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Canadian Respiratory Journal
Volume 2016, Article ID 6875210, 8 pages
Research Article

Preliminary Evidence of Reduced Urge to Cough and Cough Response in Four Individuals following Remote Traumatic Brain Injury with Tracheostomy

1Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
2Brooks Rehabilitation College of Health Sciences, Jacksonville University, Jacksonville, FL, USA
3Brooks Rehabilitation Hospital, Brooks Health, Jacksonville, FL, USA
4College of Nursing, Medical University of South Carolina, Charleston, SC, USA
5Department of Communication Sciences and Disorders, University of Central Florida, Orlando, FL, USA
6Physical Medicine and Rehabilitation Service, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA
7Veteran’s Health Administration, Center for Innovation in Disability and Rehabilitation Research, Gainesville, FL, USA
8Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA

Received 27 June 2016; Revised 24 August 2016; Accepted 30 August 2016

Academic Editor: Jörg D. Leuppi

Copyright © 2016 Erin Silverman et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Cough and swallow protect the lungs and are frequently impaired following traumatic brain injury (TBI). This project examined cough response to inhaled capsaicin solution challenge in a cohort of four young adults with a history of TBI within the preceding five years. All participants had a history of tracheostomy with subsequent decannulation and dysphagia after their injuries (resolved for all but one participant). Urge to cough (UTC) and cough response were measured and compared to an existing database of normative cough response data obtained from 32 healthy controls (HCs). Participants displayed decreased UTC and cough responses compared to HCs. It is unknown if these preliminary results manifest as a consequence of disrupted sensory (afferent) projections, an inability to perceive or discriminate cough stimuli, disrupted motor (efferent) response, peripheral weakness, or any combination of these factors. Future work should attempt to clarify if the observed phenomena are borne out in a larger sample of individuals with TBI, determine the relative contributions of central versus peripheral nervous system structures to cough sensory perceptual changes following TBI (should they exist), and formulate recommendations for systematic screening and assessment of cough sensory perception in order to facilitate rehabilitative efforts. This project is identified with the National Clinical Trials NCT02240329.