Quantitative ultrasound of submental and masticatory muscles in children with cerebral palsy.
Marloes L J Lagarde, Karen van Hulst, Corrie E Erasmus and 3 others
PMID 38995809WHAT IT FOUND
Ultrasound scans showed that muscles used for chewing and swallowing in children with cerebral palsy are structurally abnormal, appearing brighter on the scan.
These changes were found even in children who eat and drink safely, suggesting the scan may detect subtle issues missed by standard observation.
Key findings
01The echogenicity (brightness) of all measured submental and masticatory muscles was significantly increased in children with CP compared to healthy controls.
02Muscle thickness was generally not different from healthy controls, except for the temporalis muscle, which was significantly thinner.
03Muscle structure abnormalities did not correlate with the child's EDACS level (eating and drinking ability), meaning children classified as safe eaters still showed abnormal muscle scans.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study included only 25 children, which is a small sample size for detecting subtle differences or establishing robust correlations. The study was cross-sectional, so it cannot determine if these muscle changes progress over time or how they relate to long-term feeding outcomes. Ultrasound measures structural integrity but does not directly assess muscle function or strength, so the clinical impact of the observed echogenicity changes on actual chewing or swallowing performance remains unclear.
Declared interests
One author worked as an ultrasound instructor for SonoSkills and performs editorial services for Wiley Publishing, with payments going to their employer. Funding was provided by the Phelps Stichting voor spastici.
The easy way to misread this
Do not assume that a child with CP who is classified as a safe and efficient eater (EDACS level I) has normal oral muscle structure. This study found that these children still showed significant muscle abnormalities on ultrasound, meaning clinical observation alone may underestimate the extent of muscle involvement.