Department of Rehabilitation (898), Nijmegen Centre for Evidence Based Practice, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
J Neurol. 2012 Nov;259(11):2360-5. doi: 10.1007/s00415-012-6503-9. Epub 2012 Apr 24.
Decreased tongue strength (TS) might herald bulbar involvement in patients with amyotrophic lateral sclerosis (ALS) well before dysarthria or dysphagia occur, and as such might be prognostic of short survival. The purpose of this study was to investigate the prognostic value of a decreased TS, in addition to other prognostic factors, such as site of onset, bulbar symptoms, bulbar signs, age, sex, maximum phonation time, time from symptoms to diagnosis, and gastrostomy, for survival time in patients with ALS. TS was measured in four directions in 111 patients who attended the diagnostic outpatient motor neuron clinic of our university hospital. Of these patients, 54 were diagnosed with ALS. TS was considered abnormal if the strength in minimally one direction was at least two standard deviations below the reference values obtained from comparable age category and sex-groups of healthy controls (n = 119). Twenty of the patients with ALS had a decreased TS. Multivariable analysis showed that, in addition to age, TS was an independent prognostic factor for survival time in patients with ALS.
舌力下降（TS）可能预示着肌萎缩侧索硬化症（ALS）患者的延髓受累，远早于构音障碍或吞咽困难发生，因此可能与短期生存相关。本研究的目的是探讨除了其他预后因素（如发病部位、延髓症状、延髓体征、年龄、性别、最大发音时间、症状至诊断时间和胃造口术）外，TS 下降对 ALS 患者生存时间的预后价值。我们对在我院神经内科门诊就诊的 111 例患者进行了 TS 检测，检测在四个方向进行。这些患者中，54 例被诊断为 ALS。如果在至少一个方向上的力量至少比从可比年龄组和性别组的健康对照组（n = 119）获得的参考值低两个标准差，则认为 TS 异常。20 例 ALS 患者的 TS 下降。多变量分析表明，除年龄外，TS 是 ALS 患者生存时间的独立预后因素。
