Primary site of constriction during the compression phase of cough in healthy young adults

Kim, Ja Young; Davenport, Paul W.; Mou, Yuhan; Wheeler-Hegland, Karen

doi:10.1016/j.resp.2023.104033

Cited by 4 publications

(4 citation statements)

References 51 publications

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“…Structural changes may limit one's ability to coordinate breathing and swallowing, or generate adequate pressure for high velocity airflows during cough. These may include: (1) altered compliance of the chest wall, (2) weak/spastic inspiratory (e.g., diaphragm, external intercostals) and expiratory (e.g., abdominals, obliques, internal intercostals) muscles, (3) vocal fold and upper airway pathologies ( 6 , 10 , 12 , 18 , 19 ). Disruptions in neural signaling of sensorimotor pathways may also contribute to hypotussia, including dysfunctional signal reception, transmission, processing, and/or output in one, or several neural substrates: (1) pulmonary, tracheobronchial, and laryngeal receptors that receive cough stimuli input ( 10 , 12 , 25 – 27 ), (2) vagal afferents of the airways that transmit sensory input to the central nervous system, including internal superior (iSLN) and recurrent laryngeal nerves (RLN) [Box A ] ( 10 , 25 , 26 ), (3) central pattern generators (CPG) for swallow, cough, and breathing integrate sensory input to generate a reconfigured respiratory CPG (rRCPG) to execute cough [Box B ] ( 4 , 28 ), and (4) subcortex and cortical structures involved with filtering, perceiving, and processing discriminative and affective characteristics of the sensory stimuli, leading to execution of volitional cough, or suppression/augmentation of reflexive cough ( 4 , 10 , 12 , 13 , 25 – 27 , 29 ).…”

Section: Introductionmentioning

confidence: 99%

“…Cough is a vital, life-sustaining behavior essential for pulmonary homeostasis (1)(2)(3)(4). The major function of cough is to generate the high velocity airflows and shearing forces required to expel unwanted material from the airways and allow breathing to occur unobstructed (1,(5)(6)(7). Unfortunately, disordered cough (or dystussia, Table 1) is quite prevalent, especially in the context of dysphagia or swallowing disorders, exacerbating the risk of the deleterious effects which can be associated with uncompensated aspiration (3,5,18,19).…”

Section: Introductionmentioning

confidence: 99%

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Hypotussic cough in persons with dysphagia: biobehavioral interventions and pathways to clinical implementation

Dallal-York,

Troche

2024

Front. Rehabil. Sci.

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Cough is a powerful, protective expulsive behavior that assists in maintaining respiratory health by clearing foreign material, pathogens, and mucus from the airways. Therefore, cough is critical to survival in both health and disease. Importantly, cough protects the airways and lungs from both antegrade (e.g., food, liquid, saliva) and retrograde (e.g., bile, gastric acid) aspirate contents. Aspiration is often the result of impaired swallowing (dysphagia), which allows oral and/or gastric contents to enter the lung, especially in individuals who also have cough dysfunction (dystussia). Cough hyposensitivity, downregulation, or desensitization- collectively referred to as hypotussia- is common in individuals with dysphagia, and increases the likelihood that aspirated material will reach the lung. The consequence of hypotussia with reduced airway clearance can include respiratory tract infection, chronic inflammation, and long-term damage to the lung parenchyma. Despite the clear implications for health, the problem of managing hypotussia in individuals with dysphagia is frequently overlooked. Here, we provide an overview of the current interventions and treatment approaches for hypotussic cough. We synthesize the available literature to summarize research findings that advance our understanding of these interventions, as well as current gaps in knowledge. Further, we highlight pragmatic resources to increase awareness of hypotussic cough interventions and provide support for the clinical implementation of evidence-based treatments. In culmination, we discuss potential innovations and future directions for hypotussic cough research.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hypotussic cough in persons with dysphagia: biobehavioral interventions and pathways to clinical implementation

Dallal-York,

Troche

2024

Front. Rehabil. Sci.

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show abstract

“…Structural changes may limit one's ability to coordinate breathing and swallowing, or generate adequate pressure for high velocity airflows during cough. These may include: (1) altered compliance of the chest wall, (2) weak/spastic inspiratory (e.g., diaphragm, external intercostals) and expiratory (e.g., abdominals, obliques, internal intercostals) muscles, (3) vocal fold and upper airway pathologies (6,10,12,18,19). Disruptions in neural signaling of sensorimotor pathways may also contribute to hypotussia, including dysfunctional signal reception, transmission, processing, and/or output in one, or several neural substrates: (1) pulmonary, tracheobronchial, and laryngeal receptors that receive cough stimuli input (10, 12, 25-27), (2) vagal afferents of the airways that transmit sensory input to the central nervous system, including internal superior (iSLN) and recurrent laryngeal nerves (RLN) [Box A] (10, 25, 26), (3) central pattern generators (CPG) for swallow, cough, and breathing integrate sensory input to generate a reconfigured respiratory CPG (rRCPG) to execute cough [Box B] (4, 28), and (4) subcortex and cortical structures involved with filtering, perceiving, and processing discriminative and affective characteristics of the sensory stimuli, leading to execution of volitional cough, or suppression/augmentation of reflexive cough (4,10,12,13,(25)(26)(27)29).…”

Section: Domains Of Hypotussic Cough Interventions: Rehabilitative Vs...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Motor Performance During Sensorimotor Training for Airway Protection in Parkinson's Disease

Borders,

Hegland,

Vanegas-Arroyave

et al. 2023

Am J Speech Lang Pathol

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Introduction: Cough dysfunction is highly prevalent in Parkinson's disease (PD) and associated with pneumonia, a leading cause of death. Although research suggests that cough can be volitionally upregulated, patterns of improvements that occur during cough skill training and potential correlates remain unexamined. Therefore, we sought to characterize changes to peak flow during cough skill training, examine whether early variability predicted motor performance trajectories during treatment, and explore the relationship between peak flow during cough skill training and motor learning on a similar but untrained task (i.e., reflex cough testing). Method: This secondary analysis of treatment data from a randomized controlled trial included 28 individuals with PD who participated in five sessions of sensorimotor training for airway protection (smTAP). During this novel cough skill training, participants completed 25 repetitions of coughs targeting peak flow 25% above their baseline. Reflex and voluntary cough testing was performed pre- and posttreatment. Bayesian multilevel growth curve models provided group and individual-level estimates of peak flow during training. Results: The magnitude and consistency of peak flow increased during cough skill training. Variability in peak flow during the first treatment session was associated with greater improvements to peak flow in later sessions. There was no relationship between changes to peak flow during cough skill training and motor learning. Conclusions: Individuals with PD improved the strength and variability of cough peak flow during cough skill training. These findings provide a clinically relevant characterization of motor performance during cough skill training and lend insight into potential correlates to guide future treatment paradigms.

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Primary site of constriction during the compression phase of cough in healthy young adults

Cited by 4 publications

References 51 publications

Hypotussic cough in persons with dysphagia: biobehavioral interventions and pathways to clinical implementation

Hypotussic cough in persons with dysphagia: biobehavioral interventions and pathways to clinical implementation

Datasheet1.docx

Motor Performance During Sensorimotor Training for Airway Protection in Parkinson's Disease

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