Detecting Bulbar Motor Involvement in ALS: Comparing speech and chewing tasks.
Erin M Wilson, Madhura Kulkarni, Meg Simione and 3 others
PMID 30696280WHAT IT FOUND
Jaw movement speed during speech slowed as ALS severity increased, distinguishing affected from unaffected speakers.
Chewing speed increased with severity. Neither task's jaw range of motion detected these changes. Speech speed is a better candidate marker for bulbar decline than chewing.
Key findings
01Healthy controls had higher sentence maximum speed than ALS participants with unaffected speaking rate (p = 0.006) and those with affected speaking rate (p < 0.001).
02Healthy controls had the slowest chewing maximum speed as compared to ALS participants with unaffected speaking rate (p = 0.005) and those with affected speaking rate (p < 0.001).
03No significant differences were observed for jaw articulatory working space during sentence production or chewing between the controls or ALS subgroups.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size did not allow for longitudinal modelling, so the study could not track individual changes over time. Only one food consistency (Cheerios) was used for chewing, which may have limited the ability to detect differences between ALS subgroups in that task. The study did not measure tongue movement, so compensatory strategies involving the tongue could not be assessed.
Declared interests
The research was supported by the National Institutes of Health (N.I.H., Extramural). No specific commercial conflicts of interest were declared in the provided text.
The easy way to misread this
Do not assume that jaw range of motion is a useful marker for bulbar decline. This study found no significant differences in articulatory working space between healthy controls and ALS patients, whereas jaw speed showed clear differences. Focusing on range of motion may miss early signs of disease progression.