Brain Mechanisms of Virtual Reality Breathing Versus Traditional Mindful Breathing in Pain Modulation: Observational Functional Near-infrared Spectroscopy Study (Preprint)

Abstract

UNSTRUCTURED Pain is a complex experience that involves sensory-discriminative and cognitive-emotional neuronal processes. It has long been known across cultures to be relieved by mindful breathing (MB). There is a common assumption that MB exerts its analgesic effect by interoception and distraction. Interoception means the conscious refocusing of the mind’s attention to the physical sensation of an organ function, while distraction consists of the competing attention of concurrent sensory experiences. In the current study, we dissected these central analgesic processes by imaging the brains of two groups of healthy subjects exposed to either a traditional MB (TMB) or a virtual reality breathing (VRB) protocol. The VRB protocol involved an in-house developed VR 3D-lungs that synchronized with the participants’ breathing cycles in real-time, providing the participant with an immersive visual-auditory experience. We found that both breathing techniques led to significant pain threshold increase after week-long practices, measured by a thermal quantitative sensory test. However, their underlying analgesic neural mechanisms were opposite as revealed by the functional near-infrared spectroscopy (fNIRS) data. The TMB technique induced a mind-body connection pattern in the brain. The anterior prefrontal cortex (aPFC) connected with and modulated other cortical regions to a state of mindfulness, reappraising the ascending noxious inputs. Whereas the VRB practice induced a mind-body disconnection pattern, in which the overpowered audio-visual cortical regions functionally disconnected from the primary somatosensory cortex (S1), disengaging the central sensory-discriminative processing of the ascending noxious inputs by the immersive 3D experience.