Symptoms of autonomic dysfunction in chronic cough patients

Abstract

Background: Cough responses are mediated by the vagus nerve which also carries autonomic parasympathetic fibres. We hypothesised that chronic cough may be associated with symptoms of autonomic dysfunction. The aim of this study was to compare self-reported autonomic symptoms in a group of chronic cough patients with that of a healthy control group. Methods: We recruited 90 patients with chronic cough attending a specialist clinic [median age 63yrs (IQR 51-67.3), 72.1% female] and 61 healthy controls [median age 54yrs (IQR 48-60.0), 74.4% female]. Subjects completed the COMPASS 31, a validated autonomic symptom questionnaire with 6 domains, a cough severity visual analogue scale and the cough quality of life questionnaire (CQLQ). Results: COMPASS 31 scores were significantly higher in chronic cough patients than in healthy controls. The differences were greatest for gastrointestinal symptoms. Although 7 patients also had irritable bowel syndrome, excluding these subjects from the analysis did not change the findings. In chronic cough patients autonomic symptom scores were correlated with cough-specific quality of life (r=0.46, p Conclusions: This study suggests that chronic coughing may be associated with autonomic dysfunction.