Slow breathing impacts inter-organ dynamics modulating brain function and risk behavior

Successful decision-making requires that external information be interpreted in the context of the bodys state. Within the framework of body-brain interaction, deliberately modifying ones autonomic state can shape how we evaluate the world, ultimately influencing choices. Yet, it remains unclear whether and how intentional autonomic regulation affects human decision-making. In this study, we tested instructed prolonged exhalation, a slow-breathing technique designed to boost parasympathetic activity during risky decision-making. Participants followed distinct breathing protocols while making risky choices, with neural and physiological activity measured using fMRI and multi-channel monitoring. Prolonged exhalation increased risky choices by enhancing reward sensitivity and elevating cardiac parasympathetic activity. Importantly, individuals with greater parasympathetic upregulation also showed stronger reward-related responses in the ventromedial prefrontal cortex and precuneus. Our work reveals a transformative role for breathing-based interventions, demonstrating that breathing-based autonomic regulation can shape value-based decision-making through neuro-cardiac pathways. GRAPHICAL ABSTRACT O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=107 SRC="FIGDIR/small/698695v1_ufig1.gif" ALT="Figure 1"> View larger version (24K): org.highwire.dtl.DTLVardef@190293corg.highwire.dtl.DTLVardef@1835c63org.highwire.dtl.DTLVardef@1267ff3org.highwire.dtl.DTLVardef@9a583e_HPS_FORMAT_FIGEXP M_FIG C_FIG HIGHLIGHTSO_LIProlonged exhalation increases risky decisions by increasing the reward sensitivity C_LIO_LIProlonged exhalation enhances cardiac parasympathetic activity without dampening sympathetic activities C_LIO_LIGreater cardiac parasympathetic activity under prolonged exhalation amplifies neural reward sensitivity in the ventromedial prefrontal cortex and precuneus C_LI