The neural mechanisms of immediate and follow-up of the treatment effect of hypnosis on smoking craving

Hypnosis has a therapeutic effect on substance dependence. However, its neural basis remains unclear, which impedes its further clinical applications. This study investigated the mechanisms of smoking treatment based on hypnosis from two perspectives: immediate and follow-up effects. Twenty-four smokers screened from 132 volunteers underwent hypnosis suggestion and performed a smoking-related cue task twice during functional magnetic resonance imaging (fMRI) scanning (in normal and hypnotic states). The number of cigarettes smoked per day was recorded at follow-up visits. The smokers reported decreased craving after hypnosis. The activations in the right dorsal lateral prefrontal cortex (rDLPFC), the left insula and the right middle frontal gyrus (rMFG), and the functional connectivity between the rDLPFC and the left insula were increased in the hypnotic state. The reduced craving was related to the DLPFC-insula network, which reflected the immediate mechanism of hypnosis on smoking. The number of cigarette use at the 1-week and 1 month follow-up was correlated with the rMFG activation which reflecting hypnotic depth, suggesting the follow-up effect of hypnosis on smoking depended on the trait of smokers. We identified two different mechanisms of hypnosis effect on smoking, which have important implications for design and optimization of hypnotic treatments on mental disorders.