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Updated: Mar 15, 2026
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A Protocol for Comprehensive Assessment of Bulbar Dysfunction in Amyotrophic Lateral Sclerosis ALS
Published on: February 21, 2011
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Quantification of Tongue Motor Dysfunction in Amyotrophic Lateral Sclerosis Using a Smartphone-Based Task and Deep
Pedro S Rocha1, Duarte Folgado2, Vasco A Conceição1
1Institute of Physiology, and Centro de Estudos Egas Moniz, Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal.
Sensors (Basel, Switzerland)
|March 14, 2026
Summary
A smartphone app objectively assesses tongue movements in amyotrophic lateral sclerosis (ALS) patients, revealing impairments linked to speech difficulties. This technology aids in monitoring bulbar function and managing ALS progression.
Area of Science:
- Neurology
- Biomedical Engineering
- Artificial Intelligence in Medicine
Background:
- Bulbar dysfunction is a significant complication in amyotrophic lateral sclerosis (ALS).
- Objective assessment of tongue movements is crucial for monitoring bulbar function in ALS patients.
- Current methods for assessing bulbar function may not capture subtle impairments.
Purpose of the Study:
- To develop and validate a simple, smartphone-based task for objective tongue movement assessment in ALS.
- To examine the association between quantified tongue movement metrics and clinical variables in ALS.
- To explore the utility of this technology for remote monitoring and disease management.
Main Methods:
- 37 ALS patients and 20 controls performed a smartphone-recorded tongue lateralization task.
- A deep-learning U-Net++ model was employed for image segmentation and feature extraction.
- Tongue movement frequency and amplitude were quantified and correlated with clinical measures (ALSFRS-r, fasciculations, jaw jerk, spasticity).
Main Results:
- The U-Net++ model demonstrated robust segmentation performance.
- ALS patients exhibited significantly lower tongue movement frequency compared to controls (0.14 vs. 0.40, p < 0.001).
- Normalized tongue movement frequency correlated with dysarthria (p = 0.003) and speech performance (p = 0.009), along with tongue spasticity (p = 0.015).
Conclusions:
- The smartphone-based method offers an objective, minimally invasive measure of bulbar function in ALS.
- This approach correlates with clinical assessments and can detect subtle impairments.
- This technology shows promise for remote patient monitoring and improved ALS management.
