Testing effects of paced breathing on plasma Aβ and brain perivascular spaces

Aging is the strongest known risk factor for Alzheimer's disease (AD), and elevated plasma amyloid-β (Aβ) levels in healthy adults are associated with increased AD risk. Aging is also associated with autonomic imbalance, characterized by increased sympathetic and decreased parasympathetic activity. In our previous randomized clinical trial, we found that four weeks of daily slow-paced breathing designed to enhance parasympathetic activity reduced plasma Aβ42 and Aβ40 levels in younger and older adults and showed a trend toward increasing Aβ42/Aβ40 ratio only in older adults. The primary goal of the current study was to extend these findings in 62 adults aged 50 to 70 years using randomized assignment to 10 weeks of slow-paced breathing or a random-paced breathing control with three assessment time points. Secondary objectives included examining the effects of slow-paced breathing on brain structure (i.e., perivascular space and hippocampal volumes) and cognitive performance. Consistent with prior findings, the slow-paced breathing group showed greater decreases in plasma Aβ42 than the control group. However, group differences were not significant for Aβ40 or Aβ42/Aβ40 ratios, and no significant effects were observed for the secondary outcomes. The non-significant findings may be due to changes we made to both intervention and control condition methods relative to our previous trial. Further research is needed to explore the underlying mechanisms and potential effects of slow-paced breathing on Aβ accumulation in the brain.