title: Bulbar and speech motor assessment in ALS: challenges and future directions.
abstract: Bulbar motor deterioration due to amyotrophic lateral sclerosis (ALS) leads to the eventual impairment of speech and swallowing functions. Despite these devastating consequences, no standardized diagnostic procedure for assessing bulbar dysfunction in ALS exists and adequate objective markers of bulbar deterioration have not been identified. In this paper, we consider objective measures of speech motor function, which show promise for forming the basis of a comprehensive, quantitative bulbar motor assessment in ALS. These measures are based on the assessment of four speech subsystems: respiratory, phonatory, articulatory, and resonatory. The goal of this research is to design a non-invasive, comprehensive bulbar motor assessment instrument intended for early detection, monitoring of disease progression, and clinical trial application. Preliminary data from an ongoing study of bulbar motor decline are presented, which demonstrate the potential clinical efficacy of the speech subsystem approach.
authors.affiliation: The Department of Communication Sciences and Disorders, MGH Institute of Health Professions , Massachusetts , USA.
authors.forename: Jordan R
authors.initials: JR
authors.lastname: Green
authors.forename: Yana
authors.initials: Y
authors.lastname: Yunusova
authors.forename: Mili S
authors.initials: MS
authors.lastname: Kuruvilla
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.forename: Gary L
authors.initials: GL
authors.lastname: Pattee
authors.forename: Lori
authors.initials: L
authors.lastname: Synhorst
authors.forename: Lorne
authors.initials: L
authors.lastname: Zinman
authors.forename: James D
authors.initials: JD
authors.lastname: Berry
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000175:diagnosis* / Q000503:physiopathology*; D001933:Brain Stem / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology; D011597:Psychomotor Performance / Q000502:physiology*; D013060:Speech / Q000502:physiology*
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