Comparison of voluntary and reflex cough effectiveness in Parkinson's disease |
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| Institution: | 1. Department of Speech Language and Hearing Sciences, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA;2. Center for Movement Disorders and Neurorestoration, College of Medicine, University of Florida, Gainesville, FL, USA;3. Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA;4. Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, USA;1. Department of Speech, Language, and Hearing Sciences, University of Florida, USA;2. Department of Neurology, University of Florida, USA;3. Center for Movement Disorders and Neurorestoration, University of Florida, USA;4. Brain Rehabilitation Research Center, Malcom Randall VA, Gainesville, FL, USA;5. Department of Communication Sciences and Disorders, Jacksonville University, Jacksonville, FL, USA;1. Department of Neurology, Zhongshan Hospital and Shanghai Medical College, Shanghai 200032, China;2. Xinxiang College of Medicine, Xinxiang, Henan Province 453003, China;3. Institutes of Brain Science, Fudan University, Shanghai 200032, China;1. Department of Surgery, Division of Otolaryngology—Head and Neck Surgery, University of Wisconsin, Madison, WI, United States;2. Department of Communication Sciences and Disorders, University of Wisconsin, Madison, WI, United States;1. Department of Biomedical Engineering, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea;2. Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea;3. Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea |
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| Abstract: | IntroductionMultiple airway protective mechanisms are impacted with Parkinson's disease (PD), including swallowing and cough. Cough serves to eject material from the lower airways, and can be produced voluntarily (on command) and reflexively in response to aspirate material or other airway irritants. Voluntary cough effectiveness is reduced in PD however it is not known whether reflex cough is affected as well. The goal of this study was to compare the effectiveness between voluntary and reflex cough in patients with idiopathic PD.MethodsTwenty patients with idiopathic PD participated. Cough airflow data were recorded via facemask in line with a pneumotachograph. A side delivery port connected the nebulizer for delivery of capsaicin, which was used to induce cough. Three voluntary coughs and three reflex coughs were analyzed from each participant. A two-way repeated measures analysis of variance was used to compare voluntary versus reflex cough airflow parameters.ResultsSignificant differences were found for peak expiratory flow rate (PEFR) and cough expired volume (CEV) between voluntary and reflex cough. Specifically, both PEFR and CEV were reduced for reflex as compared to voluntary cough.ConclusionCough PEFR and CEV are indicative of cough effectiveness in terms of the ability to remove material from the lower airways. Differences between these two cough types likely reflect differences in the coordination of the respiratory and laryngeal subsystems. Clinicians should be aware that evaluation of cough function using voluntary cough tasks overestimates the PEFR and CEV that would be achieved during reflex cough in patients with PD. |
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| Keywords: | Airway protection Cough Parkinson's disease Reflex cough Voluntary cough |
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