Afferent neurocardiac signals, cue reactivity, and cognitive control

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This R21 application is in response to PA-20-196: NIH Exploratory/Developmental Research Grant Program, based on our discovery that a behavioral form of neuromodulation, termed ‘resonance paced breathing,’ alters brain activation during passive viewing of alcohol-related picture cues. Here we propose to determine the translational significance of this proof-of-concept finding by (1) measuring brain response during active cognitive processing in the context of alcohol cues and (2) testing the hypothesis that resonance breathing changes specific processing operations to reduce cue reactivity and support cognitive control. Multiple literatures support that these processes are mediated in part by a dynamic neurocardiac feedback loop termed the baroreflex, and that breathing paced at a resonance frequency of the cardiovascular system (~0.1Hz) modulates physiological responses to external stimuli. This knowledge has led to empirically supported long- term interventions for anxiety, depression, stress and other disorders (e.g., HRV biofeedback). Yet, the ability to use brief bouts of resonance breathing as a just-in-time intervention to alter attention to, and control over, appetitive cues is unknown. The public health significance of an accessible (via mobile app), brief, and easily trained technique to reduce alcohol cue salience is great, as cue reactivity and associated urges and craving are key precipitants of excessive drinking and relapse. We propose to test 100 binge drinking young adults (half female) in a within-subjects, repeated measures experiment to determine whether modulation of the afferent stream of the neurocardiac feedback loop through breathing paced at 0.1 Hz, compared to a control task, affects changes in neural cue reactivity and inhibitory control in the presence of salient alcohol cues. We will examine the effect of the 5-min intervention of 0.1 Hz resonance breathing task, and control task, on changes in the posterior contralateral N2 (N2pc) and P3b event-related potential (ERP) components as markers of attention allocation and motivational significance of attended stimuli using modified visual dot-probe and oddball tasks. Aim 2 will examine parallel effects on inhibitory control using the N2 component, elicited during a cued alcohol Go/NoGo paradigm. Primary hypotheses are that resonance breathing will diminish attention bias and motivational significance, and increase inhibitory control, when alcohol cues are encountered following the breathing task. Secondary analyses will explore the relation of individual differences in drinking patterns to intervention effects. If successful, this application will provide novel information about potential mechanisms through which resonance breathing is linked in a time-varying manner to neural systems that modulate cue reactivity. These preliminary data would provide premise for a larger scale study to examine the impact of resonance breathing in different high-risk populations of drinkers and its relation to drinking behavior change.