Neuromodulation and Hypnosis: Current Evidence and Future Directions (2026)
Rinaldo Livio Perri and Gloria Di Filippo
Department of Economical, Communication, and Psychological Sciences, University Niccolò Cusano, Rome, Italy
Correspondence: perri.rinaldo@gmail.com
Keywords: non-invasive brain stimulation; phenomenology of hypnosis; prefrontal cortex; hypnotic imagery
Non-invasive brain stimulation (NIBS) has emerged as one of the most promising approaches for investigating the neural mechanisms underlying hypnosis and hypnotizability (Perri & Di Filippo, 2023a). Techniques such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) enable researchers to modulate cortical activity and directly test the causal role of specific brain regions in hypnotic phenomena. Most studies have focused on the dorsolateral prefrontal cortex (DLPFC), a key region involved in executive control, metacognition, and self-awareness (Dienes & Hutton, 2013).
Early TMS studies provided the first evidence that prefrontal modulation could influence hypnotic responsiveness. Dienes and Hutton (2013) reported that inhibitory stimulation of the left DLPFC produced a modest increase in subjective responses to hypnotic suggestions. Although a subsequent replication attempt failed to replicate this result (Coltheart et al., 2018), the same study found that inhibiting the right DLPFC increased behavioral responsiveness to hypnosis, suggesting hemispheric differences in the neural mechanisms supporting hypnotic responding. More recently, Faerman et al. (2024) employed a personalized neuroimaging-guided TMS protocol targeting left DLPFC regions functionally connected to the dorsal anterior cingulate cortex (dACC). Their randomized controlled trial demonstrated a significant increase in hypnotizability, although the magnitude of this effect was modest, providing further preliminary evidence that targeted neuromodulation can alter hypnotic responsiveness.
Research using tDCS has produced particularly encouraging findings. Perri et al. (2022) applied inhibitory bilateral stimulation over the DLPFC and observed an approximately 11% increase in hypnotic depth, accompanied by a reduction in the subjective sense of volitional control. A subsequent study employing a more focal unilateral montage targeting the left DLPFC reported an approximately 15% increase in the hypnoidal state score, a phenomenological measure of hypnosis, following active stimulation compared with sham stimulation (Perri & Di Filippo, 2023a). These effects were associated with changes in phenomenological dimensions such as absorption and self-awareness, reinforcing the role of prefrontal regions in shaping the hypnotic experience. Further work demonstrated that individuals with lower baseline hypnoidal state scores benefited most from stimulation (+36%), suggesting that neuromodulation may be especially useful for enhancing this subjective measure of hypnosis in individuals who are typically less responsive (Perri & Di Filippo, 2023b).
An as-yet-unpublished study has extended this line of research by adopting an online stimulation protocol, in which inhibitory tDCS was delivered during hypnosis, rather than before hypnosis as in previous offline studies. Unlike earlier investigations, no significant effects emerged on phenomenological measures of hypnosis. However, participants with initially low imagery abilities showed a remarkable enhancement in spontaneous imagery vividness, with an average increase of approximately 70%. Notably, this effect was specific to hypnotic imagery suggestion and was not observed when the same stimulation protocol was applied during imagery tasks performed outside the hypnotic context. These findings suggest that online neuromodulation may selectively enhance hypnotic imagery processes in individuals who are less naturally predisposed to vivid mental imagery.
Overall, current evidence indicates that modulation of prefrontal regions can influence both hypnotic experience and hypnotizability. The main limitations of the current literature include small sample sizes, a predominant reliance on subjective measures of hypnotizability, the lack of neurophysiological assessments to objectively evaluate the effects of neurostimulation on brain activity, and, in some cases, the absence of evaluations of blinding integrity. Future developments—including high-definition tDCS, transcranial alternating current stimulation, and multifocal stimulation—may provide greater precision and personalization. If supported by larger longitudinal studies, these approaches could enhance the effectiveness of hypnosis-based interventions for pain management, emotional regulation, and other clinical applications.
References
Coltheart, M., Cox, R., Sowman, P., Morgan, H., Barnier, A., Langdon, R., Polito, V., & Connors, M. H. (2018). Belief, delusion, hypnosis, and the right dorsolateral prefrontal cortex: A transcranial magnetic stimulation study. Cortex, 101, 234–248. https://doi.org/10.1016/j.cortex.2018.01.001
Dienes, Z., & Hutton, S. (2013). Understanding hypnosis metacognitively: RTMS applied to left DLPFC increases hypnotic suggestibility. Cortex, 49(2), 386–392. https://doi.org/10.1016/j.cortex.2012.07.009
Faerman, A., Bishop, J. H., Stimpson, K. H., Phillips, A., Gülser, M., Amin, H., Kallioniemi, E., & Spiegel, D. (2024). Stanford hypnosis integrated with functional connectivity-targeted transcranial stimulation (SHIFT): A preregistered randomized controlled trial. Nature Mental Health, 2, 96–103. https://doi.org/10.1038/s44220-023-00184-z
Perri, R. L., & Di Filippo, G. (2023a). Alteration of hypnotic experience following transcranial electrical stimulation of the left prefrontal cortex. International Journal of Clinical and Health Psychology, 23(2), Article 100346. https://doi.org/10.1016/j.ijchp.2022.100346
Perri, R. L., & Di Filippo, G. (2023b). Transcranial electrical stimulation of the prefrontal cortex to boost the hypnosis experience: Who benefits most? Frontiers in Psychology, 14, Article 1217396. https://doi.org/10.3389/fpsyg.2023.1217396
Perri, R. L., Perrotta, D., Rossani, F., & Pekala, R. J. (2022). Boosting the hypnotic experience: Inhibition of the dorsolateral prefrontal cortex alters hypnotizability and sense of agency. A randomized, double-blind, and sham-controlled tDCS study. Behavioural Brain Research, 425(3), Article 113833. https://doi.org/10.1016/j.bbr.2022.113833