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Spezzano L, Cortese MD, Quintieri M, Pignolo L, Tonin P, Lucca FL, Tomaiuolo F, Calabrò RS, Morone G, Cerasa A. Inducing Cough Reflex by Capsaicin Spray Stimulation in Patients with Acquired Brain Injury: A Preliminary Test and Proof of Concept. Clin Pract 2023; 13:1603-1611. [PMID: 38131689 PMCID: PMC10742110 DOI: 10.3390/clinpract13060140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/08/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Abstract
Individuals with acquired brain injuries (ABIs) may experience various complications related to poor coughing or impaired cough reflex (including risk of aspiration pneumonia or respiratory infections). For this reason, cough assessment is an important component in the clinical evaluation since patients with ABI are not able to cough voluntarily due to severe motor deficits. When voluntarily coughing is not possible, it is essential for clinical practices to find a quick and minimally invasive way to induce a cough reflex. In the present study, we evaluated the cough reflex in ABI patients using a new method based on a capsaicin spray stimulation test. In total, 150 healthy controls demographically matched with 50 ABI patients were included in this study. Clinical observations demonstrated robust cough response in both healthy controls and ABI patients, as well as the safety and tolerability of capsaicin spray stimulation. ABI patients with dysphagia were characterized by slower and delayed cough responses. Further studies are needed to validate this feasible, less-invasive, and simple-to-comprehend technique in inducing cough reflex. According to this preliminary evidence, we believe that this test might be translated into a simple and effective treatment to improve reflexive cough modulation in ABI patients.
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Affiliation(s)
- Luisa Spezzano
- S’Anna Institute, 88900 Crotone, Italy; (L.S.); (M.D.C.); (M.Q.); (L.P.); (P.T.); (F.L.L.)
| | - Maria Daniela Cortese
- S’Anna Institute, 88900 Crotone, Italy; (L.S.); (M.D.C.); (M.Q.); (L.P.); (P.T.); (F.L.L.)
| | - Maria Quintieri
- S’Anna Institute, 88900 Crotone, Italy; (L.S.); (M.D.C.); (M.Q.); (L.P.); (P.T.); (F.L.L.)
| | - Loris Pignolo
- S’Anna Institute, 88900 Crotone, Italy; (L.S.); (M.D.C.); (M.Q.); (L.P.); (P.T.); (F.L.L.)
| | - Paolo Tonin
- S’Anna Institute, 88900 Crotone, Italy; (L.S.); (M.D.C.); (M.Q.); (L.P.); (P.T.); (F.L.L.)
| | - Francesca Lucia Lucca
- S’Anna Institute, 88900 Crotone, Italy; (L.S.); (M.D.C.); (M.Q.); (L.P.); (P.T.); (F.L.L.)
| | - Francesco Tomaiuolo
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy;
| | | | - Giovanni Morone
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
- San Raffaele Sulmona Institute, 67039 Sulmona, Italy
| | - Antonio Cerasa
- S’Anna Institute, 88900 Crotone, Italy; (L.S.); (M.D.C.); (M.Q.); (L.P.); (P.T.); (F.L.L.)
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy
- Pharmacotechnology Documentation and Transfer Unit, Preclinical and Translational Pharmacology, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Rende, Italy
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