Can we fix the cough reflex?

Can we fix the cough reflex?

Ground-breaking research at the University of Canterbury has been granted $150,000 to explore whether it’s possible to rehabilitate the human cough reflex.

UC academic Dr Phoebe Macrae has been awarded a Health Research Council Explorer grant of $150,000 to research the cough reflex in an innovative new project. She is working on a treatment protocol for the cough reflex and an answer to the question: can we rehabilitate a reflex?

“A cough can be seen as the ‘guard dog’ of our airway/lungs. When something enters the airway that shouldn’t – such as food or fluid – our body coughs to expel the foreign matter,” Dr Macrae says.

The project will be the first to attempt to rehabilitate impaired airway sensation. Currently, there are no treatments available for people with impaired or absent cough reflex.

The cough reflex can be diminished or abolished after neurological injury or disease. Such impairment results in decreased sensory communication from the airway to the brain. This impaired communication puts people at high risk for developing pneumonia, due to an inability to recognise when foreign matter is entering the airway, she says.

“Pneumonia increases hospitalisation costs by around $10,000 for stroke patients and is a leading cause of death in the elderly. Therefore damage to the cough reflex represents a substantial economic and welfare issue. Currently there are no rehabilitation strategies available to address specific impairments of the cough reflex,” Dr Macrae says.

“Instead patients endure non-oral methods of eating or compensatory strategies that require execution with every swallow.”

The HRC Explorer scheme provides seed support for transformative research ideas at an early stage, before an application for greater investment through standard funding mechanisms. The proposal must advance ideas considered to be transformative, innovative, exploratory or unconventional, and have potential for major impact.

The grant was awarded to Dr Macrae and co-investigator Dr Maggie-Lee Huckabee, both based at the University of Canterbury Rose Centre for Stroke Recovery and Research.

An alumna of UC with a PhD in Speech and Language Therapy, Dr Macrae undertook a two-year postdoctoral fellowship at Johns Hopkins University in the United States before returning to New Zealand to take up the role of deputy director of the UC Rose Centre for Stroke Recovery and Research.

Dr Macrae says that the combination of theory and practice in the one location allows rapid translation of research into practice, and helps maintain a functional clinical approach to the research.

“The Rose Centre is an exciting and unique place to work. It has state-of-the-art diagnostic and treatment equipment, enabling a wide variety of research projects, and catering for patients with all manner of swallowing problems. It houses over 10 postgraduate students, as well as the swallowing rehabilitation clinic.”

As well as transferring the knowledge she has gained in the US to UC clinicians who work with swallowing disorders at the Rose Centre, Dr Macrae continues to lecture at UC, teaching anatomy and physiology of speech, hearing and swallowing, voice sciences and disorders, and complex communication disorders in the Department of Communication Disorders.

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