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Neural and Psychological Mechanisms in the Relationship Between Resting Breathing Rate and Pain

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Valeria Oliva at Istituto Superiore di Sanità
Valeria Oliva
Jennifer N. Baumgartner at University of California, San Diego
Jennifer N. Baumgartner
Suzan R. Farris
Suzan R. Farris
Suzan R. Farris
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Gabriel Riegner
Gabriel Riegner
Gabriel Riegner
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Abstract and Figures

Objectives Breathing rate and pain are influenced by a spectrum of cognitive, affective, and physiological interactions. Yet, it is unknown if an individual’s resting breathing rate is associated with pain. Methods Continuous cerebral blood flow (CBF) and respiration rate were collected in 74 healthy participants during innocuous (35 °C) and noxious (49 °C) stimulation. Mindfulness and anxiety were assessed before acquiring perfusion fMRI data. Visual analog scale pain ratings were collected after pain testing. Results Slower resting respiration rate during noxious (r = 0.26, p = 0.03) and innocuous (r = 0.28, p = 0.02) heat was associated with lower pain sensitivity. Analyses of the whole-brain fMRI data revealed that higher CBF in the supramarginal gyrus, a central node of the ventral attention network, was associated with a slower breathing rate during noxious heat (r = − 0.51, p < 0.001) and lower reported pain levels (r = − 0.24, p = 0.04). Higher levels of dispositional mindfulness, but not anxiety (p > 0.20), were associated with slower breathing rate (r = − 0.28, p = 0.02) and lower pain (r = − 0.25, p = 0.03). Conclusions These findings demonstrate that individuals who naturally breathe slower report lower pain and engage unique mechanisms, suggesting the allocation of attention to physical bodily processes.
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Vol:.(1234567890)
Mindfulness (2023) 14:1780–1789
https://doi.org/10.1007/s12671-023-02176-7
1 3
ORIGINAL PAPER
Neural andPsychological Mechanisms intheRelationship Between
Resting Breathing Rate andPain
ValeriaOliva1· JenniferN.Baumgartner1· SuzanR.Farris2· GabrielRiegner1· LoraKhatib1· YoungkyooJung3·
RobertC.Coghill4,5· FadelZeidan1
Accepted: 14 June 2023 / Published online: 13 July 2023
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023
Abstract
Objectives Breathing rate and pain are influenced by a spectrum of cognitive, affective, and physiological interactions. Yet,
it is unknown if an individual’s resting breathing rate is associated with pain.
Methods Continuous cerebral blood flow (CBF) and respiration rate were collected in 74 healthy participants during innocu-
ous (35°C) and noxious (49°C) stimulation. Mindfulness and anxiety were assessed before acquiring perfusion fMRI data.
Visual analog scale pain ratings were collected after pain testing.
Results Slower resting respiration rate during noxious (r = 0.26, p = 0.03) and innocuous (r = 0.28, p = 0.02) heat was associ-
ated with lower pain sensitivity. Analyses of the whole-brain fMRI data revealed that higher CBF in the supramarginal gyrus,
a central node of the ventral attention network, was associated with a slower breathing rate during noxious heat (r = − 0.51,
p < 0.001) and lower reported pain levels (r = − 0.24, p = 0.04). Higher levels of dispositional mindfulness, but not anxiety
(p > 0.20), were associated with slower breathing rate (r = − 0.28, p = 0.02) and lower pain (r = − 0.25, p = 0.03).
Conclusions These findings demonstrate that individuals who naturally breathe slower report lower pain and engage unique
mechanisms, suggesting the allocation of attention to physical bodily processes.
Keywords Pain sensitivity· Nociception· Respiration rate· Dispositional mindfulness· fMRI· Arterial spin labeling
Pain and respiration are interconnected psychophysiologi-
cal processes that reciprocally influence our survival. It is
well-established that slow, controlled breathing techniques
can reliably reduce experimental pain (Chalaye etal., 2009;
Jafari etal., 2017, 2020; Joseph etal., 2022; Martin etal.,
2012; Wells etal., 2020). In contrast, the effects of con-
trolled breathing on clinical pain are more variable (Downey
& Zun, 2009; Joseph etal., 2022; Kapitza et al., 2010).
Importantly, the relationship between uncontrolled (i.e., rest-
ing) respiration rate during noxious and non-noxious sensory
stimulation remains unknown. Thus, the primary aim of the
present study was to determine if slower, non-manipulated
breathing is associated with lower pain sensitivity.
Psychological mechanisms also influence breathing rate
and pain sensitivity. Anxiety increases attention to breathing
sensations (Harrison etal., 2021), respiration rate (Masaoka
& Homma, 2001; Studer etal., 2011), and pain (Ploghaus
etal., 2001; Rhudy & Meagher, 2000). In contrast, disposi-
tional mindfulness, the innate capacity to sustain non-reac-
tive attention to the present moment (Baer etal., 2008), is
associated with lower anxiety (Brown etal., 2012; Zeidan
etal., 2014) and pain (Harrison etal., 2018; Zeidan etal.,
2018). Highly mindful individuals who report long-term
meditation practice exhibit slower resting respiration rate
when compared to age-matched controls (Wielgosz etal.,
2016). Thus, we postulate that anxiety and mindful nonreac-
tivity are two empirically antithetical constructs (Goldin &
Gross, 2010; Wielgosz etal., 2016; Zeidan etal., 2018). The
* Fadel Zeidan
fzeidan@health.ucsd.edu
1 Department ofAnesthesiology, University ofCalifornia San
Diego, SanDiego92103, USA
2 Department ofNeurobiology andAnatomy, Wake Forest
School ofMedicine, Winston-Salem27157, USA
3 Department ofRadiology, University ofCalifornia Davis,
Davis95817, USA
4 Department ofPediatrics, University ofCincinnati College
ofMedicine Cincinnati, Cincinnati, OH, USA
5 Division ofBehavioral Medicine andClinical Psychology,
Cincinnati Children’s Hospital Medical Center, Cincinnati,
OH, USA
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
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