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

ABSTRACT Successful decision-making requires that external information be interpreted in the context of the body’s state. Within the framework of body-brain interaction, deliberately modifying one’s 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. HIGHLIGHTS Prolonged exhalation increases risky decisions by increasing the reward sensitivity Prolonged exhalation enhances cardiac parasympathetic activity without dampening sympathetic activities Greater cardiac parasympathetic activity under prolonged exhalation amplifies neural reward sensitivity in the ventromedial prefrontal cortex and precuneus Competing Interest Statement The authors have declared no competing interest. Footnotes ↵11Lead contact