George Umemoto1,2, Shinsuke Fujioka3, Hajime Arahata4, Nobutaka Sakae4, Naokazu Sasagasako4, Mine Toda5, Hirokazu Furuya6, Yoshio Tsuboi3. 1. Swallowing Disorders Center, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan. george@fukuoka-u.ac.jp. 2. Department of Neurology, Neuro-Muscular Center, NHO Omuta National Hospital, Fukuoka, Japan. george@fukuoka-u.ac.jp. 3. Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan. 4. Department of Neurology, Neuro-Muscular Center, NHO Omuta National Hospital, Fukuoka, Japan. 5. Department of Clinical Nutrition & Food services, NHO Omuta National Hospital, Fukuoka, Japan. 6. Department of Neurology, Faculty of Medicine, Kochi University, Kochi, Japan.
Abstract
BACKGROUND: Swallowing dysfunction is related to major cause of adverse events and an indicator of shorter survival among patients with neuromuscular disorders (NMD). It is critical to assess the swallowing function during disease progression, however, there are limited tools that can easily evaluate swallowing function without using videofluoroscopic or videoendoscopic examination. Here, we evaluated the longitudinal changes in tongue thickness (TT) and maximum tongue pressure (MTP) among patients with amyotrophic lateral sclerosis (ALS), myotonic dystrophy type 1 (DM1), and Duchenne muscular dystrophy (DMD). METHODS: Between 2010 and 2020, TT and MTP were measured from 21 ALS, 30 DM1, and 14 DMD patients (mean ages of 66.9, 44.5, and 21.4 years, respectively) at intervals of more than half a year. TT was measured, by ultrasonography, as the distance from the mylohyoid muscle raphe to the tongue dorsum, and MTP was determined by measuring the maximum compression on a small balloon when pressing the tongue against the palate. Then we examined the relationship between these evaluations and patient background and swallowing function. RESULTS: Mean follow-up periods were 24.0 months in the ALS group, 47.2 months in the DM1group, and 61.1 months in the DMD group. The DMD group demonstrated larger first TT than the other groups, while the DM1 group had lower first MTP than the ALS group. The ALS group showed a greater average monthly reduction in mean TT than the DM1 group and greater monthly reductions in mean body weight (BW) and MTP than the other groups. Significant differences between the first and last BW, TT, and MTP measures were found only in the ALS group. CONCLUSIONS: This study suggests that ALS is associated with more rapid degeneration of tongue function over several years compared to DMD and DM1.
BACKGROUND:Swallowing dysfunction is related to major cause of adverse events and an indicator of shorter survival among patients with neuromuscular disorders (NMD). It is critical to assess the swallowing function during disease progression, however, there are limited tools that can easily evaluate swallowing function without using videofluoroscopic or videoendoscopic examination. Here, we evaluated the longitudinal changes in tongue thickness (TT) and maximum tongue pressure (MTP) among patients with amyotrophic lateral sclerosis (ALS), myotonic dystrophy type 1 (DM1), and Duchenne muscular dystrophy (DMD). METHODS: Between 2010 and 2020, TT and MTP were measured from 21 ALS, 30 DM1, and 14 DMDpatients (mean ages of 66.9, 44.5, and 21.4 years, respectively) at intervals of more than half a year. TT was measured, by ultrasonography, as the distance from the mylohyoid muscle raphe to the tongue dorsum, and MTP was determined by measuring the maximum compression on a small balloon when pressing the tongue against the palate. Then we examined the relationship between these evaluations and patient background and swallowing function. RESULTS: Mean follow-up periods were 24.0 months in the ALS group, 47.2 months in the DM1group, and 61.1 months in the DMD group. The DMD group demonstrated larger first TT than the other groups, while the DM1 group had lower first MTP than the ALS group. The ALS group showed a greater average monthly reduction in mean TT than the DM1 group and greater monthly reductions in mean body weight (BW) and MTP than the other groups. Significant differences between the first and last BW, TT, and MTP measures were found only in the ALS group. CONCLUSIONS: This study suggests that ALS is associated with more rapid degeneration of tongue function over several years compared to DMD and DM1.
Authors: Mamede de Carvalho; Reinhard Dengler; Andrew Eisen; John D England; Ryuji Kaji; Jun Kimura; Kerry Mills; Hiroshi Mitsumoto; Hiroyuki Nodera; Jeremy Shefner; Michael Swash Journal: Clin Neurophysiol Date: 2007-12-27 Impact factor: 3.708
Authors: L van den Engel-Hoek; I J M de Groot; L T Sie; H W van Bruggen; S A F de Groot; C E Erasmus; N van Alfen Journal: Neuromuscul Disord Date: 2016-04-06 Impact factor: 4.296
Authors: G Ruoppolo; I Schettino; V Frasca; E Giacomelli; L Prosperini; C Cambieri; R Roma; A Greco; P Mancini; M De Vincentiis; V Silani; M Inghilleri Journal: Acta Neurol Scand Date: 2013-05-14 Impact factor: 3.209