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.
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Neurogenic Cough
- Coughing is usually not caused by a primary neurological issue.
- However, neurogenic cough can manifest in some neurological syndromes.
Cough Reflex Mechanism
- Cough is a protective reflex triggered by noxious stimuli, similar to pain or nausea.
- Cough involves vagal afferents, the nucleus of the solitary tract, and a network overlapping with the respiratory system.
Cough and Pain Overlap
- Cough and pain share similar neurobiological mechanisms, including afferent fiber types and sensitization processes.
- This overlap explains the effectiveness of medications like pregabalin, gabapentin, and amitriptyline for chronic cough.