NEUTRINO: Neural correlates of morphine in chronic cough, V1.0
Research type
Research Study
Full title
Neural Correlates of Low Dose Opioid Therapy in Chronic Cough (NEUTRINO)
IRAS ID
356572
Contact name
Paul Marsden
Contact email
ISRCTN Number
ISRCTN15129584
Duration of Study in the UK
1 years, 1 months, 1 days
Research summary
Refractory chronic cough (RCC) is a distressing condition defined as excessive coughing that lasts for more than 8 weeks with no underlying cause or does not respond to treatment of underlying conditions (e.g. asthma, gastro-oesophageal reflux). The causes of RCC are poorly understood and specific, effective treatments are lacking. RCC is thought to be caused by heightened sensitivity of nerves in the airways and/or an impairment in the brain pathways that would normally control how much a person coughs (called descending inhibitory control pathways).
One treatment currently used ‘off-label’ for RCC, is the opioid painkiller morphine sulphate (MST), which can provide some relief and reduce coughing in RCC patients when taken at low doses. However, the mechanism by which MST reduces coughing is poorly understood. We hypothesise that MST partly regulates the descending inhibitory control pathways in chronic cough patients; similar to how MST relieves pain.
Networks of the brain can be studied by using functional magnetic resonance imaging (fMRI). We recently performed 50 baseline resting fMRI brain scans in RCC which showed differences in brain network activity compared with healthy volunteers.
In this study, we aim to carry out fMRI brain scanning in RCC patients, before and after taking MST, to assess how the treatment influences brain networks and ultimately better understand the mechanisms involved in RCC. We will also assess how changes in the brain relate to MST-related improvements in coughing.
This single-centre, observational study will enrol 20 RCC patients from our North West specialist cough clinics. Participants will attend 6 visits over a maximum period of 23 days at Wythenshawe Hospital and Manchester University. Procedures will include questionnaires, cough monitoring, vital signs, breathing tests and fMRI brain scans.
The study is funded by the North West Lung Centre Charity and Biomedical Research Centre.
REC name
North West - Preston Research Ethics Committee
REC reference
25/NW/0275
Date of REC Opinion
3 Nov 2025
REC opinion
Further Information Favourable Opinion