Author: Xiao-Su Hu1, Katherine Beard1, Mary Catherine Sherbel1,2, Thiago D Nascimento1, Sean Petty3, Eddie Pantzlaff1, David Schwitzer1, Niko Kaciroti1,4, Eric Maslowski5, Lawrence M Ashman1,6, Stephen E Feinberg1,6, Alexandre F DaSilva1
Affiliation: <sup>1</sup> Headache & Orofacial Pain Effort Lab, Biologic and Materials Sciences & Prosthodontics Department, University of Michigan School of Dentistry, Ann Arbor, MI, United States.
<sup>2</sup> Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, United States.
<sup>3</sup> 3D Lab, Digital Media Commons, University of Michigan, Ann Arbor, MI, United States.
<sup>4</sup> Center for Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, United States.
<sup>5</sup> Moxytech Inc, Ann Arbor, MI, United States.
<sup>6</sup> Department of Oral & Maxillofacial Surgery, University of Michigan School of Dentistry, Ann Arbor, MI, United States.
Conference/Journal: J Med Internet Res
Date published: 2021 Oct 12
Other:
Volume ID: 23 , Issue ID: 10 , Pages: e27298 , Special Notes: doi: 10.2196/27298. , Word Count: 299
Background:
Pain is a complex experience that involves sensory-discriminative and cognitive-emotional neuronal processes. It has long been known across cultures that pain can be relieved by mindful breathing (MB). There is a common assumption that MB exerts its analgesic effect through interoception. Interoception refers to consciously refocusing the mind's attention to the physical sensation of internal organ function.
Objective:
In this study, we dissect the cortical analgesic processes by imaging the brains of healthy subjects exposed to traditional MB (TMB) and compare them with another group for which we augmented MB to an outside sensory experience via virtual reality breathing (VRB).
Methods:
The VRB protocol involved in-house-developed virtual reality 3D lungs that synchronized with the participants' breathing cycles in real time, providing them with an immersive visual-auditory exteroception of their breathing.
Results:
We found that both breathing interventions led to a significant increase in pain thresholds after week-long practices, as measured by a thermal quantitative sensory test. However, the underlying analgesic brain mechanisms were opposite, as revealed by functional near-infrared spectroscopy data. In the TMB practice, the anterior prefrontal cortex uniquely modulated the premotor cortex. This increased its functional connection with the primary somatosensory cortex (S1), thereby facilitating the S1-based sensory-interoceptive processing of breathing but inhibiting its other role in sensory-discriminative pain processing. In contrast, virtual reality induced an immersive 3D exteroception with augmented visual-auditory cortical activations, which diminished the functional connection with the S1 and consequently weakened the pain processing function of the S1.
Conclusions:
In summary, our study suggested two analgesic neuromechanisms of VRB and TMB practices-exteroception and interoception-that distinctively modulated the S1 processing of the ascending noxious inputs. This is in line with the concept of dualism (Yin and Yang).
Keywords: functional near-infrared spectroscopy; mobile phone; pain; traditional mindful breathing; virtual reality breathing.
PMID: 34636731 DOI: 10.2196/27298