Sensorimotor Cough Dysfunction Is Prevalent and Pervasive in Progressive Supranuclear Palsy

Area of Science:

• Neurology
• Pulmonology
• Geriatrics

Background:

• Pneumonia is a major cause of mortality in progressive supranuclear palsy (PSP), stemming from impaired airway protection, including cough and swallowing deficits.
• Cough is crucial for airway protection by expelling aspirate and may be a therapeutic target for preventing pneumonia in dysphagia.
• Objective characterization and comparison of cough function in PSP versus Parkinson's disease (PD) are lacking.

Purpose of the Study:

• To examine and compare voluntary and reflex cough function in patients with PSP and PD, matched for disease duration.

Main Methods:

• Twenty-six PSP and 26 PD patients underwent voluntary and reflex cough testing using spirometry.
• Linear mixed effects models were employed to compare cough sensory and motor outcomes between groups and within cough types.

Main Results:

• PSP patients exhibited significantly reduced cough motor function compared to PD patients, including lower peak expiratory flow rate, cough expiratory volume, and cough inspiratory volume.
• Both groups had similar reflex cough thresholds, but PSP patients reported an increased perception of cough stimuli.

Conclusions:

• Sensorimotor cough dysfunction is common in PSP, with motor deficits being more severe than in PD.
• These cough deficits likely contribute to pneumonia development in PSP, underscoring the need to include cough assessment in airway protection evaluations.
• Targeting cough function may reduce adverse events and enhance quality of life for individuals with PSP.