Tongue thickness evaluation using ultrasonography can predict swallowing function in amyotrophic lateral sclerosis patients.
OBJECTIVE
Dysphagia is a critical issue in amyotrophic lateral sclerosis (ALS) patients. An evaluation of swallowing function is important for assessing the risk of aspiration. We investigated the validity of tongue sonography compared with videofluoroscopic examination for ALS patients.


METHODS
We investigated 18 ALS patients. Nine subjects underwent repeated investigations. All of the subjects underwent tongue sonography and videofluoroscopic examination. Additionally, tongue sonography was evaluated in 18 age- and sex-matched healthy volunteers. To determine tongue thickness, we measured the vertical distance from the surface of the mylohyoid muscle to the tongue dorsum using ultrasonography.


RESULTS
In the ALS patients, the tongue was significantly thinner than in healthy subjects. Tongue thickness was associated with body mass index and onset type in the ALS patients (p=0.006). Temporal analyses of videofluoroscopy revealed that tongue thickness was associated with oral preparatory and transit time (p=0.032) but not with pharyngeal transit time. Repeated measurement data revealed a decrease in tongue thickness over the course of the measurements (p=0.002).


CONCLUSIONS
In ALS patients, reduced tongue thickness suggests disease progression and tongue dysfunction.


CONCLUSIONS
Tongue sonography is a useful modality for the non-invasive and quantitative evaluation of tongue thickness and dysphagia in ALS patients.
Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan; Mifukai Viha-ra Hananosato Hospital, Miyoshi, Japan.
Masahiro
M
Nakamori
Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan. Electronic address: nhosomi@hiroshima-u.ac.jp.
Naohisa
N
Hosomi
Mifukai Viha-ra Hananosato Hospital, Miyoshi, Japan.
Sachiko
S
Takaki
Mifukai Viha-ra Hananosato Hospital, Miyoshi, Japan.
Masaya
M
Oda
Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
Aya
A
Hiraoka
Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
Mineka
M
Yoshikawa
Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
Hayato
H
Matsushima
Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
Kazuhide
K
Ochi
Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
Kazuhiro
K
Tsuga
Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
Hirofumi
H
Maruyama
Mifukai Viha-ra Hananosato Hospital, Miyoshi, Japan; Department of Clinical Neuroscience, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.
Yuishin
Y
Izumi
Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
Masayasu
M
Matsumoto
D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D014059:Tongue / Q000000981:diagnostic imaging* / Q000502:physiology*; D014463:Ultrasonography
Amyotrophic lateral sclerosis; Dysphagia; Tongue sonography; Tongue thickness; Videofluoroscopic examination