Neurology® Podcast
Central Mechanisms of Cough and Their Neurologic Implications
Dec 12, 2024
Rhys Haas, a neurology fellow at the Mayo Clinic, dives into the fascinating world of cough from a neurological perspective. He discusses the neuroanatomy of the cough reflex and its unexpected ties to pain mechanisms. Haas sheds light on chronic neurogenic cough, particularly in conditions like CANVAS and long COVID. He also explores innovative treatment strategies, including new medications and the effects of vagus nerve stimulation. This engaging conversation uncovers the intricate connections between coughing and neurology that could reshape clinical approaches.
11:59
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Quick takeaways
- Coughing is a complex protective reflex involving specific neuroanatomical pathways that are influenced by various cognitive factors.
- Neurogenic cough can result from neurological disorders like CANVAS, highlighting the need for targeted research and treatment strategies.
Deep dives
Understanding the Cough Reflex Mechanism
Coughing primarily serves as a protective reflex triggered by various noxious stimuli, which are processed by specific neuroanatomical pathways. Mechanical, chemical, or thermal irritants activate vagal afferents, with the subsequent signaling passing through key neural structures like the nucleus of the solitary tract and the pre-Bötzinger complex. Excitatory neurotransmitters, particularly glutamate and substance P, facilitate this reflex response by stimulating cough-related networks that overlap with respiratory control. Additionally, higher brain regions, including the cerebellum and the anterior mid-cingulate cortex, modulate cough, indicating a complex interaction between basic reflex actions and cognitive processes.
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