Department of Rehabilitation Medicine, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Beijing, 100050, China.
Respir Res. 2022 Apr 21;23(1):99. doi: 10.1186/s12931-022-02020-x.
Chronic cough is prevalent in the clinic. The existing therapies are mostly limited to medical treatment, with poor curative effects and serious side effects. Studies have suggested that the right dorsolateral prefrontal cortex (rDLPFC) may play an active role in the inhibitory pathway of cough elicitation. Thus, this study explored the effect of transcranial direct current stimulation (tDCS) on the rDLPFC activation in relation to cough reflex and urge-to-cough sensitivity.
Twenty-three healthy young adults completed the experiment. Participants randomly received tDCS anodal stimulation, cathodal stimulation, and sham stimulation, and the interval between every two stimuli was at least one week. The tDCS (2 mA, 30 min) stimulated brain rDLPFC region. After tDCS intervention, cough reflex threshold and urge-to-cough were evaluated immediately by inhalation of citric acid-saline solution.
Compared with sham stimulation, the cough reflex thresholds logC and logC have increased under tDCS anodal stimulation (1.78 ± 0.55 g/L vs. 1.57 ± 0.57 g/L, p < 0.05; 1.92 ± 0.53 g/L vs. 1.67 ± 0.56 g/L, p < 0.05), accompanied by the increase of the urge-to-cough threshold LogC (0.76 ± 0.53 g/L vs. 0.47 ± 0.44 g/L, p < 0.05). In contrast, the urge-to-cough sensitivity expressed as UTC slope was not significantly changed (1.21 ± 0.86 point·L/g vs. 1.00 ± 0.37 point·L/g, p > 0.05), and there were no apparent changes in cough reflex thresholds Log C and logC, urge-to-cough threshold LogC, and urge-to-cough sensitivity UTC slope under tDCS cathodal stimulation, compared with sham stimulation.
This study found that anodal tDCS stimulation of rDLPFC could significantly decrease cough reflex sensitivity, accompanied by the increase of urge-to-cough threshold. Further investigations targeting different brain regions using multiple central intervention techniques to explore the underlying mechanisms are warranted. Trial registration The study protocol was registered for the clinical trial in China (registration number: ChiCTR2100045618).
慢性咳嗽在临床上较为常见。现有的治疗方法大多局限于药物治疗,疗效差,副作用严重。研究表明,右侧背外侧前额叶皮质(rDLPFC)可能在咳嗽诱发的抑制通路中发挥积极作用。因此,本研究探讨了经颅直流电刺激(tDCS)对 rDLPFC 激活与咳嗽反射和咳嗽冲动敏感性的关系。
23 名健康年轻成年人完成了该实验。参与者随机接受 tDCS 阳极刺激、阴极刺激和假刺激,两次刺激之间的间隔至少为一周。tDCS(2 mA,30 分钟)刺激大脑 rDLPFC 区域。tDCS 干预后,立即通过吸入柠檬酸盐水溶液评估咳嗽反射阈值和咳嗽冲动。
与假刺激相比,tDCS 阳极刺激下咳嗽反射阈值 logC 和 logC 增加(1.78±0.55 g/L 比 1.57±0.57 g/L,p<0.05;1.92±0.53 g/L 比 1.67±0.56 g/L,p<0.05),同时咳嗽冲动阈值 LogC 增加(0.76±0.53 g/L 比 0.47±0.44 g/L,p<0.05)。相反,UTC 斜率表示的咳嗽冲动敏感性没有明显变化(1.21±0.86 点·L/g 比 1.00±0.37 点·L/g,p>0.05),rDLPFC 阴极刺激与假刺激相比,咳嗽反射阈值 logC 和 logC、咳嗽冲动阈值 LogC 和咳嗽冲动敏感性 UTC 斜率均无明显变化。
本研究发现,rDLPFC 的阳极 tDCS 刺激可显著降低咳嗽反射敏感性,同时增加咳嗽冲动阈值。需要进一步使用多种中枢干预技术针对不同脑区进行研究,以探讨其潜在机制。
该研究方案在中国(注册号:ChiCTR2100045618)进行了临床试验注册。