Behavioral Cough Suppression Therapy for Refractory Chronic Cough

Refractory chronic cough (RCC) is a condition where coughing persists despite treatment of the underlying causes, making it challenging and costly to manage. This study focuses on a therapy called behavioral cough suppression (BCS) which has been effective in reducing cough frequency and improving quality of life, although it's not widely used and its working mechanism is not well understood. The trial aims to explore how BCS works and whether combining it with capsaicin, a cough stimulant, improves its effectiveness. This research is important as it could lead to better treatments for people with RCC who struggle to find relief with current options. Participants in this study will be randomly assigned to one of three groups: BCS with capsaicin stimulation, BCS with a sham stimulation, or capsaicin stimulation alone. Over several weeks, participants will attend 12 treatment sessions. The study will measure how well participants can suppress their cough, the sensitivity of their cough reflex, and changes in brain activity related to coughing. These will be evaluated using different methods including questionnaires, cough frequency monitoring, and brain scans. By comparing the outcomes, researchers hope to determine which treatment combination is most effective and understand the mechanisms behind BCS therapy.