Speech Movement Measures as Markers of Bulbar Disease in Amyotrophic Lateral Sclerosis Purpose The goal of this study was to identify the effects of amyotrophic lateral sclerosis (ALS) on tongue and jaw control, both cross-sectionally and longitudinally. The data were examined in the context of their utility as a diagnostic marker of bulbar disease. Method Tongue and jaw movements were ... Research Article
Research Article  |   October 01, 2016
Speech Movement Measures as Markers of Bulbar Disease in Amyotrophic Lateral Sclerosis
 
Author Affiliations & Notes
  • Sanjana Shellikeri
    University of Toronto, Ontario, Canada
  • Jordan R. Green
    MGH Institute of Health Professions, Boston, MA
  • Madhura Kulkarni
    Sunnybrook Health Sciences Centre, Biological Sciences, University of Toronto, Ontario, Canada
  • Panying Rong
    MGH Institute of Health Professions, Boston, MA
  • Rosemary Martino
    University of Toronto, Ontario, Canada
  • Lorne Zinman
    ALS/MND Clinic, Sunnybrook Health Sciences Centre, Department of Neurology, University of Toronto, Ontario, Canada
  • Yana Yunusova
    University of Toronto, Ontario, Canada
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Yana Yunusova: yana.yunusova@utoronto.ca
  • Editor: Jody Kreiman
    Editor: Jody Kreiman×
  • Associate Editor: Julie Liss
    Associate Editor: Julie Liss×
Article Information
Speech, Voice & Prosodic Disorders / Special Populations / Speech, Voice & Prosody / Speech / Research Articles
Research Article   |   October 01, 2016
Speech Movement Measures as Markers of Bulbar Disease in Amyotrophic Lateral Sclerosis
Journal of Speech, Language, and Hearing Research, October 2016, Vol. 59, 887-899. doi:10.1044/2016_JSLHR-S-15-0238
History: Received July 8, 2015 , Revised October 19, 2015 , Accepted December 18, 2015
 
Journal of Speech, Language, and Hearing Research, October 2016, Vol. 59, 887-899. doi:10.1044/2016_JSLHR-S-15-0238
History: Received July 8, 2015; Revised October 19, 2015; Accepted December 18, 2015

Purpose The goal of this study was to identify the effects of amyotrophic lateral sclerosis (ALS) on tongue and jaw control, both cross-sectionally and longitudinally. The data were examined in the context of their utility as a diagnostic marker of bulbar disease.

Method Tongue and jaw movements were recorded cross-sectionally (n = 33 individuals with ALS, 13 controls) and longitudinally (n = 10 individuals with ALS) using a three-dimensional electromagnetic articulography system during the production of the sentence Buy Bobby a puppy. The movements were examined for evidence of changes in size, speed, and duration and with respect to disease severity and time in the study.

Results Maximum speed of tongue movements and movement durations were significantly different only at an advanced stage of bulbar ALS compared with the healthy control group. The longitudinal analysis revealed a reduction in tongue movement size and speed with time at early stages of disease, which was not seen cross-sectionally. As speaking rate declined, tongue movements decreased in maximum speed, whereas jaw movements increased in maximum speed.

Conclusions Longitudinal analyses of sentence-level kinematic data show their sensitivity to early bulbar impairment. A change in articulatory kinematics can serve as a useful diagnostic marker for bulbar ALS and to track bulbar disease progression in a clinical setting.

Acknowledgments
This research was supported by the National Institutes of Health R01 DC009890 (awarded to Jordan R. Green and Yana Yunusova) and R01 DC0135470 (awarded to Jordan R. Green). We are grateful for the patients and their families for participating in this project. We also thank Danielle Thomas, Lori Synhorst, and Vincci Tau for their assistance with this project.
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