CHRONIC COUGH (CC)

Characterisation & Treatment
(Professor Gibson / Nicole Ryan)

At the University of Newcastle Nicole Ryan, CCRE PhD Scholar, in collaboration with Prof Peter Gibson has been working on the characterisation and treatment of refractory chronic cough (CC). Their research has found that at least half of the CC subjects tested had laryngeal dysfunction presenting as paradoxical vocal fold movement (PVFM). The mechanism is extrathoracic airway hyper-responsiveness. This finding is significant as it provides another avenue for CC characterisation and treatment. This is also important to the community as PVFM presents with similar symptoms to asthma and many CC patients are unnecessarily treated with often high levels of corticosteroids.

Speech pathology (SP) has been found to be successful in the treatment of PVFM and CC. Research this year has focused on treatment for refractory CC with SP. The aim of this research is to answer the following 1) is SP effective for cough by decreasing a patient’s cough reflex sensitivity or is it effective due to a patient’s voluntary cortical control? 2) How many sessions of SP is required to improve a person’s cough and quality of life and is this maintained after treatment has finished? Other work in this area focuses on an exciting and novel treatment of CC with chronic pain medication. Again the principle is calming down the damaged laryngeal nerve but from a pharmacological perspective rather than from a speech pathology perspective. This is a large RCT the first of its kind world wide and so far 9 participants of a required 56 have been recruited.

Comparing cough reflex sensitivity in chronic cough patients before, during and after speech pathology intervention
(Dr Anne Vertigan)

This research helps understand the pathophysiology behind improvements in cough after speech pathology intervention. Preliminary results show that cough reflex sensitivity decreases during and following successful speech pathology intervention for chronic cough. Fifteen participants have been recruited to this project and plans are to recruit a further five.

Evaluation of alternative options in the treatment of chronic cough: Self managed treatment
(Dr Anne Vertigan)

The aim of this project is to develop a less resource intensive service delivery model for chronic cough. Three participants have been recruited and a further seven are planned. Self education materials have been developed for this program and are continuing to be refined.