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

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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.


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.


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).


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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The authors are not planning on sharing the data at this time.


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This work was supported by the National Center for Complementary and Integrative Health (K99/R00-AT008238, R21-AT007247, R01-AT009693, F32-AT010843), and the Mind and Life Institute’s Francisco J. Varela Award.

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Authors and Affiliations



VO: conceptualization, methodology, data curation, visualization, writing, reviewing and editing.

JB: writing — original draft preparation.

SRF: investigation, data curation.

GB: data curation.

LK: data curation.

YJ: conceptualization, methodology.

RCC: conceptualization, methodology, visualization, writing — reviewing and editing, supervision.

FZ: conceptualization, methodology, data curation, visualization, writing — original draft preparation, reviewing and editing, supervision.

Corresponding author

Correspondence to Fadel Zeidan.

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Ethics Approval

The study was approved by the Wake Forest School of Medicine’s Institutional Review Board.

Informed Consent

Written informed consent was obtained from all participants included in the study.

Conflict of Interest

The authors declare no competing financial interests.

Use of Artificial Intelligence

Artificial intelligence was not used.

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Oliva, V., Baumgartner, J.N., Farris, S.R. et al. Neural and Psychological Mechanisms in the Relationship Between Resting Breathing Rate and Pain. Mindfulness 14, 1780–1789 (2023).

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