{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T11:49:59Z","timestamp":1773056999019,"version":"3.50.1"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T00:00:00Z","timestamp":1718668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>Objective and practical biomarkers to determine the need for gastrostomy in patients with amyotrophic lateral sclerosis (ALS) are lacking. Tongue pressure (TP) is a promising biomarker because it is associated with bulbar dysfunction. The aims of this study were to evaluate the association of TP with the need for gastrostomy, and to determine its optimal cut\u2010off value.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective observational study included participants with ALS taking nutrition orally. TP was evaluated using the Iowa Oral Performance Instrument. Need for gastrostomy as determined by a multidisciplinary team during a 12\u2010month follow up period was recorded. Associations between TP and need for gastrostomy placement were performed. ROC curve analysis determined the optimal cut\u2010off value of TP to predict gastrostomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 208 screened participants, 119 were included. Gastrostomy was indicated in 45% (53), in a 12\u2010month follow up period. TP of \u226420\u2009kPA was a strong predictor of gastrostomy indication (OR 11.8, CI 95% [4.61, 34.7], <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). The association persisted even after adjustment for weight loss, pneumonia, prolonged feeding duration, Revised ALS Functional Rating Scale score, and American Speech\u2010Language\u2010Hearing Association scale score (OR 4.51, CI 95% [1.50, 14.9], <jats:italic>p<\/jats:italic>\u2009=\u2009.009). By receiver operating characteristic curve analysis, 20\u2009kPA represented the optimal cut\u2010off value (sensitivity 0.75, specificity 0.89).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>TP is a strong independent predictor of gastrostomy indication in the subsequent 12\u2009months in patients with ALS, with good sensitivity and specificity at a cutoff value of \u226420\u2009kPA, suggesting that it may be a promising biomarker in clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.28174","type":"journal-article","created":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T08:53:51Z","timestamp":1718700831000},"page":"409-412","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Tongue pressure is a strong predictor of recommendation for gastrostomy in amyotrophic lateral sclerosis"],"prefix":"10.1002","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8370-2873","authenticated-orcid":false,"given":"Amanda E.","family":"Mendes","sequence":"first","affiliation":[{"name":"Speech\u2010Language Pathology Department University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guilherme D.","family":"Silva","sequence":"additional","affiliation":[{"name":"Neurology Department University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederico M. H.","family":"Jorge","sequence":"additional","affiliation":[{"name":"Neurology Department University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dagoberto","family":"Callegaro","sequence":"additional","affiliation":[{"name":"Neurology Department University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,6,18]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000110176"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(96)00087-1"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-13-84"},{"issue":"10","key":"e_1_2_12_5_1","article-title":"Functional and endoscopic indicators for percutaneous endoscopic gastrostomy (PEG) in amyotrophic lateral sclerosis patients","volume":"7","author":"Conde B","year":"2018","journal-title":"J Clin Med Res"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-021-10346-9"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14310"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12700"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40141-023-00396-5"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1123\/mcj.2.2.148"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1044\/2022_AJSLP-21-00385"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-017-9797-z"},{"key":"e_1_2_12_13_1","volume-title":"El Escorial Revisited: Revised Criteria for the Diagnosis of ALS. A Consensus Conference Held at Airlie House","author":"Brooks BR","year":"1998"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0004-282X2010000100010"},{"key":"e_1_2_12_15_1","unstructured":"RockvilleMD.American Speech\u2010Language\u2010Hearing Association National Outcome Measurement System (NOMS). Adult Speech\u2010Language Pathology training manual. ASHA."},{"key":"e_1_2_12_16_1","volume-title":"Iowa Oral Performance Instrument: Users Manual","author":"IOPI Medical LLC","year":"2008"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181bc01a4"}],"container-title":["Muscle &amp; Nerve"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.28174","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T13:53:11Z","timestamp":1723643591000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mus.28174"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,18]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1002\/mus.28174"],"URL":"https:\/\/doi.org\/10.1002\/mus.28174","archive":["Portico"],"relation":{},"ISSN":["0148-639X","1097-4598"],"issn-type":[{"value":"0148-639X","type":"print"},{"value":"1097-4598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,18]]},"assertion":[{"value":"2023-02-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}