• Thomas Janssens, Sarah Brepoels, Lieven Dupont, and Omer Van den Bergh.
• Health Psychology, KU Leuven (University of Leuven), Leuven, Belgium. Electronic address: thomas.janssens@ppw.kuleuven.be.
• Pulm Pharmacol Ther. 2015 Apr 1; 31: 9-14.

PurposeThe cough reflex is an automatic protective reflex, which can be modulated by conscious effort or other forms of top-down control. In this experiment, we investigated whether information about harmfulness of a cough-inducing substance would augment cough reflex sensitivity and associated urge-to-cough.MethodsHealthy participants (N = 39) were randomized to receive information that they were to inhale a harmless substance (natural citric acid), or a potentially harmful substance (a potent agro-chemical acid). Using dosimeter-controlled inhalations, the dose of citric acid eliciting at least three coughs (C3) was determined. Next, participants received 4 blocks of randomized presentations of citric acid at the C3 dose, a sub-threshold dose of citric acid and saline control.ResultsC3 was reached for 27/39 participants, and C3 thresholds were not influenced by harmfulness information. During repeated citric acid presentations, framing the cough-inducing substance as a potentially harmful chemical resulted in a greater urge-to-cough compared to information framing it as natural citric acid (p < .01). The experimental manipulation did not influence cough frequencies.ConclusionsOur findings show that harmfulness information influences urge-to-cough, corroborating the role of cortical mechanisms in modulating the urge-to-cough and suggesting that cognitive manipulations may contribute to cough treatment.Copyright © 2015 Elsevier Ltd. All rights reserved.

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