bibr">2010</xref>). In particular, we chose the vestibulo-spinal reflex (VR) evoked by galvanic stimulation of the labyrinth as a “probe for involuntariness.” In fact, the vestibular stimulation induces body sway depending on the head position with respect to the body (Manzoni, <xref rid="B35" ref-type="bibr">2005</xref>; Shaikh et al., <xref rid="B51" ref-type="bibr">2005</xref>), that is in the frontal plane with the participant's head directed forward and in the sagittal plane with the head rotated toward one side. This shift in the direction of body sway depends on the cerebellar integration of vestibular and neck proprioceptive inputs (Kammermeier et al., <xref rid="B26" ref-type="bibr">2009</xref>). In addition, the VR earliest component elicited in any head position is not modulated by expectancy (Guerraz and Day, <xref rid="B19" ref-type="bibr">2005</xref>) and volition (Reynolds, <xref rid="B45" ref-type="bibr">2010</xref>).</p><p>We elicited VR in highs and lows with their head directed forward as well as physically and imaginatively rotated toward one side (“… please, imagine that your head is rotated toward the right side… you can see your chin aligned with your shoulder… and feel the tension in your neck muscles… ”) and observed that only the highs' VR earliest component occurred in the sagittal plane for both the real and imagined head rotation, in spite of the similar absorption and vividness of imagery. Given the characteristics of VR, we have to admit that imagery of “rotated head” generated the same neural conditions associated with real head rotation, despite the subjects could not predict which neural circuits should be activated/inhibited and the studied reflex could not be voluntarily controlled. In other words, highs can transform into appropriate neural activations not only the mental images of voluntary movement and of selected perceptions (Jeannerod, <xref rid="B25" ref-type="bibr">2001</xref>; Kosslyn et al., <xref rid="B31" ref-type="bibr">2001</xref>; Moulton and Kosslyn, <xref rid="B40" ref-type="bibr">2009</xref>; Munzert et al., <xref rid="B41" ref-type="bibr">2009</xref>; Hétu et al., <xref rid="B20" ref-type="bibr">2013</xref>), as observed in the general population, but also the images of sensory contexts whose neural correlates cannot be predicted and controlled. The highs' experience of involuntariness may reflect this “automatic” activation of neural circuits enabling these individuals to change their internal model for postural control according to their mental images. This change does not require any dissociative barrier (Dienes et al., <xref rid="B13" ref-type="bibr">2009</xref>; Dell, <xref rid="B12" ref-type="bibr">2010</xref>; Lynn and Green, <xref rid="B33" ref-type="bibr">2011</xref>), is not a consequence of deep absorption/high expectancy (Lynn and Green, <xref rid="B33" ref-type="bibr">2011</xref>), and cannot be assimilated to the preparation of voluntary movements (Custers and Aarts, <xref rid="B11" ref-type="bibr">2010</xref>).</p><p>The <italic>highs'</italic> deeper embodiment of the image of rotated head, however, may derive also from their preferential employment of the kinesthetic modality of imagery. In fact, in line with earlier findings (Carli et al., <xref rid="B4" ref-type="bibr">2007</xref>), they more often reported to have “felt the neck muscles tension” rather than to have “seen their chin in line with the shoulder”(Santarcangelo et al., <xref rid="B48" ref-type="bibr">2010</xref>), and the kinesthetic modality is more efficacious than the visual one in the body representation (Shenton et al., <xref rid="B53" ref-type="bibr">2004</xref>).</p><p>In contrast to the imagery of rotated head, which consists of an entirely imagined sensory context, the obstructive suggestion of anesthesia, which requires only the ability to attenuate/abolish the perception of a physical stimulation, reduces the amplitude of the VR earliest component in both groups (Santarcangelo et al., <xref rid="B48" ref-type="bibr">2010</xref>), as observed for the suggestion of analgesia during nociceptive stimulation (Santarcangelo et al., <xref rid="B47" ref-type="bibr">2013</xref>). Thus, on the basis of the observed hypnotizability-related capacity to transform mental images into sensori-motor physiological conditions, <italic>highs</italic> may represent the upper extreme of a continuum in the ability to modulate neural conditions through imagery.</p></sec></sec><sec><title>Responses to sensory suggestions and the cerebellum</title><p>Impaired performance at cerebellar tests during suggestions of anesthesia had suggested a cerebellar involvement in the motor response to sensory suggestions, but hypnotic relaxation may have influenced the performance (Wallace and Hoyenga, <xref rid="B58" ref-type="bibr">1981</xref>). It has been also shown that overactivity in the cerebellum and in the parietal cortex is associated with the misattribution of actions to an external source (Blakemore et al., <xref rid="B1" ref-type="bibr">2003</xref>), but this report did not consider a possible real, physiologically based involuntariness.