Investigation of the neural control of cough and cough suppression in humans using functional brain imaging

Excessive coughing is one of the most common reasons for seeking medical advice, yet the available therapies for treating cough disorders are inadequate. Humans can voluntarily cough, choose to suppress their cough, and are acutely aware of an irritation that is present in their airways. This indica...

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Bibliographic Details
Published in:The Journal of neuroscience 2011-02, Vol.31 (8), p.2948-2958
Main Authors: Mazzone, Stuart B, Cole, Leonie J, Ando, Ayaka, Egan, Gary F, Farrell, Michael J
Format: Article
Language:English
Subjects:
Adult
Brain Mapping - methods
Cerebral Cortex - pathology
Cerebral Cortex - physiology
Cough - pathology
Cough - physiopathology
Cough - prevention & control
Female
Humans
Magnetic Resonance Imaging - methods
Male
Nerve Net - pathology
Nerve Net - physiology
Neural Inhibition - physiology
Young Adult
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Summary:Excessive coughing is one of the most common reasons for seeking medical advice, yet the available therapies for treating cough disorders are inadequate. Humans can voluntarily cough, choose to suppress their cough, and are acutely aware of an irritation that is present in their airways. This indicates a significant level of behavioral and conscious control over the basic cough reflex pathway. However, very little is known about the neural basis for higher brain regulation of coughing. The aim of the present study was to use functional brain imaging in healthy humans to describe the supramedullary control of cough and cough suppression. Our data show that the brain circuitry activated during coughing in response to capsaicin-evoked airways irritation is not simply a function of voluntarily initiated coughing and the perception of airways irritation. Rather, activations in several brain regions, including the posterior insula and posterior cingulate cortex, define the unique attributes of an evoked cough. Furthermore, the active suppression of irritant-evoked coughing is also associated with a unique pattern of brain activity, including an involvement of the anterior insula, anterior mid-cingulate cortex, and inferior frontal gyrus. These data demonstrate for the first time that evoked cough is not solely a brainstem-mediated reflex response to irritation of the airways, but rather requires active facilitation by cortical regions, and is further regulated by distinct higher order inhibitory processes.
ISSN:0270-6474
1529-2401
DOI:10.1523/jneurosci.4597-10.2011