AUTHOR=Gwak Dae-Won , Jung Seung-Hwan , Min Yu-Sun , Park Jin-Sung , Cho Hee-Jin , Park Donghwi , Hong Min Woo , Kang Min-Gu 

TITLE=Correlation Between Maximal Tongue Pressure and Swallowing Function in Spinal and Bulbar Muscular Atrophy

JOURNAL=Frontiers in Neurology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.704788

DOI=10.3389/fneur.2021.704788

ISSN=1664-2295

ABSTRACT=<p><bold>Background:</bold> Spinal and bulbar muscular atrophy (SBMA) is an X-lined motor neuron disease characterized by progressive muscle weakness, bulbar palsy, and dysphagia. Dysphagia is associated with tongue weakness, which is a common manifestation of SBMA. This study aimed to investigate the correlations between tongue pressure and dysphagia in patients with SBMA.</p><p><bold>Materials and Methods:</bold> Thirty-nine genetically confirmed SBMA patients underwent a videofluoroscopic swallowing study (VFSS) and tongue pressure assessment. Then, we analyzed the maximal tongue pressure (MTP), oral transit time, penetration-aspiration scale (PAS), videofluoroscopic dysphagia scale (VDS), amyotrophic lateral sclerosis functional rating scale-revised (ALSFRS-R), and 6-min walk test (6MWT). Pearson and Spearman correlation coefficients were calculated to analyze the association of the MTP with clinical, swallowing, and functional parameters.</p><p><bold>Results:</bold> In the correlation analysis, MTP was negatively correlated with disease duration (<italic>r</italic> = −0.396, <italic>p</italic> = 0.013) and VDS (<italic>r</italic> = −0.426, <italic>p</italic> = 0.007), and positively correlated with ALSFRS-R (<italic>r</italic> = 0.483, <italic>p</italic> = 0.002) and 6MWT (<italic>r</italic> = 0.396, <italic>p</italic> = 0.013). The bulbar (<italic>r</italic> = 0.367, <italic>p</italic> = 0.022) and gross motor (<italic>r</italic> = 0.486, <italic>p</italic> = 0.002) domains of the ALSFRS-R were correlated with MTP.</p><p><bold>Conclusion:</bold> Tongue pressure assessment can be used as a safe and easy tool to assess swallowing function in SBMA patients. Moreover, MTP reflects functional states, including activities of daily living and gait performance, showing it to be a potential biomarker for physical performance in SBMA.</p>