</p><p>In our study of the imagery of rotated head (Santarcangelo et al., <xref rid="B48" ref-type="bibr">2010</xref>) the embodiment of the mental image of rotated head involuntarily produced is likely to enable the cerebellum to act routinely on the imaginatively constructed sensory information. Alternatively, imagery-triggered top down signals may change the cerebellar internal model according to the mental images' content. In both instances, the perceived involuntariness would be physiologically sustained. In contrast, in the studies on imagery of leg pain (Scattina et al., <xref rid="B50" ref-type="bibr">2012</xref>) and of inertial backward falling (Carli et al., <xref rid="B6" ref-type="bibr">2006</xref>), in which the response to suggestions could be expected and voluntarily controlled (despite the participants' subjective reports), real involuntariness could be sustained by reduced cerebellar inhibition (Groiss and Ugawa, <xref rid="B18" ref-type="bibr">2013</xref>) of motor cortices (Figure <xref ref-type="fig" rid="F1">1</xref>).</p><p>Together with parietal associative areal, the cerebellum is likely to be responsible also for the different internal models (Ito, <xref rid="B22" ref-type="bibr">2006</xref>) for postural control observed in <italic>highs</italic> and <italic>lows</italic> in the absence of suggestions (Santarcangelo et al., <xref rid="B49" ref-type="bibr">2008</xref>). It should be also studied whether cerebellar peculiarities may contribute to the cognitive aspects of hypnotic responding through vestibulo-<italic>coeruleus</italic> and rubro-thalamo-prefrontal pathways (Groiss and Ugawa, <xref rid="B18" ref-type="bibr">2013</xref>).</p></sec><sec><title>Frontiers: hypnotizability and nitric oxide</title><p>Studies of the post-occlusion flow-mediated dilation (FMD) of the brachial artery (Green et al., <xref rid="B16" ref-type="bibr">2014</xref>) have indicated greater availability of endothelial nitric oxide (NO) in <italic>highs</italic> during mental stress and nociceptive stimulation (Jambrik et al., <xref rid="B23" ref-type="bibr">2005</xref>). A quite important question is whether, in these individuals, larger NO availability characterizes also the brain vessels. In fact, the brain endothelial NO is responsible for basal vascular tone, interacts with other mediators, and acts as a neurotransmitter after diffusion to the extracellular compartment. Thus, (Figure <xref ref-type="fig" rid="F1">1</xref>), in the whole brain, endothelial NO could prime cascade processes modulating the neuronal activity in <italic>highs</italic> and <italic>lows</italic> differentially. In addition, in animals NO increases the release of acetylcholine, decreases the dopamine release and increases its metabolism; in humans, larger endothelial NO availability in hypnotizability-related circuits (Hoeft et al., <xref rid="B21" ref-type="bibr">2012</xref>) could account for the <italic>highs'</italic> attentional characteristics (see Presciuttini et al., <xref rid="B43" ref-type="bibr">2014</xref>) and could be involved in the cognitive aspects of hypnotizability.</p><p>In the cerebellum NO acts also as a negative regulator of granule cell precursor proliferation, promotes survival and differentiation of these neurons and regulates bidirectional plasticity at parallel fiber-Purkinje neuron synapses (Contestabile, <xref rid="B10" ref-type="bibr">2012</xref>). Thus, in the cerebellum, NO could be responsible for different functional properties. On the whole, <italic>highs</italic> and <italic>lows</italic> may exhibit NO-dependent different activation of sensory and associative regions such as those belonging to the salience and executive circuits, cerebellar inhibition of the motor cortex, internal model for postural control.</p><p>In conclusion, our findings allow to include hypnotizability among the individual traits responsible for part of the variability in postural control and indicate that it may be involved in the construction of individual sensorimotor selves. They suggest a key role of the cerebellum in hypnotic responding and go beyond psychological theories by suggesting that the involuntariness in action reported after a few sensori-motor suggestions can be real rather than merely experienced.</p><sec><title>Conflict of interest statement</title><p>The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p></sec></sec></body><back><ack><p>I am sincerely grateful to D. Manzoni for his advice on vestibulo-cerebellar physiology and to E. Scattina for her enthusiastic collaboration. The discussed research was funded by the Italian Space Agency (ASI).</p></ack><ref-list><title>References</title><ref id="B1"><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Blakemore</surname><given-names>S. J.</given-names></name><name><surname>Oakley</surname><given-names>D. 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