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BACKGROUND: The urge-to-cough is a consciously perceived compulsion, previously investigated in healthy volunteers inhaling irritants. We aimed to characterise the urge-to-cough and associated sensations in a group of chronic cough patients attending a specialist clinic. METHODS: 100 patients with chronic cough [mean age 60 yrs (±11.89), 71 female, median cough duration 7 yrs (IQR 11.13) completed an investigator-led survey describing aggravating and relieving factors for urge-to-cough, associated somatic sensations (quality, location, intensity) and emotions. Subjects rated each using a 5-point Likert scale (strongly disagree to strongly agree) or visual analogue scale (VAS). Cluster analysis identified groups of patients with similar patterns of responses. RESULTS: Subjects rated the severity of urge-to-cough highly (84.5 mm on VAS). The majority always cough in response to the urge-to-cough (91%), but fewer (69%) always experienced an urge-to-cough before coughing. The somatic sensations associated with the urge-to-cough were described as an irritation (86%) or tickle (73%), localised in the neck (75%). The urge-to-cough was triggered by various stimuli including smoky atmospheres (79%), talking (72%), cold temperatures (67%) and dry atmospheres (66%) and relieved by coughing (63%), and drinking (61%); in 42% nothing provided relief. Cluster analysis suggested two distinct patient groups, differing in the factors precipitating the urge-to-cough rather than quality or location of associated sensations. CONCLUSION: The unifying characteristics of patients with chronic cough are a severe urge-to-cough associated with throat irritation, consistent with sensory neuronal dysfunction of vagal afferents. Precipitants of the urge-to-cough vary though, and can be used to classify sub-groups of patients who may share similar underlying pathophysiology.

Original publication

DOI

10.1016/j.rmed.2015.03.011

Type

Journal article

Journal

Respir Med

Publication Date

06/2015

Volume

109

Pages

701 - 707

Keywords

Chronic cough, Cluster analysis, Urge-to-cough, Aged, Chronic Disease, Cough, Female, Humans, Irritants, Male, Middle Aged, Perception, Pharynx, Quality of Life, Reflex, Sensation, Sensory Receptor Cells, Surveys and Questionnaires