Patients with neuronal hypersensitivity syndromes have enhanced autonomic symptoms. Chronic cough is considered a neuronal hypersensitivity disorder and, as a result, could be linked with increased autonomic symptoms.

A new study published in ERJ Open Research included 96 patients with chronic cough from a tertiary cough clinic at Wythenshawe Hospital, Manchester, UK. The study also included 76 healthy controls. All study participants were>18 years of age. Investigators excluded all the subjects who had significant respiratory disease, significant smoking history or were taking any drug that could affect cough or autonomic function. Participants were required to complete the Composite Autonomic Symptom Score (COMPASS) 31 autonomic symptom questionnaire, the Cough Quality of Life Questionnaire (CQLQ) and a cough severity visual analogue scale (VAS).

Overall, 96 chronic cough patients and 76 healthy volunteers were part of the analysis. 

Findings - 

• Mann–Whitney U-tests comparing COMPASS 31 scores in both study groups revealed that the score was significantly higher in the patient group with a median of 18.4 (interquartile range (IQR) 7.5–32.0), compared to the control group (median 3.6, IQR 1.1–9.5; p<0.001).
• Participants with chronic cough had significantly higher symptom scores in comparison with the healthy volunteers in all domains except for vasomotor symptoms.
• A positive association was evident between COMPASS 31 and CQLQ among the patient group, but not between COMPASS 31 and VAS.

Conclusion – 

Patients with chronic cough do have more frequent and severe autonomic symptoms compared to healthy individuals.

Reference

Dockry RJ, Farrelly CL, Mitchell J, et al. Chronic cough is associated with increased reporting of autonomic symptoms. ERJ Open Res. 2021 Jul; 7(3): 00105-2021.

*Dysautonomia seems to be tied to several conditions marked by neuronal/visceral hypersensitivity