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Cough center
The cough center of the brain is a region of the brain which controls coughing, located in the medulla oblongata area of the brain. Antitussives and other cough medicines focus their action on the cough center.〔D.C. Bolser. Central Mechanisms II: Pharmacology of Brainstem Pathways. Handb Exp Pharmacol. 2009; (187): 203–217. 〕
==Structure==
The exact location and functionality of the cough center has remained somewhat elusive: while Johannes Peter Müller 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.〔J.G. Widdicombe, Neurophysiology of the Cough Reflex, Eur Respir J, 1995, 8, 1193–1202〕 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, which project to other parts of the respiratory networks. In particular, the pre-Bötzinger complex may act as a pattern generator for the cough response. Parts of the caudal medullary raphe nucleus (nucleus raphe obscurus and nucleus raphe magnus) 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 lateral tegmental field and the deep cerebellar nuclei.〔R. Shannon, D.M. Baekey, K.F. Morris, S.C. Nuding, L.S. Segers, B.G. Lindsey. Production of reflex cough by brainstem respiratory networks, Pulmonary Pharmacology & Therapeutics 17 (2004) 369–376〕 Successful joint models of medullary systems coordinating breathing, coughing and swallowing has been constructed based on this model.〔Bolser DC, Pitts TE, Morris KF. The use of multiscale systems biology approaches to facilitate understanding of complex control systems for airway protection. Curr Opin Pharmacol. 2011 Jun;11(3):272-7. Epub 2011 Jul 1.〕〔Russell O’Connor, Lauren S. Segers, Kendall F. Morris, Sarah C. Nuding, Teresa Pitts, Donald C. Bolser, Paul W. Davenport, and Bruce G. Lindsey, A Joint Computational Respiratory Neural Network-Biomechanical Model for Breathing and Airway Defensive Behaviors. Front Physiol. 2012; 3: 264. 〕
Coughing can occur or be inhibited as a voluntary action, 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; 〕
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