Preliminary Evidence of Reduced Urge to Cough and Cough Response in Four Individuals following Remote Traumatic Brain Injury with Tracheostomy

Erin Silverman, Christine M Sapienza, Sarah Miller, Giselle Carnaby, Charles Levy, Hsiu-Wen Tsai, Paul W Davenport, Erin Silverman, Christine M Sapienza, Sarah Miller, Giselle Carnaby, Charles Levy, Hsiu-Wen Tsai, Paul W Davenport

Abstract

Cough and swallow protect the lungs and are frequently impaired following traumatic brain injury (TBI). This project examined cough response to inhaled capsaicin solution challenge in a cohort of four young adults with a history of TBI within the preceding five years. All participants had a history of tracheostomy with subsequent decannulation and dysphagia after their injuries (resolved for all but one participant). Urge to cough (UTC) and cough response were measured and compared to an existing database of normative cough response data obtained from 32 healthy controls (HCs). Participants displayed decreased UTC and cough responses compared to HCs. It is unknown if these preliminary results manifest as a consequence of disrupted sensory (afferent) projections, an inability to perceive or discriminate cough stimuli, disrupted motor (efferent) response, peripheral weakness, or any combination of these factors. Future work should attempt to clarify if the observed phenomena are borne out in a larger sample of individuals with TBI, determine the relative contributions of central versus peripheral nervous system structures to cough sensory perceptual changes following TBI (should they exist), and formulate recommendations for systematic screening and assessment of cough sensory perception in order to facilitate rehabilitative efforts. This project is identified with the National Clinical Trials NCT02240329.

Figures

Figure 1
Figure 1
Comparison of urge to cough (UTC) ratings at increasing concentrations of capsaicin, healthy controls (HCs) compared to participants with TBI. On this scale, 1 = “no urge to cough” and 10 = “maximum urge to cough.” Participants with TBI were presented with an additional three presentations of 500 μM capsaicin, for which there is no HC comparison data.
Figure 2
Figure 2
Number of cough events (CTot) recorded following presentation of capsaicin solution at various consistencies; healthy controls (HCs) compared to participants with TBI. Participants with TBI were presented with an additional three presentations of 500 μM capsaicin, for which there is no HC comparison data.

