3-D Helps Detect ALS Speech Declines

The same technology used to bring King Kong to life in the movies is helping researchers better understand amyotrophic lateral sclerosis, or ALS, a neurodegenerative disease that attacks neurons and weakens muscles over time. About 30,000 Americans suffer from ALS, commonly called Lou Gehrig’s disease.

UNL speech-language pathologist Jordan Green and colleague Yana Yunosova at the University of Toronto are using computer technology to study the decline in speech in ALS patients with a $2.37 million, five-year grant from the National Institutes of Health’s National Institute on Deafness and Other Communication Disorders. Their work may lead to earlier diagnosis and aid in treatment development.

Currently, no tests can definitively diagnose ALS. Physicians must rely on observing weakening muscles and ruling out other causes, which often takes 18 months after initial symptoms appear.

For more than one-fourth of patients, symptoms begin with speech impairment, called bulbar symptoms. While bulbar deterioration impairs speech and swallowing, relatively few studies have focused on these symptoms. Measuring muscles involved in speech is particularly difficult, which can delay diagnosis and treatment.

"To produce speech you need to coordinate the activities of between 30 to 70 muscles," said Green. "We’re using computer technology to quantify small changes in speech production that are otherwise undetectable."

Green is following 100 bulbar-onset ALS patients at UNL and the University of Toronto to study progression of speech degeneration. He’s using 3-D motion analysis to track facial movements in fine detail, electromagnetic equipment to track tongue motion and special equipment to evaluate speech breathing and voice.

Sensitive measurements of facial muscles will help determine abnormal muscle strength for early diagnosis, monitor disease progression and predict when patients will lose speech so they can better prepare.

Finely detailed measurements also will help in the search for effective treatments. "Outcomes measures in the bulbar system are fairly blunt," Green said. "They need sensitive measures to determine small changes, and that will expedite drug trials."