Refractory chronic cough Signs and Symptoms
Conditions
Interventions
Participants diagnosed with refractory chronic cough will be recruited from specialist chronic cough service clinics in Manchester and Preston. Screening tests will include physical examination, spiro
Sponsors
University of Manchester
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1. Males and females aged 18-80 years inclusive 2. Non-smokers and ex-smokers with 6 months abstinence 3. Diagnosis of refractory chronic cough (RCC) as per guidelines 4. Right-handedness 5. No substantial abnormalities on chest radiograph or CT scan of the thorax in the 5 years prior, which, in the opinion of the investigator, may have contributed to chronic cough 6. No evidence of lung disease, which may contribute to chronic cough (including COPD and asthma) 7. Normal spirometry; forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) predicted values =70% and FEV1/FVC ratio of =70%
Exclusion criteria
Exclusion criteria: 1. Taking any medications likely to alter cough (including ACE inhibitors) within 2 weeks of enrolment 2. Pregnant/breastfeeding 3. Significant change in pulmonary status or respiratory tract infection within the prior 4 weeks 4. Contraindications to fMRI scanning (e.g. metal plates, claustrophobia) 5. Previous opiate or pharmacological anti-tussive therapy use 6. Chronic pain/taking regular analgesia (if using as required, must be able to omit for the duration of the study) 7. Previous stroke and diagnosis of dementia 8. Other severe, acute, or chronic medical or psychiatric conditions that may increase the risk associated with trial participation or may interfere with the interpretation of trial results
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Changes in central nervous system (CNS) connectivity with low-dose morphine therapy measured by the blood-oxygen-level dependent (BOLD) signal using functional magnetic resonance imaging (fMRI), specifically the sensorimotor resting state network, the precuneus and the default mode resting state network following 6-8 days of low-dose morphine therapy | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Changes in objective daytime cough frequency (coughs per hour), cough severity visual analogue scale (VAS), Leicester Cough Questionnaire (LCQ) score, and the Triggers and Sensations Provoking Cough (ToPIC) questionnaire score following 6-8 days of low-dose morphine therapy. 2. Correlations between the changes in CNS connectivity (as measured by BOLD signal) and changes in objective daytime cough frequency per hour following 6-8 days of low-dose morphine therapy, reported cough severity VAS and measures of expectation. 3. Correlations between resting state network activity (as measured by BOLD activity) and changes in daytime cough frequency following 6-8 days of low-dose morphine treatment, reported cough severity, ToPIC score and measures of expectation. 4. Changes in cerebral blood flow following 6-8 days of low-dose morphine therapy as measured by arterial spin labelling (ASL) fMRI methods. | — |
Countries
England, United Kingdom
Contacts
Public ContactRachel Dockry
Outcome results
None listed