Resonance-Paced Breathing Alters Neural Response to Visual Cues: Proof-of-Concept for a Neuroscience-Informed Adjunct to Addiction Treatments

Figure 1. Schematic overview of the neurocardiac feedback loop. Efferent information (blue arrows) emanates from cortical, subcortical, and brain stem structures of the central-autonomic network and flows to the sinoatrial (SA) node of the heart via the sympathetic and parasympathetic branches of the autonomic nervous system. Afferent information (red arrows) from the heart and blood vessels is conveyed back to the brain via baroreceptors located mainly in the walls of the aortic and carotid arteries. Afferent signals enter the brain (shaded in green) via the nucleus tractus solitarius in the brain stem and are integrated with other sensory, cognitive, and affective information as it ascends to cortical regions, including the medial frontal, cingulate, and insular cortices.

Figure 2. Physiological data from one representative individual collected during a 5-min baseline task (normal breathing) and a 5-min resonance breathing task. Resonance breathing elicited instantaneous changes in respiration, heart rate, pulse transit time (i.e., vascular tone), systolic arterial pressure, and baroreflex sensitivity such that oscillations were magnified and more rhythmic across all measures. In addition, resonance breathing decreased systolic pressure, improved vascular tone, and increased the sensitivity of the neurocardiac feedback loop (i.e., baroreflex). Adapted from (12). Used with permission.

Figure 3. Visual depiction of the study and cue task design. Panel (A) shows the complete study design. Participants first viewed a set of nature picture cues (data not shown). Participants then viewed a set of alcohol picture cues (A1), followed by a 5-min intervention task (active condition: resonance breathing; control condition: vanilla task). They then immediately viewed a second, distinct set of alcohol picture cues (A2). The study ended with a 6-min resting state task (data not shown). Panel (B) shows representative images from the alcohol cue tasks, both of which involved viewing 30 unique images that were presented for 6 s, with 4-s inter-stimulus intervals.

Figure 4. Significant Neural Activation to Visual Alcohol Cue Sets. One-sample t-tests were used to identify areas of significant neural activation during alcohol cue set viewing. The neural responses of the active intervention (resonance breathing) group are shown in Panels (A) (A1 task, cues viewed prior to the intervention) and (B) (A2 task, cues viewed after the intervention). The neural responses of the control intervention (vanilla task) group are shown in Panels (C) (A1 task, cues viewed prior to the intervention) and (D) (A2 task, cues viewed after the intervention). Axial slices are shown in MNI standard space at z = −6 (first slice) and every fourth subsequent slice. Images are oriented using radiological convention. Areas of significant activation are shown in red.

Figure 5. Significant Clusters of Activation in Resonance Breathing Group. Blue-cyan clusters represent regions with greater activation during A1 compared to A2 (A1 > A2), and red-yellow clusters represent regions with greater activation during A2 compared with A1 (A2 > A1). Voxels were thresholded at p < 0.05. Image is shown in MNI standard space at x = −4, y = −66, z = 6, and oriented using radiological convention.