Central nervous system control of cough: pharmacological implications

For many years the idea of a cough center in the brain dominated discussions in the field without any substantial progress in defining what this cough center is or how it functions. Substantial progress has now been made and many of the central neural elements involved in coughing are being described. Furthermore, hypothesis driven research into the function of these neural elements is providing exciting new leads for possible therapeutic targets. The concept of a specific, centrally acting drug for cough suppression is fast becoming a reality. This review summarizes the key findings from the past few years and provides a perspective on future directions for the development of novel antitussives.

► Cough is a reflex or behavioral event accompanied by a preceding urge-to-cough.
► Brainstem and higher brain processing are involved in both cough and urge-to-cough.
► Brainstem targets for cough suppression include NMDA and opioid receptors.
► Higher brain targets for cough suppression are at present speculative.