References

    1. Brooks S. M. Perspective on the human cough reflex. Cough. 2011;7(1, article 10) doi: 10.1186/1745-9974-7-10.
    1. Mazzone S. B., McGovern A. E., Yang S.-K., et al. Sensorimotor circuitry involved in the higher brain control of coughing. Cough. 2013;9(1, article 7) doi: 10.1186/1745-9974-9-7.
    1. Dicpinigaitis P. V., Dobkin J. B. Effect of zafirlukast on cough reflex sensitivity in asthmatics. Journal of Asthma. 1999;36(3):265–270. doi: 10.3109/02770909909075410.
    1. Van Den Bergh O., Van Diest I., Dupont L., Davenport P. W. On the psychology of cough. Lung. 2012;190(1):55–61. doi: 10.1007/s00408-011-9347-7.
    1. Bigler E. D. Neuroimaging biomarkers in mild traumatic brain injury (mTBI) Neuropsychology Review. 2013;23(3):169–209. doi: 10.1007/s11065-013-9237-2.
    1. Leung L. Y. E., Deng-Bryant Y., Shear D., Tortella F. Combined hypoxemic and hypotensive insults altered physiological responses and neurofunction in a severity-dependent manner following penetrating ballistic-like brain injury in rats. The Journal of Trauma and Acute Care Surgery. 2015;79(4):S130–S138. doi: 10.1097/ta.0000000000000785.
    1. Lee S. C., Kang S.-W., Kim M. T., Kim Y. K., Chang W. H., Im S. H. Correlation between voluntary cough and laryngeal cough reflex flows in patients with traumatic brain injury. Archives of Physical Medicine and Rehabilitation. 2013;94(8):1580–1583. doi: 10.1016/j.apmr.2012.11.006.
    1. Terré R., Mearin F. Prospective evaluation of oro-pharyngeal dysphagia after severe traumatic brain injury. Brain Injury. 2007;21(13-14):1411–1417. doi: 10.1080/02699050701785096.
    1. Leder S. B. Fiberoptic endoscopic evaluation of swallowing in patients with acute traumatic brain injury. Journal of Head Trauma Rehabilitation. 1999;14(5):448–453. doi: 10.1097/00001199-199910000-00005.
    1. Buchholz D. W. Dysphagia associated with neurological disorders. Acta Oto-Rhino-Laryngologica Belgica. 1994;48(2):143–155.
    1. Lazarus C., Logemann J. A. Swallowing disorders in closed head trauma patients. Archives of Physical Medicine and Rehabilitation. 1987;68(2):79–84.
    1. Taylor-Clark T. E. Peripheral neural circuitry in cough. Current Opinion in Pharmacology. 2015;22:9–17. doi: 10.1016/j.coph.2015.02.001.
    1. Shavelle R. M., Strauss D., Whyte J., Day S. M., Yu Y. L. Long-term causes of death after traumatic brain injury. American Journal of Physical Medicine and Rehabilitation. 2001;80(7):510–516. doi: 10.1097/00002060-200107000-00009.
    1. Harrison-Felix C., Kreider S. E. D., Arango-Lasprilla J. C., et al. Life expectancy following rehabilitation: a NIDRR traumatic brain injury model systems study. Journal of Head Trauma Rehabilitation. 2012;27(6):E69–E80. doi: 10.1097/htr.0b013e3182738010.
    1. Harrison-Felix C. L., Pretz C. R., Hammond F., et al. Life expectancy after inpatient rehabilitation for traumatic brain injury in the United States. Journal of Neurotrauma. 2014;32(23):1893–1901. doi: 10.1089/neu.2014.3353.
    1. Harrison-Felix C. L., Whiteneck G. G., Jha A., DeVivo M. J., Hammond F. M., Hart D. M. Mortality over four decades after traumatic brain injury rehabilitation: a retrospective cohort study. Archives of Physical Medicine and Rehabilitation. 2009;90(9):1506–1513. doi: 10.1016/j.apmr.2009.03.015.
    1. Hansen T. S., Larsen K., Engberg A. W. The association of functional oral intake and pneumonia in patients with severe traumatic brain injury. Archives of Physical Medicine and Rehabilitation. 2008;89(11):2114–2120. doi: 10.1016/j.apmr.2008.04.013.
    1. Dicpinigaitis P. V., Tibb A. S., Ramsey D. L., Carr A. N., Poore C. L. Stability of cough reflex sensitivity during viral upper respiratory tract infection (common cold) Pulmonary Pharmacology and Therapeutics. 2014;28(2):154–157. doi: 10.1016/j.pupt.2014.05.004.
    1. Dicpinigaitis P. V., Allusson V. R. C., Baldanti A., Nalamati J. R. Ethnic and gender differences in cough reflex sensitivity. Respiration. 2001;68(5):480–482. doi: 10.1159/000050554.
    1. Dicpinigaitis P. V., Grimm D. R., Lesser M. Baclofen-induced cough suppression in cervical spinal cord injury cord injury. Archives of Physical Medicine and Rehabilitation. 2000;81(7):921–923. doi: 10.1053/apmr.2000.5612.
    1. Dicpinigaitis P. V., Grimm D. R., Lesser M. Cough reflex sensitivity in subjects with cervical spinal cord injury. American Journal of Respiratory and Critical Care Medicine. 1999;159(5 I):1660–1662. doi: 10.1164/ajrccm.159.5.9810060.
    1. Davenport P. W., Sapienza C. M., Bolser D. C. Psychophysical assessment of the urge-to-cough. European Respiratory Review. 2002;12(85):249–253.
    1. van den Bergh O., van Diest I., Dupont L., Davenport P. W. On the psychology of cough. Lung. 2012;190(1):55–61. doi: 10.1007/s00408-011-9347-7.
    1. Troche M. S., Brandimore A. E., Godoy J., Hegland K. W. A framework for understanding shared substrates of airway protection. Journal of Applied Oral Science. 2014;22(4):251–260. doi: 10.1590/1678-775720140132.
    1. Hegland K. W., Bolser D. C., Davenport P. W. Volitional control of reflex cough. Journal of Applied Physiology. 2012;113(1):39–46. doi: 10.1152/japplphysiol.01299.2011.
    1. Pitts T., Bolser D., Rosenbek J., Troche M., Sapienza C. Voluntary cough production and swallow dysfunction in Parkinson's disease. Dysphagia. 2008;23(3):297–301. doi: 10.1007/s00455-007-9144-x.
    1. Pitts T., Troche M., Mann G., Rosenbek J., Okun M. S., Sapienza C. Using voluntary cough to detect penetration and aspiration during oropharyngeal swallowing in patients with Parkinson disease. Chest. 2010;138(6):1426–1431. doi: 10.1378/chest.10-0342.
    1. Hammond C. A. S., Goldstein L. B., Horner R. D., et al. Predicting aspiration in patients with ischemic stroke. Chest. 2009;135(3):769–777. doi: 10.1378/chest.08-1122.
    1. Hagan C., Malkmus D., Durham P. Rancho Los Amigos Cognitive Scale. Rancho Los Amigos National Rehabilitation Center; 1972.
    1. Nasreddine Z. S., Phillips N. A., Bédirian V., et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society. 2005;53(4):695–699. doi: 10.1111/j.1532-5415.2005.53221.x.
    1. Costanzo M. T., Yost R. A., Davenport P. W. Standardized method for solubility and storage of capsaicin-based solutions for cough induction. Cough. 2014;10(1, article 6) doi: 10.1186/1745-9974-10-6.
    1. Borg G. Perceived exertion as an indicator of somatic stress. Scandinavian Journal of Rehabilitation Medicine. 1970;2(2):92–98.
    1. Shrestha K. K., Mohindra S., Mohindra S. How to decannulate tracheostomised severe head trauma patients: a comparison of gradual vs abrupt technique. Nepal Medical College Journal. 2012;14(3):207–211.
    1. Meyer P. G., Orliaguet G., Blanot S., et al. Complications of emergency tracheal intubation in severely head-injured children. Paediatric Anaesthesia. 2000;10(3):253–260. doi: 10.1046/j.1460-9592.2000.00496.x.
    1. Antonios N., Carnaby-Mann G., Crary M., et al. Analysis of a physician tool for evaluating dysphagia on an inpatient stroke unit: the modified mann assessment of swallowing ability. Journal of Stroke and Cerebrovascular Diseases. 2010;19(1):49–57. doi: 10.1016/j.jstrokecerebrovasdis.2009.03.007.
    1. Wheeler Hegland K., Troche M. S., Brandimore A. E., Davenport P. W., Okun M. S. Comparison of voluntary and reflex cough effectiveness in Parkinson's disease. Parkinsonism & Related Disorders. 2014;20(11):1226–1230. doi: 10.1016/j.parkreldis.2014.09.010.

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren