Respiratory Reflex Responses to Stimulation of Tracheal Mucosa in Enflurane-Anesthetized Humans

Nishino, Takashi; Hiraga, Kenji; Mizuguchi, Tadanobu; Honda, Yoshiyuki

doi:10.1097/00132586-198908000-00008

Cited by 15 publications

(20 citation statements)

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“…However, exercise (electrically induced hindlimb muscular contractions) in ovalbumin-sensitized rabbits fails to produce similar effects (Tiotiu et al, 2017). An important characteristic of the cough reflex is its very strong dependency on the sleep-wakefulness state as well as on anesthesia (Nishino et al, 1988;Widdicombe and Singh 2006). This reflex, in addition to a potent voluntary control, has also sensory, affective and cognitive components.…”

Section: Neuronal Recordings C-fos Immunohistochemistry and Lesion Ementioning

confidence: 99%

Brainstem mechanisms underlying the cough reflex and its regulation

Mutolo

2017

Respiratory Physiology & Neurobiology

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A B S T R A C TCough is a very important airway protective reflex. Cough-related inputs are conveyed to the caudal nucleus tractus solitarii (cNTS) that projects to the brainstem respiratory network. The latter is reconfigured to generate the cough motor pattern. A high degree of modulation is exerted on second-order neurons and the brainstem respiratory network by sensory inputs and higher brain areas. Two medullary structures proved to have key functions in cough production and to be strategic sites of action for centrally active drugs: the cNTS and the caudal ventral respiratory group (cVRG). Drugs microinjected into these medullary structures caused downregulation or upregulation of the cough reflex. The results suggest that inhibition and disinhibition are prominent regulatory mechanisms of this reflex and that both the cNTS and the cVRG are essential in the generation of the entire cough motor pattern. Studies on the basic neural mechanisms subserving the cough reflex may provide hints for novel therapeutic approaches. Different proposals for further investigations are advanced.

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Section: Neuronal Recordings C-fos Immunohistochemistry and Lesion Ementioning

confidence: 99%

Brainstem mechanisms underlying the cough reflex and its regulation

Mutolo

2017

Respiratory Physiology & Neurobiology

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“…However, EMG records are limited in interpretation by the nonrespiratory actions of the abdominal muscles and by posture, and the inspiratory phase of the cough efforts is not recorded. Airflow can be recorded, which will give inspiratory and expiratory phases [2,8,28]. Inductance plethysmography could be used but practical factors may limit its usefulness.…”

Section: Cough: What's In a Name?mentioning

confidence: 99%

“…This is induced by mechanical or chemical irritation of the vocal cords [4,6] or of the trachea [7,8], and consists of a forced expiratory effort (without preceding inspiration) with closure of the glottis, followed by opening of the glottis and an expulsive phase ( fig. 2).…”

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confidence: 99%

Cough: what's in a name?

Widdicombe

Fontana²

2006

Eur Respir J

119

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The cough reflex (CR) and the expiration reflex (ER) are two defensive reflexes from the respiratory tract, the latter mainly from the larynx. Both are elicited by mechanical and chemical irritation of the airway mucosa, and are a characteristic of airway diseases, but they have different functions. The CR first draws air into the lungs, to accentuate the subsequent expulsive phase; the ER consists of a strong expiration, to prevent aspiration of material into the lungs. They have different sensory pathways, central nervous circuits, and physiological and pharmacological modulations. In practice, coughing often consists of a combination of the two reflexes, a cough bout, epoch or attack. Articles on cough usually do not distinguish between the two reflexes, or whether the coughs are single events or epochs; they usually only measure frequency of expiratory efforts, and neglect other aspects. Current methods for measuring and assessing cough are described, with indications of when the use of these methods may be important.

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“…Not all animals cough in response to airways irritation and cough evoked by many stimuli is absent during general anesthesia (Nishino et al, 1988;Canning et al, 2004;Mazzone et al, 2009b). One approach for identifying brain regions involved in coughing in humans is to use an event-related functional magnetic resonance imaging (fMRI) protocol that measures blood oxygen level-dependent (BOLD) responses, representative of neural activity, during periods of airway irritation and/or voluntary or reflex-evoked coughing.…”

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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Respiratory Reflex Responses to Stimulation of Tracheal Mucosa in Enflurane-Anesthetized Humans

Cited by 15 publications

References 0 publications

Brainstem mechanisms underlying the cough reflex and its regulation

Brainstem mechanisms underlying the cough reflex and its regulation

Cough: what's in a name?

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

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