The cough center is a region of the

brain A brain is an organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It is located in the head, usually close to the sensory organs for senses such as vision. It is the most complex organ in a v ...

which controls

coughing A cough is a sudden expulsion of air through the large breathing passages that can help clear them of fluids, irritants, foreign particles and microbes. As a protective reflex, coughing can be repetitive with the cough reflex following three phas ...

. The cough center is located in the

medulla oblongata The medulla oblongata or simply medulla is a long stem-like structure which makes up the lower part of the brainstem. It is anterior and partially inferior to the cerebellum. It is a cone-shaped neuronal mass responsible for autonomic (involun ...

in the

brainstem The brainstem (or brain stem) is the posterior stalk-like part of the brain that connects the cerebrum with the spinal cord. In the human brain the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is cont ...

. Cough suppressants focus their action on the cough center.

Structure

The exact location and functionality of the cough center has remained somewhat elusive: while

Johannes Peter Müller Johannes Peter Müller (14 July 1801 – 28 April 1858) was a German physiologist, comparative anatomy, comparative anatomist, ichthyology, ichthyologist, and herpetology, herpetologist, known not only for his discoveries but also for his ability ...

observed in 1838 that the medulla coordinates the cough reflex, investigating it has been slow because the usual anaesthetics for experimental animals were morphine or opiates, drugs which strongly inhibit cough. In addition, the center likely overlaps with the respiratory rhythm generator networks. It is hence not so much a specific area, but a function within the respiration and reflex networks of the brainstem. Cough receptors project to relay neurones in the

solitary nucleus In the human brainstem, the solitary nucleus, also called nucleus of the solitary tract, nucleus solitarius, and nucleus tractus solitarii, (SN or NTS) is a series of purely sensory nuclei (clusters of nerve cell bodies) forming a vertical column ...

, which project to other parts of the respiratory networks. In particular, the

pre-Bötzinger complex The preBötzinger complex, sometimes written pre-Bötzinger complex (preBötC), is a functionally and anatomically specialized site in the ventral-lateral region of the lower medulla oblongata (i.e., lower brainstem). The preBötC is part of the ven ...

may act as a

pattern generator A pattern is a regularity in the world, in human-made design, or in abstract ideas. As such, the elements of a pattern repeat in a predictable manner. A geometric pattern is a kind of pattern formed of geometric shapes and typically repeated l ...

for the cough response. Parts of the caudal medullary raphe nucleus (

nucleus raphe obscurus The nucleus raphe obscurus, despite the implications of its name, has some very specific functions and connections of afferent and efferent nature. The nucleus raphes obscurus projects to the cerebellar lobes VI and VII and to crus II along with th ...

and

nucleus raphe magnus Nucleus ( : nuclei) is a Latin word for the seed inside a fruit. It most often refers to: *Atomic nucleus, the very dense central region of an atom *Cell nucleus, a central organelle of a eukaryotic cell, containing most of the cell's DNA Nucle ...

) are known to be essential for the cough response. Other systems that may be involved in pattern generation and regulation are the

pontine respiratory group The respiratory center is located in the medulla oblongata and pons, in the brainstem. The respiratory center is made up of three major respiratory groups of neurons, two in the medulla and one in the pons. In the medulla they are the dorsal r ...

, the

lateral tegmental field The tegmentum (from Latin for "covering") is a general area within the brainstem. The tegmentum is the ventral part of the midbrain and the tectum is the dorsal part of the midbrain. It is located between the ventricular system and distinctive ba ...

and the deep

cerebellar nuclei The cerebellum (Latin for "little brain") is a major feature of the hindbrain of all vertebrates. Although usually smaller than the cerebrum, in some animals such as the mormyrid fishes it may be as large as or even larger. In humans, the cereb ...

. Successful joint models of medullary systems coordinating breathing, coughing and swallowing has been constructed based on this model. Coughing can occur or be inhibited as a

voluntary action Voluntary action is an anticipated goal-oriented movement. The concept of voluntary action arises in many areas of study, including cognitive psychology, operant conditioning, philosophy, neurology, criminology, and others. Additionally, voluntary ...

, suggesting control from higher systems in the brain. Functional brain imaging of voluntary, suppressed, and induced coughing show that a number of cortical areas can get involved and may be important even for non-voluntary coughing. In contrast, voluntary coughing does not seem to activate medullary systems.Stuart B. Mazzone, Leonie J. Cole, Ayaka Ando, Gary F. Egan, and Michael J. Farrell. Investigation of the Neural Control of Cough and Cough Suppression in Humans Using Functional Brain Imaging. The Journal of Neuroscience, 23 February 2011, 31(8): 2948-2958;

References

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Structure

References

See also