{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T21:42:17Z","timestamp":1778103737619,"version":"3.51.4"},"reference-count":73,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,12,26]],"date-time":"2022-12-26T00:00:00Z","timestamp":1672012800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although reduced lingual strength is a confirmed early manifestation of amyotrophic lateral sclerosis (ALS), its functional impact on swallowing remains unclear. We therefore sought to examine relationships between maximum anterior isometric lingual pressure (MAIP) with swallowing safety, swallowing efficiency, and swallowing timing metrics in a large cohort of individuals with ALS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ninety\u2010seven participants with ALS completed a standardized videofluoroscopic swallowing examination (VF) and lingual pressure testing (Iowa Oral Performance Instrument). Duplicate and blinded ratings of the Penetration\u2010Aspiration Scale (PAS) and Analysis of Swallowing Physiology: Events, Kinematics and Timing (ASPEKT) percent efficiency (%C2\u2013C4<jats:sup>2<\/jats:sup>) and timing (<jats:italic>laryngeal vestibule closure (LVC) duration<\/jats:italic>: amount of time (milliseconds, msec) between LVC onset and laryngeal vestibule opening; <jats:italic>time\u2010to\u2010LVC<\/jats:italic>: hyoid burst to onset of LVC (msec); and <jats:italic>swallow reaction time<\/jats:italic>: interval between bolus passing ramus of mandible and onset of LVC (msec)) were performed across bolus trials. Swallowing safety (safe PAS: 1, 2, 4; unsafe PAS: 3, 5, 6, 7, and 8) and efficiency (inefficient: \u22653% worst total residue) were derived. Statistical analyses including descriptives, binary logistic regressions, and Spearman's rho correlations were performed (<jats:italic>\u03b1<\/jats:italic>\u00a0=\u00a00.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Mean MAIP was 36.3\u00a0kPa (SD: 18.7). Mean MAIP was higher in those with safe swallowing as compared to those who penetrated (mean difference: 12\u2009kPa) or aspirated (mean difference: 18\u2009kPa). Individuals with efficient swallowing demonstrated higher MAIP than those with inefficient swallowing (mean difference: 11\u2009kPa). Binary logistic regression analyses revealed increasing MAIP was significantly associated with a 1.06 (95% CI: 1.03\u20131.09) and 1.04 (95% CI: 1.01\u20131.06) greater odds of safe and efficient swallowing, respectively. No relationships were observed between MAIP and swallow reaction time across all bolus trials. Longer time\u2010to\u2010LVC (5\u00a0ml thin liquid: <jats:italic>r<\/jats:italic><jats:sub>s<\/jats:sub>\u00a0=\u00a0\u22120.35, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.002; cup sip thin liquid: <jats:italic>r<\/jats:italic><jats:sub>s<\/jats:sub>\u00a0=\u00a0\u22120.26, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.02; moderately thick liquid: <jats:italic>r<\/jats:italic><jats:sub>s<\/jats:sub>\u00a0=\u00a0\u22120.28, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.01) and prolonged LVC duration (cup sip thin liquid, <jats:italic>r<\/jats:italic><jats:sub>s<\/jats:sub>\u00a0=\u00a0\u22120.34, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.003) were associated with lower MAIP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Inferences<\/jats:title><jats:p>Reduced lingual strength was confirmed in this group of 97 individuals with ALS that was associated with a diminished ability to effectively transport boluses and aide in laryngeal vestibule closure to prevent entry of material into the airway.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14521","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T06:26:35Z","timestamp":1672122395000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Maximum lingual pressure impacts both swallowing safety and efficiency in individuals with amyotrophic lateral sclerosis"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4750-0769","authenticated-orcid":false,"given":"Raele Donetha","family":"Robison","sequence":"first","affiliation":[{"name":"Aerodigestive Research Core University of Florida  Gainesville Florida USA"},{"name":"Department of Medicine University of Wisconsin\u2010Madison  Madison Wisconsin USA"},{"name":"Center for Health Disparities Research University of Wisconsin\u2010Madison  Madison Wisconsin 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