title: A protocol for identification of early bulbar signs in amyotrophic lateral sclerosis.
abstract: The purpose of this project is to identify characteristics that may be of assistance in establishing the diagnosis and monitoring early progression of bulbar dysfunction in patients with Amyotrophic Lateral Sclerosis (ALS). Early identification of bulbar dysfunction would assist in clinical trials and management decisions. A database of 218 clinic visits of patients with ALS was developed and formed the basis for these analyses. As a framework for the description of our methodology, the Disablement Model [World Health Organization. WHO International classification of impairment, activity, and participation: beginner's guide. In: WHO, editor. Beta-1 draft for field trials; 1999] was utilized. Our data identified that the strongest early predictors of bulbar speech dysfunction include altered voice quality (laryngeal control), speaking rate, and communication effectiveness. A protocol for measuring these speech parameters was therefore undertaken. This paper presents the protocol used to measure these bulbar parameters.
authors.affiliation: Munroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, USA. lball@unmc.edu
authors.forename: L J
authors.initials: LJ
authors.lastname: Ball
authors.forename: A
authors.initials: A
authors.lastname: Willis
authors.forename: D R
authors.initials: DR
authors.lastname: Beukelman
authors.forename: G L
authors.initials: GL
authors.lastname: Pattee
mesh_terms: D000690:Amyotrophic Lateral Sclerosis / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D001933:Brain Stem / Q000503:physiopathology*; D016208:Databases, Factual; D018450:Disease Progression; D006801:Humans; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D013062:Speech Articulation Tests / Q000379:methods; D013064:Speech Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D013065:Speech Intelligibility; D013068:Speech Production Measurement