Macroglossia in advanced amyotrophic lateral sclerosis
Corresponding Author
Chiharu Matsuda RN, MNS
ALS Nursing Care Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, 156-8506 Japan
Department of Frontier Health Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
Correspondence to: C. Matsuda; e-mail: [email protected]Search for more papers by this authorToshio Shimizu MD, PhD
Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
Search for more papers by this authorYuki Nakayama RN, PhD
ALS Nursing Care Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, 156-8506 Japan
Search for more papers by this authorMichiko Haraguchi RN, PhD
ALS Nursing Care Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, 156-8506 Japan
Search for more papers by this authorChiyoko Hakuta DDS, PhD
Department of Preventive Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
Search for more papers by this authorYumi Itagaki RN, MNS
ALS Nursing Care Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, 156-8506 Japan
Search for more papers by this authorAkiko Ogura RN, PhD
ALS Nursing Care Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, 156-8506 Japan
Search for more papers by this authorKanako Murata RN, PhD
Department of Nursing, School of Nursing and Rehabilitation Sciences, Showa University, Kanagawa, Japan
Search for more papers by this authorMasato Taira DDS, PhD
Department of Cognitive Neurobiology Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
Center for Brain Integration Research, Tokyo, Japan
Search for more papers by this authorTakaya Numayama MD, PhD
Department of Neurology, Sayama Neurological Hospital, Saitama, Japan
Search for more papers by this authorMasanobu Kinoshita MD, PhD
Department of Frontier Health Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
Search for more papers by this authorCorresponding Author
Chiharu Matsuda RN, MNS
ALS Nursing Care Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, 156-8506 Japan
Department of Frontier Health Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
Correspondence to: C. Matsuda; e-mail: [email protected]Search for more papers by this authorToshio Shimizu MD, PhD
Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
Search for more papers by this authorYuki Nakayama RN, PhD
ALS Nursing Care Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, 156-8506 Japan
Search for more papers by this authorMichiko Haraguchi RN, PhD
ALS Nursing Care Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, 156-8506 Japan
Search for more papers by this authorChiyoko Hakuta DDS, PhD
Department of Preventive Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
Search for more papers by this authorYumi Itagaki RN, MNS
ALS Nursing Care Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, 156-8506 Japan
Search for more papers by this authorAkiko Ogura RN, PhD
ALS Nursing Care Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, 156-8506 Japan
Search for more papers by this authorKanako Murata RN, PhD
Department of Nursing, School of Nursing and Rehabilitation Sciences, Showa University, Kanagawa, Japan
Search for more papers by this authorMasato Taira DDS, PhD
Department of Cognitive Neurobiology Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
Center for Brain Integration Research, Tokyo, Japan
Search for more papers by this authorTakaya Numayama MD, PhD
Department of Neurology, Sayama Neurological Hospital, Saitama, Japan
Search for more papers by this authorMasanobu Kinoshita MD, PhD
Department of Frontier Health Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
Search for more papers by this authorThis study was supported by JSPS KAKENHI (Grant-in-Aid for Scientific Research C No. 25463459) and by the Joint Program for ALS Research, Tokyo Metropolitan Institute of Medical Science.
ABSTRACT
Introduction: An enlarged tongue (macroglossia) has been reported in advanced-stage patients with amyotrophic lateral sclerosis (ALS). Methods: In this study we examined the prevalence of macroglossia and analyzed clinical correlations in 65 ALS patients on tracheostomy-invasive ventilation (TIV). Results: Macroglossia was found in 22 patients (33.8%). Compared with those without macroglossia, patients with macroglossia had a younger age of onset, longer duration of disease and TIV use, lower ALS Functional Rating Scale score, higher body mass index, lower energy intake, more severe communication impairment, and lower oral function. Logistic multivariate analysis showed that body mass index (BMI; P = 0.007) and communication impairment (P = 0.029) were significantly correlated with macroglossia. The duration of TIV use was at the cut-off level of significance (P = 0.05). Conclusions: Macroglossia may be the result of overfeeding and replacement by fat during long-term TIV use in patients with advanced ALS. Muscle Nerve, 2016 Muscle Nerve 54: 386–390, 2016
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