Unraveling the temporal interplay of slow‐paced breathing and prefrontal transcranial direct current stimulation on cardiac indices of autonomic activity.

The neurovisceral integration model proposes that information flows bidirectionally between the brain and the heart via the vagus nerve, indexed by vagally mediated heart rate variability (vmHRV). Voluntary reduction in breathing rate (slow‐paced breathing, SPB, 5.5 Breathing Per Minute (BPM)) can enhance vmHRV. Additionally, prefrontal transcranial direct current stimulation (tDCS) can modulate the excitability of the prefrontal region and influence the vagus nerve. However, research on the combination of SPB and prefrontal tDCS to increase vmHRV and other cardiac (heart rate (HR) and blood pressure) and peripheral (skin conductance) indices is scarce. We hypothesized that the combination of 20 min of SPB and prefrontal tDCS would have a greater effect than each intervention in isolation. Hence, 200 participants were divided into four groups: active tDCS with SPB, active tDCS with 15 BPM breathing, sham tDCS with SPB, and sham tDCS with 15 BPM breathing. Regardless of the tDCS condition, the 5.5 BPM group showed a significant increase in vmHRV over 20 minutes and significant decreases in HR at the first and second 5‐min epochs of the intervention. Regardless of breathing condition, the active tDCS group exhibited higher HR at the fourth 5‐min epoch of the intervention than the sham tDCS group. No other effects were observed. Overall, SPB is a robust technique for increasing vmHRV, whereas prefrontal tDCS may produce effects that counteract those of SPB. More research is necessary to test whether and how SPB and neuromodulation approaches can be combined to improve cardiac vagal tone. This study explored, for the first time, the temporal course of physical (slow‐paced breathing, SPB) and neuromodulation (prefrontal tDCS) interventions to enhance cardiac vagal tone. Through a well‐sampled between‐subjects sham‐controlled design, this study found that SPB has a very rapid impact on increasing vagally mediated HRV and decreasing HR and blood pressure. Prefrontal tDCS, on the contrary, has a slower effect, mainly increasing heart rate suggesting more sympathetic arousal. Unexpectedly, the combination did not yield beneficial results. [ABSTRACT FROM AUTHOR]