Bulbar and speech motor assessment in ALS: Challenges and future directions

Authors

Jordan R. Green, MGH Institute of Health Professions, Massachusetts
Yana Yunusova, University of TorontoFollow
Mili S. Kuruvilla, University of Nebraska Medical CenterFollow
Jun Wang, University of Texas at Dallas, Texas
Gary Pattee, University of Nebraska Medical Center
Lori Synhorst, University of Nebraska - LincolnFollow
Lorne Zinman, Sunnybrook Health Science Centre, Toronto, OntarioFollow
James D. Berry, Massachusetts General Hospital

Document Type

Article

Date of this Version

2013

Citation

Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 2013; 14: 494–500

Comments

© 2013 Informa Healthcare

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 identifi ed. 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 effi cacy of the speech subsystem approach.