Mapping supramedullary pathways involved in cough using functional brain imaging: Comparison with pain

Mazzone, Stuart B.; McGovern, Alice E; Koo, Kendrick; Farrell, Michael J.

doi:10.1016/j.pupt.2008.08.003

Cited by 43 publications

(39 citation statements)

References 32 publications

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“…These regions This is a post-print version of the following article: Farrell, Michael J., Cole, Leonie J., Neural correlates coding stimulus level and perception of capsaicin-evoked urge-to-cough in humans. NeuroImage, 61 4: 1324-1335. encompassed sensory, motor, pre-motor and limbic structures, and were not dissimilar to the regions of brain activation that accompany somatic and visceral pain associated with noxious stimulation (Coen et al, 2007;Mazzone et al, 2007; reviewed in Mazzone et al, 2009). In the present study we set out to characterize response patterns in this network and test the hypothesis that regional brain activation during two doses of capsaicin inhalation could help differentiate components of this network that encode stimulus level, sensory intensity and spatial sensory discrimination.…”

Section: Introductionmentioning

confidence: 98%

Neural correlates coding stimulus level and perception of capsaicin-evoked urge-to-cough in humans

et al. 2012

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Section: Introductionmentioning

confidence: 98%

Neural correlates coding stimulus level and perception of capsaicin-evoked urge-to-cough in humans

et al. 2012

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“…Airway irritations also lead to the perception of the urge to cough, a clinical symptom that is analogous to an itch and may underlie behavioral coughing in airways diseases (Davenport, 2009). We have described urge-to-cough brain activations, many of which overlap with the cortical and subcortical correlates of pain (Mazzone et al, 2007(Mazzone et al, , 2009a. Indeed, like pain, airways irritation evokes activations in areas associated with sensory, motor, cognitive, affective, and motivational responses (Mazzone et al, 2009a).…”

Section: Introductionmentioning

confidence: 99%

“…We have described urge-to-cough brain activations, many of which overlap with the cortical and subcortical correlates of pain (Mazzone et al, 2007(Mazzone et al, , 2009a. Indeed, like pain, airways irritation evokes activations in areas associated with sensory, motor, cognitive, affective, and motivational responses (Mazzone et al, 2009a). Deciphering the roles of higher order processes in excessive coughing in disease represents a significant challenge.…”

Section: Introductionmentioning

confidence: 99%

Investigation of the Neural Control of Cough and Cough Suppression in Humans Using Functional Brain Imaging

et al. 2011

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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.

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“…As might be expected, more recent studies suggest cortical involvement in cough production. Cortical activation during VC has been demonstrated in healthy volunteers in functional magnetic resonance imaging studies [11,12]. Using transcranial magnetic stimulation, increased latency and decreased amplitude of the motor-evoked potentials from the abdominal (expiratory) muscles, and reduction of the evoked rise in gastric pressure (Pga), have recently been shown in acute stroke patients compared with controls, suggesting impaired cortical control of the abdominal muscles after stroke [13].…”

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confidence: 99%

Acute ischaemic hemispheric stroke is associated with impairment of reflex in addition to voluntary cough

Ward¹,

Seymour²,

Steier³

et al. 2010

European Respiratory Journal

103

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Cough function is impaired after stroke; this may be important for protection against chest infection. Reflex cough (RC) intensity indices have not been described after stroke. RC, voluntary cough (VC) and respiratory muscle strength were studied in patients within 2 weeks of hemispheric infarct. The null hypotheses were that patients with cortical hemisphere stroke would show the same results as healthy controls on: 1) objective indices of RC and VC intensity; and 2) respiratory muscle strength tests.Peak cough flow rate (PCFR) and gastric pressure (Pga) were measured during maximum VC and RC. Participants also underwent volitional and nonvolitional respiratory muscle testing. Nonvolitional expiratory muscle strength was assessed by measuring Pga increase after magnetic stimulation over the T 10 nerve roots (twitch T 10 Pga). Stroke severity was scored using the National Institutes of Health Stroke Scale (NIHSS; maximum531).18 patients (mean¡SD age 62¡15 yrs and NIHSS score 14¡8) and 20 controls (56¡16 yrs) participated. VC intensity was impaired in patients (PCFR 287¡171 versus 497¡122 L?min VC and RC are both impaired in hemispheric stroke patients, despite preserved expiratory muscle strength. Cough coordination is probably cortically modulated and affected by hemispheric stroke.

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Mapping supramedullary pathways involved in cough using functional brain imaging: Comparison with pain

Cited by 43 publications

References 32 publications

Neural correlates coding stimulus level and perception of capsaicin-evoked urge-to-cough in humans

Neural correlates coding stimulus level and perception of capsaicin-evoked urge-to-cough in humans

Investigation of the Neural Control of Cough and Cough Suppression in Humans Using Functional Brain Imaging

Acute ischaemic hemispheric stroke is associated with impairment of reflex in addition to voluntary cough

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