2017
DOI: 10.1016/j.pupt.2017.01.010
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Central mechanisms of airway sensation and cough hypersensitivity

Abstract: The airway sensory nervous system is composed of two anatomically distinct processing pathways that allow for the production of respiratory reflexes and voluntary evoked respiratory behaviours in response to sensing an airway irritation. Disordered sensory processing is a hallmark feature of many pulmonary disorders and results in the development of cough hypersensitivity syndrome, characterised by chronic cough and a persistent urge-to-cough in affected individuals. However, the mechanism underpinning how the… Show more

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Cited by 53 publications
(27 citation statements)
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“…The central neural processes of cough regulation are altered in chronic cough patients as demonstrated in functional brain imaging studies by Mazzone et al30 The sensation of laryngeal irritation (urge-to-cough) following tussigen inhalation normally accompanies activation in diverse areas of brain networks both in cough patients and healthy controls. However, the activation areas differed significantly in 3 areas of the midbrain—the nucleus cuneiformis, periaqueductal grey, and dorsal raphe—where cough hypersensitive patients showed marked increases in activation signals, whereas controls showed no such increases 35.…”
Section: Evidence For Neuropathology In Cough Hypersensitivity Syndromementioning
confidence: 99%
“…The central neural processes of cough regulation are altered in chronic cough patients as demonstrated in functional brain imaging studies by Mazzone et al30 The sensation of laryngeal irritation (urge-to-cough) following tussigen inhalation normally accompanies activation in diverse areas of brain networks both in cough patients and healthy controls. However, the activation areas differed significantly in 3 areas of the midbrain—the nucleus cuneiformis, periaqueductal grey, and dorsal raphe—where cough hypersensitive patients showed marked increases in activation signals, whereas controls showed no such increases 35.…”
Section: Evidence For Neuropathology In Cough Hypersensitivity Syndromementioning
confidence: 99%
“…At times, physical palpation of the neck in the distribution of the vagus nerve can often elicit a coughing spasm as can stimulation of Arnold's nerve within the ear canal . Evidence suggests that peripheral inflammatory events can lead to increases in local neurotransmitter and inflammatory cytokine release that can result in hyperexcitability of second‐order neurons within the brainstem . This central hyperexcitability can then efferently lead to intense activation of other subsets of the brainstem resulting in the aforementioned symptoms.…”
Section: Discussionmentioning
confidence: 99%
“…12 Evidence suggests that peripheral inflammatory events can lead to increases in local neurotransmitter and inflammatory cytokine release that can result in hyperexcitability of second-order neurons within the brainstem. 13 This central hyperexcitability can then efferently lead to intense activation of other subsets of the brainstem resulting in the aforementioned symptoms. Activation of the rapidly adapting receptors of the airway and C-fibers at the peripheral nerve terminals lead to excitation of the efferent parasympathetic reflex arc of the cough reflex.…”
Section: Discussionmentioning
confidence: 99%
“…73 This neuronal plasticity can result from central glial cell responses given that mice infected with a respiratory pneumovirus show microglial activation, increased astrocytic expression markers, and increased levels of cytokines accompanying increased neuronal excitability. 64 Similarly, ozone inhalation increases astrocytic coverage of glutamatergic (excitatory) synapses in the nucleus of the solitary tract, 74 whereas ovalbumin sensitization and pulmonary challenge increase the activity of the nucleus of the solitary tract neurons, promote endocannabinoid signaling, and activate microglial cells. 75 How peripheral tissue inflammation in the airways of patients with chronic cough is translated to the central sites of cough sensorimotor processing is not known.…”
Section: Central Neuroimmune Mechanisms In Coughmentioning
confidence: 99%