Behavioral cough suppression therapy with an inhaled substance for refractory chronic cough

You may qualify if

• 18 - 99 years of age
• Diagnosis of refractory or unexplained chronic cough
• Normal chest imaging (x-ray or CT scan) within past 2 years, without change in cough symptoms
• If you a potential participant has asthma, the following criteria must be met:; Asthma diagnosed by a pulmonary provider; Documentation from a pulmonary provider that asthma is well-controlled; Agree to carry prescribed rescue inhaler to each study visit; Can tolerate, and agree to, avoid rescue inhaler use for 4 hours prior to each study visit. If rescue inhaler use is unavoidable within 4 hours of a study visit, agree to inform researchers in advance so that the session can be rescheduled.
• Normal pulmonary function testing with spirometry (FEV1/FVC of at least 70% if diagnosed with asthma) within 2 years (6 months for those with a diagnosis of asthma), without change in symptoms since (NOTE: spirometry is included as part of cough threshold testing and can serve as this criteria if the participant has not had spirometry within the designated time.)
• Laryngoscopy or stroboscopy within 2 years without evidence of structural pathology and no change in vocal quality since exam
• Proficient reader/speaker of English
• Willing to take a pregnancy test before enrollment (if applicable)
• Willing to use contraception during the study (if applicable)
• Access to reliable internet, working email address (for surveys) and a smart phone (for use with CoughMonitor Watch)
• Demonstrates understanding in study procedures and risks in order to consent
• Available, and willing, to comply to all study procedures and clinic visits.

You can't join if

• Any of the following will be grounds for exclusion from the study:; Currently a smoker of any substance or has a positive history of smoking any substance within the last 6 months; Currently suffering from any signs of an upper respiratory infection (other than cough); Hemoptysis (coughing up blood) within the last 6 months; Pulmonary diagnosis other than asthma; Asthma criteria - participant is deemed ineligible if screened for one or more of the following:; Use of rescue inhaler in response to active asthma symptoms ≥ 2 times per week; Respiratory related emergency department visit within the past 4 weeks; Respiratory related ICU admission within the past 12 months; Asthma exacerbation requiring systemic corticosteroid use within the past 4 weeks; Pregnant or trying to become pregnant; Any complaints or clinical symptoms of dysphagia; Live with someone with chronic cough or work with someone with chronic cough who is in close proximity (e.g., within 25 feet) on a daily or nearly daily basis; Known allergy to peppers; Currently receiving or has received BCS therapy for management of refractory chronic cough; Excluded concomitant medications:; Inhaled pulmonary medications (inhaled corticosteroids, short-acting beta agonists, long-acting beta-agonist, short-acting muscarinic antagonists), unless prescribed for asthma by pulmonary provider: 30 days prior to Visit 1 through completion of study participation; ACE inhibitor (benazepril, captopril, enalapril, fosiniopril, lisinopril, perindopril, quinapril, ramipril, trandolapril): 30 days prior to Visit 1 through completion of study participation.; Narcotic antitussive (hydrocodone, oxycodone, morphine, codeine, tramadol): 7 days prior to Visit 1 through completion of study participation; Non-narcotic antitussive (benzonatate/Tessalon, dextromethorphan/Delsym, carbetapentane/Solotuss): 7 days prior to Visit 1 through completion of study; P2X3 receptor antagonist (gefapixant/Lyfnua): 14 days prior to Visit 1 through completion of study; Any off-label prescription medication prescribed for cough (pregabalin/Lyrica, gabapentin/Neurontin, amitriptyline/Elavil): 14 days prior to Visit 1 through completion of study *if a neuromodulator is prescribed for something other than cough, participant must be on a stable dose for a minimum of 7 days The following additional exclusion criteria will apply to participants who will undergo fMRI:; Presence of metal implants, devices or fragments (e.g., shrapnel) in the body; Claustrophobia