Maximum Tongue Pressure is Associated with Swallowing Dysfunction in ALS Patients
Maximum Tongue Pressure is Associated with Swallowing Dysfunction in ALS Patients
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DOI：
10.1007/s00455-017-9797-z
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发表时间：
2017-08-01
期刊：
影响因子：
2.6
通讯作者：
Tsuga, Kazuhiro
中科院分区：
文献类型：
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作者：
Hiraoka, Aya;Yoshikawa, Mineka;Tsuga, Kazuhiro
最大舌压（MTP）测量是一种方便，创伤性较小的评估，已开发用于量化舌强度;然而，目前尚不清楚MTP是否适用于肌萎缩侧索硬化症（ALS）患者吞咽障碍的检测。本研究的目的是阐明MTP和吞咽障碍的视频透视特征之间的关系，并确定舌压测量对评估ALS患者吞咽功能的有用性。根据ALS功能评定量表修订版（ALSFRS-R）对25例ALS患者进行评估，并通过视频X线透视观察其吞咽酸奶的能力。使用配备有气囊探针的装置（TPM-01，JMS，广岛）测量MTP。然后，分析ALSFRS-R评分、吞咽功能和MTP之间的关系。与正常特征的受试者相比，舌功能减退（p = 0.002）或咽部残留（p = 0.006）的受试者的MTP显著降低。在MTP降低的患者中，推注形成时间、口腔通过时间和咽部通过时间显著延长。MTP在21.0 kPa的临界值与ALSFRS-R的球相关项目的满分相关。MTP与ALS患者的吞咽特征有良好的相关性，可作为ALS患者吞咽功能障碍的早期诊断新工具。
Maximum tongue pressure (MTP) measurement is a convenient, less invasive assessment that has been developed to quantify tongue strength; however, it is unclear whether MTP is useful for the detection of swallowing disorders in amyotrophic lateral sclerosis (ALS) patients. The purpose of this study was to clarify the relationship between MTP and the characteristics of swallowing disorders on videofluorography and to determine the usefulness of tongue pressure measurement for the assessment of swallowing function in ALS patients. Twenty-five ALS patients were evaluated according to the ALS functional rating scale-revised (ALSFRS-R), and their ability to swallow yogurt was observed via videofluorography. MTP was measured using a device (TPM-01, JMS, Hiroshima) equipped with a balloon probe. Then, the relationships between the ALSFRS-R score, swallowing function, and MTP were analyzed. MTP was significantly lower in the subjects with reduced tongue function (p = 0.002) or with pharyngeal residue (p = 0.006) than in the subjects with normal characteristics. Bolus formation and oral transit time and pharyngeal transit time were significantly prolonged among those with reduced MTP. MTP at a cut-off value of 21.0 kPa was associated with a full score on the bulbar-related items of the ALSFRS-R. MTP may serve as a new diagnostic tool for the early detection of swallowing dysfunction in ALS patients, because of its good relationship with their swallowing characteristics.