Lingual and Jaw Kinematic Abnormalities Precede Speech and Swallowing Impairments in ALS.
Bridget J Perry, Rosemary Martino, Yana Yunusova and 2 others
PMID 29774424WHAT IT FOUND
People with ALS who had no speech or swallowing symptoms moved their tongue differently during water drinking than controls.
Their posterior tongue moved less and more slowly, and their jaw moved more and faster.
Key findings
01Posterior tongue range and speed were lower in ALS: range 11.40 mm ± 4.01 versus 16.07 mm ± 5.27; speed 83.67 mm/s ± 47.96 versus 141.35 mm/s ± 66.54.
02Lingual coordination lag was shorter in ALS: 0.04 s ± 0.11 versus 0.17 s ± 0.19; lingual movement duration was longer in ALS: 13.46 s ± 6.75 versus 9.21 s ± 3.28.
03Jaw range was greater and jaw speed was faster in ALS: range 9.86 mm ± 5.38 versus 6 mm ± 3.78; speed 68.62 mm/s ± 50.13 versus 34.72 mm/s ± 17.75.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample was small: 16 participants with ALS and 18 controls. Only one liquid swallowing task was tested, a 3-oz water task. A single trial may not reflect overall performance or fatigue over a meal. The reported outcomes were tongue and jaw movement measures, not aspiration, nutrition, survival, or clinical swallowing outcomes. EMA is not clinically feasible because equipment is expensive and tongue sensor placement is time consuming. Sex was not controlled for, because the authors cite prior work that found no sex differences in lingual movement. The ALS group was selected to be asymptomatic for speech and swallowing, so findings apply only to very early bulbar change, not to established dysphagia.
Declared interests
The work was funded by the National Institute on Deafness and Other Communication Disorders. No author conflicts of interest are reported.
The easy way to misread this
Do not assume this means tongue and jaw movement changes can diagnose ALS or guide treatment now. The study used research EMA during one 3-oz water task in 16 people with ALS and 18 controls, and the authors note EMA is not clinically feasible.