From language to pain: brain-behavior representations of hypnotic verbal suggestions for pain modulation

Language can shape pain by conveying conceptual information about future somatosensory experiences. However, how verbal input is encoded in the brain and how these representations are later implemented during pain modulation remains unclear. We used a standardized hypnotic procedure with fMRI to test how verbal suggestions of hypoalgesia and hyperalgesia (vs neutral control) modulate pain. We quantified convergent neural responses across individuals during both suggestion encoding and pain processing, using inter-subject correlation and multivoxel pattern similarity approaches, respectively, and related these measures to individual differences in hypnotic suggestibility using representational similarity analysis. More suggestible individuals showed similar temporal dynamics in language-related regions during encoding and more similar hypoalgesia-specific patterns in the left parahippocampal gyrus (PHG) during pain. In contrast, lower suggestibility was associated with convergent responses in sensorimotor and monitoring systems across phases, demonstrating different neural implementation in individuals less successful in converting suggestions into hypoalgesia. These findings identify the PHG as a key region linking the effect of verbal suggestions to subsequent pain relief and show that hypnotic suggestibility structures how neural dynamics during language processing translate into altered pain experiences. This study offers a mechanistic lens for understanding how medical hypnosis and language-based therapies influence pain.