THE EFFECT OF ATTENTIONAL MANIPULATION ON COUGH REFLEX SENSITIVITY IN PATIENTS WITH COUGH HYPERSENSITIVITY SYNDROME

Abstract

The cough reflex is complex and requires integration of sensorimotor information from the central and peripheral nervous system. Cough motor output can be volitionally modified even when a strong urge-to-cough (UTC) is felt which reinforces the idea of cortical involvement in cough and opens the door to consider how manipulating attention or changing cognitive load may impact cough reflex sensitivity. Two prior studies have shown healthy individuals have reduced cough reflex sensitivity to inhaled tussigenic stimulants when completing a distracting task, presumably due to influence from increased cognitive load. In this prospective case series study, 13 patients with cough hypersensitivity syndrome completed cough challenge testing with capsaicin with and without a distracting task at the University of Montana between April and July 2022. It was hypothesized that similarly to healthy individuals, patients would have reduced cough reflex sensitivity when cognitive load was increased. Contrary to this prediction, there was no statistically significant difference in cough frequency or UTC when comparing the control condition (i.e., cough challenge testing only) to the experimental condition (i.e., cough challenge testing plus a concurrent cognitive task). The results point toward a high level of individual variability in cough reflex sensitivity in patients with cough hypersensitivity syndrome. Additional research including testing a healthy control group with this study’s procedures is needed to strengthen the interpretation of results. Conclusions and implications for future work are provided