Worldwide survey of chronic cough: A manifestation of enhanced somatosensory response

Alyn H. Morice, Adam D. Jakes, Shoaib Faruqi, Surinder S. Birring, Lorcan Mcgarvey, Brendan Canning, Jaclyn A. Smith, Sean M. Parker, Kian Fan Chung, Kefang Lai, Ian D. Pavord, Jan Van Den Berg, Woo Jung Song, Eva Millqvist, Michael J. Farrell, Stuart B. Mazzone, Peter Dicpinigaitis

Research output: Contribution to journalArticlepeer-review

201 Scopus citations


Reports from individual centres suggest a preponderance of females with chronic cough. Females also have heightened cough reflex sensitivity. Here we have reviewed the age and sex of unselected referrals to 11 cough clinics. To investigate the cause of any observed sex dimorphism, functional magnetic resonance imaging of putative cough centres was analysed in normal volunteers. The demographic profile of consecutive patients presenting with chronic cough was evaluated. Cough challenge with capsaicin was undertaken in normal volunteers to construct a concentration-response curve. Subsequent functional magnetic resonance imaging during repeated inhalation of sub-Tussive concentrations of capsaicin observed areas of activation within the brain and differences in the sexes identified. Of the 10 032 patients presenting with chronic cough, two-Thirds (6591) were female (mean age 55 years). The patient profile was largely uniform across centres. The most common age for presentation was 60-69 years. The maximum tolerable dose of inhaled capsaicin was lower in females; however, a significantly greater activation of the somatosensory cortex was observed. Patients presenting with chronic cough from diverse racial and geographic backgrounds have a strikingly homogeneous demographic profile, suggesting a distinct clinical entity. The preponderance of females may be explained by sex-related differences in the central processing of cough sensation.

Original languageEnglish (US)
Pages (from-to)1149-1155
Number of pages7
JournalEuropean Respiratory Journal
Issue number5
StatePublished - 2014

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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