Conditioned fear selectively increases the perception and neural processing of respiratory stimuli relative to somatosensory stimuli

Interoception is crucial to the experience of bodily complaints in chronic conditions. Fear can distort the perception of sensations like breathlessness and pain, yet few studies investigated the effects of conditioned fear on both self-report and neural processing of these sensations. In the current study, we conditioned fear of neutral female faces in healthy adults, pairing certain faces (CS+) with an aversive scream. In Experiment 1, we delivered paired inspiratory occlusions during the viewing of the faces. We collected self-reported intensity and unpleasantness of occlusions, and measured N1 and P2 amplitudes of the respiratory-related evoked potential (RREP) in the electroencephalogram, as well as neural gating (the ratio of N1 response to the second over the first occlusion, S2/S1). Skin conductance and self-reported fear increased in response to CS+ faces, and perception of occlusions increased during fear conditioning (FC) relative to baseline, with higher unpleasantness and RREP amplitudes during CS+ relative to CS- trials. We found no effects on neural gating. In Experiment 2, we used the same FC protocol, and delivered paired electrocutaneous pulses during the viewing of the faces. We measured intensity/unpleasantness, fear, N1/P2 amplitudes of the somatosensory evoked potential (SEP), and neural gating. While skin conductance and fear increased, no perceptual effects were found. Unexpectedly, SEP amplitudes decreased and neural gating increased during FC, likely due to habituation. The current results indicate that FC increases the perception and neural processing of respiratory stimuli specifically, consistent with previous literature on respiratory psychophysiology and fearful states.