{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T15:10:37Z","timestamp":1788793837423,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["25ek0109735"],"award-info":[{"award-number":["25ek0109735"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["25fk0108733"],"award-info":[{"award-number":["25fk0108733"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["25bm1423033"],"award-info":[{"award-number":["25bm1423033"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["25ek0109617"],"award-info":[{"award-number":["25ek0109617"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["25ek0109759"],"award-info":[{"award-number":["25ek0109759"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["25FC1012"],"award-info":[{"award-number":["25FC1012"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP25K02584"],"award-info":[{"award-number":["JP25K02584"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP24K10542"],"award-info":[{"award-number":["JP24K10542"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction\/Aims<\/jats:title>\n                    <jats:p>Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease accompanied by bulbar dysfunction, in which tongue atrophy contributes to dysarthria and dysphagia. Conventional tongue assessments rely on inspection, palpation, or electrophysiological testing but are limited by subjectivity and invasiveness. A rapid, objective, and repeatable imaging\u2010based method for evaluating tongue size would be valuable. We quantified tongue atrophy in ALS using a standardized protocol for transoral tongue ultrasonography (TOTU) and assessed discrimination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective, cross\u2010sectional study included 15 patients with ALS and 15 controls who underwent TOTU. Using standardized mid\u2010sagittal images, tongue cross\u2010sectional area (cm\n                      <jats:sup>2<\/jats:sup>\n                      ) and tongue thickness (mm) were measured three times per subject and averaged. Associations with age, body mass index (BMI), disease duration, and ALS Functional Rating Scale\u2013Revised (ALSFRS\u2010R) scores were explored. Discrimination was evaluated using receiver operating characteristic (ROC) analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both tongue cross\u2010sectional area (6.26\u2009\u00b1\u20091.37 vs. 9.44\u2009\u00b1\u20091.02\u2009cm\n                      <jats:sup>2<\/jats:sup>\n                      ) and tongue thickness (31.47\u2009\u00b1\u20093.0 vs. 39.44\u2009\u00b1\u20091.39\u2009mm) were significantly lower in the ALS group than in controls (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). These indices showed no significant associations with age, BMI, disease duration, or ALSFRS\u2010R scores. ROC analyses showed high discriminative ability, with an area under the curve of 0.982 for tongue cross\u2010sectional area and 1.000 for tongue thickness.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Standardized TOTU enables rapid, quantitative, noninvasive assessment of tongue size and reliably detects tongue atrophy in ALS, supporting bedside evaluation of bulbar involvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mus.70370","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T08:58:45Z","timestamp":1785833925000},"page":"1238-1245","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quantitative Assessment of Tongue Atrophy in Amyotrophic Lateral Sclerosis Using Transoral Tongue Ultrasonography (\n                    <scp>TOTU<\/scp>\n                    ): A Retrospective Single\u2010Center Study"],"prefix":"10.1002","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8001-6604","authenticated-orcid":false,"given":"Naoki","family":"Iijima","sequence":"first","affiliation":[{"name":"Division of Neurology St. Marianna University Yokohama City Seibu Hospital  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3420-4218","authenticated-orcid":false,"given":"Yuta","family":"Hagiwara","sequence":"additional","affiliation":[{"name":"Division of Neurology St. Marianna University Yokohama City Seibu Hospital  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiya","family":"Ishii","sequence":"additional","affiliation":[{"name":"Division of Neurology St. Marianna University Yokohama City Seibu Hospital  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wataru","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Division of Neurology St. Marianna University Yokohama City Seibu Hospital  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Araga","sequence":"additional","affiliation":[{"name":"Division of Neurology St. Marianna University Yokohama City Seibu Hospital  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7527-0345","authenticated-orcid":false,"given":"Yoshihisa","family":"Yamano","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Internal Medicine St. Marianna University School of Medicine  Kawasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.00106"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/21678421.2013.817585"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2015.07.032"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2020.102233"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-021-02225-5"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2024.11.008"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2007.09.143"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2020.04.005"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awad202"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2020.06.027"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afae209"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.4072"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201903-0692OC"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2023.09.002"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-009-5100-z"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PHM.0000052588.28912.A4"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/21681163.2016.1162752"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.12315"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpor.2017.12.001"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aex051"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-009-9162-2"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2014.06.019"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27218"}],"container-title":["Muscle &amp; Nerve"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.70370","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mus.70370","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.70370","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T14:42:42Z","timestamp":1788792162000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mus.70370"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,4]]},"references-count":23,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/mus.70370"],"URL":"https:\/\/doi.org\/10.1002\/mus.70370","archive":["Portico"],"relation":{},"ISSN":["0148-639X","1097-4598"],"issn-type":[{"value":"0148-639X","type":"print"},{"value":"1097-4598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,4]]},"assertion":[{"value":"2026-02-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}