{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T17:17:12Z","timestamp":1793121432063,"version":"4.5.0"},"reference-count":45,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,4,26]],"date-time":"2020-04-26T00:00:00Z","timestamp":1587859200000},"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":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Oropharyngeal dysphagia (OD) is common in amyotrophic lateral sclerosis (ALS), leading to a reduction of swallowing safety and efficacy. The tongue has an important role in swallowing function for oral processing and bolus propulsion through the pharynx. The study aims to analyze the association between instrumental findings of OD and tongue pressure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with ALS referred for fiberoptic endoscopic evaluation of swallowing (FEES) were recruited. FEES was conducted to test swallowing function with liquid (5, 10, and 20\u00a0ml), semisolid (5, 10, and 20\u00a0ml), and solid. FEES recordings were assessed for swallowing safety, using the penetration\u2010aspiration scale (PAS), and for swallowing efficacy, using the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS). PAS scores &gt;2 were suggestive of penetration, PAS scores &gt;5 of aspiration, and YPRSRS scores &gt;2 of residue. Maximum tongue pressure (MTP) and tongue endurance were measured using the Iowa Oral Performance Instrument. Tongue pressure measurements were compared between patients with and without penetration, aspiration, or residue.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key results<\/jats:title><jats:p>Fifty\u2010five patients with ALS were included. Mean MTP was 29.7\u00a0kPa, and median tongue endurance was 10\u00a0seconds. Patients with residue in the pyriform sinus had a significantly lower MTP than patients without residue in the pyriform sinus with semisolids 10\u00a0ml (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.011) and 20\u00a0ml (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.032). Patients with a tongue endurance &lt;10\u00a0seconds exhibited higher frequency of penetration with liquids 5\u00a0ml (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.046), liquids 10\u00a0ml (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.015), and solids (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.22).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion and inferences<\/jats:title><jats:p>In patients with ALS, MTP is significantly associated with an impairment of swallowing efficacy and tongue endurance was significantly associated with an impairment of swallowing safety.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13859","type":"journal-article","created":{"date-parts":[[2020,4,27]],"date-time":"2020-04-27T00:24:43Z","timestamp":1587947083000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Association between maximum tongue pressure and swallowing safety and efficacy in amyotrophic lateral sclerosis"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3939-0742","authenticated-orcid":false,"given":"Nicole","family":"Pizzorni","sequence":"first","affiliation":[{"name":"Department of Biomedical and Clinical Sciences \u201cLuigi Sacco\u201d University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Ginocchio","sequence":"additional","affiliation":[{"name":"ALS Center Istituti Clinici Scientifici Maugeri IRCCS Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Bianchi","sequence":"additional","affiliation":[{"name":"ALS Center Istituti Clinici Scientifici Maugeri IRCCS Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Feroldi","sequence":"additional","affiliation":[{"name":"ALS Center Istituti Clinici Scientifici Maugeri IRCCS Milan 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