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We evaluated the effect of slow, deep breathing on visceral pain and explored putative mediating mechanisms including autonomic and emotional responses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty\u2010seven healthy volunteers (36 females, mean age\u00a0=\u00a022.0\u00a0years) performed controlled, deep breathing at a slow frequency (6 breaths per minute), controlled breathing at a normal frequency (14 breaths per minute; active control), and uncontrolled breathing (no\u2010treatment control) in randomized order. Moderate painful stimuli were given during each condition by delivering electrical stimulation in the distal esophagus. Participants rated pain intensity after each stimulation. Heart rate variability and self\u2010reported arousal were measured during each condition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Compared to uncontrolled breathing, pain intensity was lower during slow, deep breathing (Cohen\u2019s <jats:italic>d<\/jats:italic>\u00a0=\u00a00.40) and normal controlled breathing (<jats:italic>d<\/jats:italic>\u00a0=\u00a00.47), but not different between slow, deep breathing and normal controlled breathing. Arousal was lower (<jats:italic>d<\/jats:italic>\u00a0=\u00a00.53, 0.55) and heart rate variability was higher (<jats:italic>d<\/jats:italic>\u00a0=\u00a00.70, 0.86) during slow, deep breathing compared to the two control conditions. The effect of slow, deep breathing on pain was not mediated by alterations in heart rate variability or arousal but was moderated by pain catastrophizing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Inferences<\/jats:title><jats:p>Slow, deep breathing can reduce visceral pain intensity. However, the effect is not specific to the slow breathing frequency and is not mediated by autonomic or emotional responses, suggesting other underlying mechanisms (notably distraction). Whether a long\u2010term practice of slow, deep breathing can influence (clinical) visceral pain warrants to be investigated.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14242","type":"journal-article","created":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T10:43:49Z","timestamp":1628678629000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Effect of slow, deep breathing on visceral pain perception and its underlying psychophysiological mechanisms"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8674-450X","authenticated-orcid":false,"given":"Ali","family":"Gholamrezaei","sequence":"first","affiliation":[{"name":"Laboratory for Brain\u2010Gut Axis Studies (LaBGAS) Translational Research Center for Gastrointestinal Disorders (TARGID) Department of Chronic Diseases, Metabolism and Ageing KU Leuven  Leuven Belgium"},{"name":"Health Psychology Research Group KU Leuven  Leuven Belgium"},{"name":"Pain Management Research Institute Faculty of Medicine and Health The University of Sydney  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0048-774X","authenticated-orcid":false,"given":"Ilse","family":"Van Diest","sequence":"additional","affiliation":[{"name":"Health Psychology Research Group KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2718-2065","authenticated-orcid":false,"given":"Qasim","family":"Aziz","sequence":"additional","affiliation":[{"name":"Centre for Neuroscience and Trauma Blizard Institute Wingate Institute of Neurogastroeneterology Queen Mary University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ans","family":"Pauwels","sequence":"additional","affiliation":[{"name":"Gastrointestinal Sensitivity and Motility Research Group Translational Research Center for Gastrointestinal Disorders (TARGID) Department of Chronic Diseases, Metabolism and Ageing KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3206-6704","authenticated-orcid":false,"given":"Jan","family":"Tack","sequence":"additional","affiliation":[{"name":"Gastrointestinal Sensitivity and Motility Research Group Translational Research Center for Gastrointestinal Disorders (TARGID) Department of Chronic Diseases, Metabolism and Ageing KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0437-6665","authenticated-orcid":false,"given":"Johan W. 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