Standard MRI scans of the tongue could help detect and monitor motor neurone disease (MND) at an earlier stage, new research has found.
The study discovered that people living with MND who have difficulty speaking or swallowing tend to have smaller tongue muscles, which could provide an early indication of the neurodegenerative disease.
MND, also known as amyotrophic lateral sclerosis (ALS), causes progressive muscle weakness and wasting throughout the body, affecting movement, speech and swallowing.
The research, led by Dr Thomas Shaw from the University of Queensland’s School of Electrical Engineering and Computer Science, examined more than 200 historical MRI scans, including some from people living with MND.
“There are eight interconnected muscles in our tongues, each with a different role allowing us to eat, swallow and speak,” Dr Shaw said.
“But for someone with a motor neurone disease, the tongue muscles – like many others in the body – progressively weaken and sadly, waste away.
“Being able to detect and track this symptom early would help patients and clinicians, especially with interventions like early access to clinical trials.”
Dr Shaw said studying tongue muscles inside the mouth of a person with MND has traditionally been difficult and invasive.
“Luckily a standard brain scan will often capture the tongue as well as the brain,” he said. Applying a combination of AI-assisted and advanced imaging techniques, we were able to get precise measurements of tongue muscle volume and shape.
“Cross-sectional comparisons showed significant differences between the scans of people with MND and those without.”
He said previous research has shown that people whose MND symptoms occur in the mouth, tongue, throat or neck muscles – known as bulbar onset – often have a shorter survival time than those whose symptoms begin in their limbs.
“This played out in our own results – people with lower tongue volumes had a worse prognosis,” Dr Shaw said.
“So importantly, this measurement can potentially tell us about both life expectancy for people living with MND and faster diagnosis, which in turn can assist in planning and speedier enrolment into clinical trials.”
Co-author and speech pathologist Dr Brooke-Mai Whelan from UQ’s School of Health and Rehabilitation Sciences said the tongue performs thousands of coordinated movements each day, which are only noticed when they begin to fail.
“Understanding which specific tongue muscles waste away in MND will help us develop strategies to compensate, including modifying the person’s speech patterns to rely on unaffected muscle groups,” Dr Whelan said.
“It would also help plan for interventions like voice banking – recording the natural speaking voice to use in communication devices after speech loss – so this is done as early as possible.”
Dr Shaw said the data and methodologies have been made publicly available to support further MND research.
