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Cough, an important respiratory symptom, predominantly involves the brainstem and the urge-to-cough UTC is modulated by the cerebral cortex. Lewy body disease is associated with decreased cough reflex sensitivity and central respiratory chemosensitivity. We investigated the relationships between cognition and cough reflex and the UTC and compared the differences in responses of patients with DLB and other dementia subtypes. We conducted a cross-sectional study within a geriatric ward of a university hospital involving elderly patients diagnosed with Alzheimer's disease AD , DLB, or non-dementia controls.
Subjects were asked to rate the UTC based on the threshold concentrations C u using the modified Borg scale.
This result might be valuable in treating patients with DLB. Morbidity and mortality of aspiration pneumonia AP in people with dementia are increasing. The cough reflex sensitivity and the urge to cough, which are important responsible factors for AP, are deteriorated in dementia with Lewy bodies. Cough is a crucial response function of the respiratory defence mechanism and involves the brainstem, where information from sensory nerve endings is processed in response to various stimuli.
The urge-to-cough UTC is a sensation that plays an essential role in both initiating and inhibiting reflexive cough [ 1 ]. The UTC as a cognitive cough sensation, mediated by the cerebral cortex or the subcortical regions, occurs at a concentration threshold of cough-evoking stimuli lower than that required to evoke a motor cough [ 2 ]. Recently, the UTC was reported to activate multiple brain regions such as the insula, anterior midcingulate cortex, primary sensory cortex, orbitofrontal cortex, supplementary motor area and cerebellum [ 2 , 3 ].
