AP-HP. Nord, Geriatric Department, Bichat Hospital, 46 rue Henri Huchard, 75018, Paris, Cedex 18, France.
Gérond'If, Gérontopôle d'Ile-de-France, 33 rue du Fer à Moulin, 75005, Paris, France.
Alzheimers Res Ther. 2022 Sep 2;14(1):120. doi: 10.1186/s13195-022-01065-w.
Core cerebrospinal fluid (CSF) amyloid and tau biomarker assessment has been recommended to refine the diagnostic accuracy of Alzheimer's disease. Lumbar punctures (LP) are invasive procedures that might induce anxiety and pain. The use of non-pharmacological techniques must be considered to reduce the patient's discomfort, in this setting. The objective of this study was to examine the efficacy of hypnosis on anxiety and pain associated with LP.
A monocentric interventional randomized-controlled pilot study is conducted in a university geriatric day hospital. Cognitively impaired patients aged over 70 were referred for scheduled LP for the diagnostic purpose (CSF biomarkers). The participants were randomly assigned either to a hypnosis intervention group or usual care. Pain and anxiety were both self-assessed by the patient and hetero-evaluated by the operator.
We included 50 cognitively impaired elderly outpatients (women 54%, mean age 77.2 ± 5.0, mean Mini-Mental State Examination score 23.2 ± 3.5). Hypnosis was significantly associated with reduced self-assessed (p < 0.05) and hetero-assessed anxiety (p < 0.01). Hetero-evaluated pain was significantly lower in the hypnosis group (p < 0.05). The overall perception of hypnosis was safe, well-accepted, and feasible in all the participants of the intervention group with 68% perceiving the procedure as better or much better than expected.
This pilot study suggested that hypnosis was feasible and may be used to reduce the symptoms of discomfort due to invasive procedures in older cognitively impaired patients. Our results also confirmed the overall good acceptance of LP in this population, despite the usual negative perception.
ClinicalTrials.gov NCT04368572. Registered on April 30, 2020.
核心脑脊髓液（CSF）淀粉样蛋白和tau 生物标志物评估已被推荐用于提高阿尔茨海默病的诊断准确性。腰椎穿刺（LP）是一种侵入性程序，可能会引起焦虑和疼痛。在这种情况下，必须考虑使用非药物技术来减轻患者的不适。本研究的目的是检查催眠术对 LP 相关焦虑和疼痛的疗效。
在一所大学老年日医院进行了一项单中心干预性随机对照试验。认知障碍的 70 岁以上患者因诊断目的（CSF 生物标志物）而被转诊进行 LP。参与者被随机分配到催眠干预组或常规护理组。疼痛和焦虑均由患者自我评估和操作者异评估。
我们纳入了 50 名认知障碍的老年门诊患者（女性 54%，平均年龄 77.2 ± 5.0，平均简易精神状态检查评分 23.2 ± 3.5）。催眠术与自我评估的（p < 0.05）和异评估的焦虑（p < 0.01）显著相关。催眠组的异评估疼痛显著较低（p < 0.05）。干预组的所有参与者都认为催眠术安全、易于接受且可行，68%的人认为该程序比预期的更好或好得多。
这项初步研究表明，催眠术是可行的，可以用于减轻老年认知障碍患者因侵入性程序而引起的不适症状。我们的结果还证实了在这一人群中对 LP 的总体接受程度较好，尽管通常对 LP 的看法较为消极。
ClinicalTrials.gov NCT04368572。注册于 2020 年 4 月 30 日。
