Clark Heather M, Stierwalt Julie A, Meade Gabriela, Ali Farwa, Stephens Yehkyoung, Botha Hugo, Tosakulwong Nirubol, Weigand Stephen, Josephs Keith A, Whitwell Jennifer L
Mayo Clinic Rochester Department of Neurology, USA.
Mayo Clinic Rochester Department of Neurology, USA.
Parkinsonism Relat Disord. 2025 Jun;135:107839. doi: 10.1016/j.parkreldis.2025.107839. Epub 2025 Apr 14.
Tongue weakness is common in patients with neurologic disease, including parkinsonism. The aim of this study is to describe tongue strength in progressive supranuclear palsy and its relationship to dysphagia and dysarthria.
Participants were 119 (58 female) individuals with probable or possible progressive supranuclear palsy. Each participant underwent a motor speech assessment to determine type and severity of dysarthria. Quantification of dysphagia included the Modified Barium Swallow Impairment Profile, the Penetration-Aspiration Scale, and the Functional Oral Intake Scale. Anterior elevation tongue strength was assessed by measuring maximum pressure exerted by the tongue on an air-filled bulb positioned against the hard palate.
Mean maximum tongue elevation pressure was 38 kPa. Tongue strength correlated significantly with age, dysarthria severity, and disease severity. Tongue strength was not differentially affected by dysarthria type, but was weakly correlated with pharyngeal dysphagia severity.
Average tongue strength in speakers with progressive supranuclear palsy is lower than reported for neurologically healthy adults and for patients with Parkinson's Disease. Likely reflecting a combination of age-related loss of muscle mass and damage to the basal ganglia and/or pyramidal tracts, reduced tongue strength on its own does not appear to be a primary driver of swallowing difficulties in this population. Further study is warranted to better understand the physiologic mechanisms contributing to reduced tongue strength in PSP, how tongue strength changes as disease progresses, and what other mechanisms contribute to dysphagia in PSP.
舌肌无力在包括帕金森症在内的神经系统疾病患者中很常见。本研究的目的是描述进行性核上性麻痹患者的舌肌力量及其与吞咽困难和构音障碍的关系。
参与者为119名（58名女性）可能或疑似进行性核上性麻痹的个体。每位参与者都接受了运动言语评估，以确定构音障碍的类型和严重程度。吞咽困难的量化评估包括改良钡餐吞咽障碍量表、渗透-误吸量表和功能性经口摄食量表。通过测量舌头对抵靠硬腭放置的充气球囊施加的最大压力来评估舌前抬高力量。
平均最大舌抬高压力为38千帕。舌肌力量与年龄、构音障碍严重程度和疾病严重程度显著相关。舌肌力量不受构音障碍类型的差异影响，但与咽部吞咽困难严重程度弱相关。
进行性核上性麻痹患者的平均舌肌力量低于神经健康成年人和帕金森病患者的报告值。舌肌力量降低可能反映了与年龄相关的肌肉质量损失以及基底神经节和/或锥体束受损的综合情况，但其本身似乎并不是该人群吞咽困难的主要驱动因素。有必要进一步研究，以更好地了解导致进行性核上性麻痹患者舌肌力量降低的生理机制、舌肌力量如何随疾病进展而变化，以及还有哪些其他机制导致进行性核上性麻痹患者出现吞咽困难。
