Resonance paced breathing alters neural response to visual cues: Proof-of-concept for a neuroscience informed adjunct to addiction treatments

Conscious attempts to regulate alcohol and drug use are often undermined by automatic attention and arousal processes that are activated in the context of salient cues. Response to these cues involves body and brain signals that are linked via dynamic feedback loops, yet no studies have targeted the cardiovascular system as a potential conduit to alter automatic neural processes that maintain cue salience. This proof-of-concept study examined within-person changes in neural response to parallel, but unique sets of visual alcohol-related cues at two points in time: prior to versus following a brief behavioral intervention. The active intervention was resonance breathing, a rhythmical breathing task paced at 0.1Hz (6 breaths per minute) that helps normalize neurocardiac feedback. The control intervention was a low cognitive demand task. Functional magnetic resonance imaging (fMRI) was used to assess changes in brain response to the cues presented before (A1) and after (A2) the intervention in 41 emerging adult men and women with varying drinking behaviors. The resonance breathing group exhibited significantly less activation to A2 cues compared to A1 cues in left inferior and superior lateral occipital cortices, right inferior lateral occipital cortex, bilateral occipital pole, and temporal occipital fusiform cortices. This group also showed significantly greater activation to A2 cues compared to A1 cues in medial prefrontal, anterior and posterior cingulate, and precuneus cortices, paracingulate and lingual gyri. The control group showed no significant changes. Thus, following resonance breathing, activation in brain regions involved in visual processing of cues was reduced, while activation in brain areas implicated in behavioral control, internally-directed cognition, and brain-body integration was increased. These findings provide preliminary evidence that manipulation of the cardiovascular system with resonance breathing alters neural activation in a manner theoretically consistent with a dampening of automatic sensory input and strengthening of higher level cognitive processing.