The Urge-to-Cough is a factor of the brain motivation system which usually mediates cognitive responses to cough stimuli. Six stages are present in the cough motivation-to-action system: (1) stimulus, which is the trigger for the neural event; (2) urge, which is the physical need of responding to the stimulus; (3) desire, which is the translation of urge in a central neural targeted goal; (4) action, which is a physical response satisfying the urge-desire; (5) evidence, which is the feedback to the neural system that is on the action; (6) reward, which is sensory system determining if the urge was satisfied.

Urge-to-Cough is associated with three fundamental types of coughs, namely, reflex cough, voluntary cough and behavioral cough. Urge-to-Cough with reflex cough can be considered by assessing the sensations produced by a cough stimulus. Neural processes with voluntary cough can be assessed by using magnitude production with cognitive psychometric methods. Outcomes of these studies are shown if the participants can consistently estimate their Urge-to-Cough. The urge increases with increase in cough stimulus and there is a relationship between the Urge-to-Cough and cough intensity. There is a threshold for causing the sensation of the urge preceding the motor cough behavior. The participants can voluntarily produce coughs of variable magnitudes. The motor cough pattern is directly correlated to the alleged magnitude of a cough and the volitional triggers of a cough are connected directly to the reflex cough pattern, and neural triggers of cough induce a stereotypic motor output. Thus, understanding the Urge-to-Cough motivation-to-action system unlocks new strategies for exploring central neural cough mechanisms.

Source: Davenport PW. Urge-to-cough: what can it teach us about cough? Lung. 2008;186 Suppl 1:S107-11. doi: 10.1007/s00408-007-9045-7. Epub 2007 Oct 22. PMID: 17952695.