Pain perception and EEG dynamics: Does hypnotizability account for the efficacy of the suggestions of analgesia?

•Pain perception is modulated in highly hypnotizable Ss by suggestions of analgesia.•Traits different from hypnotizability may be crucial in pain experience/EEG dynamics.•The activity of the Behavioral Inhibition/Activation System (BIS/BAS) is one of them.•BAS variability masks the role of hypnotizability in pain experience and EEG dynamics.•BIS accounts for all the hypnotizability/stimulation/suggestions related EEG effects.

We report novel findings concerning the role of hypnotizability, suggestions of analgesia and the activity of the Behavioral Inhibition/Activation System (BIS/BAS) in the modulation of the subjective experience of pain and of the associated EEG dynamics. The EEG of high (highs) and low hypnotizable participants (lows) who completed the BIS/BAS questionnaire was recorded during basal conditions, tonic nociceptive stimulation without (PAIN) and with suggestions for analgesia (AN). Participants scored the perceived pain intensity at the end of PAIN and AN. The EEG midline dynamics was characterized by indices indicating the signal predictability (Determinism) and complexity (Entropy) obtained through the Recurrence Quantification Analysis. The reduced pain intensity reported by highs during AN was partially accounted for by the activity of the Behavioral Activation System. The decreased midline cortical Determinism observed during nociceptive stimulation in both groups independently of suggestions remained significantly reduced only in lows after controlling for the activity of the Behavioral Activation System. Finally, controlling for the activity of the Behavioral Inhibition System abolished stimulation, suggestions and hypnotizability-related differences. Results indicate that the BIS/BAS activity may be more important than hypnotizability itself in pain modulation and in the associated EEG dynamics.