Media release

From: The University of Queensland

Standard MRI scans of a person’s tongue could assist in the early detection and ongoing monitoring of Motor Neurone Disease (MND).

Research led by Dr Thomas Shaw from The University of Queensland’s School of Electrical Engineering and Computer Science found people living with MND, also known as ALS, who have difficulty speaking or swallowing tend to have smaller tongue muscles.

Dr Shaw said this could serve as an early indication of neurodegenerative disease.

“There are 8 interconnected muscles in our tongues, each with a different role allowing us to eat, swallow and speak,” he said.

“But for someone with a motor neuron 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, a neuroscientist, said studying tongue muscles inside the mouth of a person living with MND has traditionally been difficult and invasive.

“Luckily a standard brain scan will often capture the tongue as well as the brain, so we examined more than 200 historical MRI scans, including some of people living with MND,” 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.”

Dr Shaw said previous research has shown people whose MND symptoms occur in the mouth, tongue, throat and neck muscles have a shorter survival time compared to those with an onset of symptoms in their limbs.

“This played out in our own results – people with lower tongue volumes had a worse prognosis,” he 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.”

Research co-author and speech pathologist Dr Brooke-Mai Whelan from UQ’s School of Health and Rehabilitation Sciences said the tongue was a complex organ, executing thousands of precisely co-ordinated movements every day which are only noticed when they begin to fail.

“When tongue function is impaired, swallowing can become dangerous and speech difficult to understand,” Dr Whelan said.

“People with MND report that the loss of speech is more devastating than the loss of the ability to eat, drink or walk.

“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.

“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 provide a valuable resource to the wider research community.

“There’s currently a lag of around 12 months between someone experiencing MND symptoms and their diagnosis, so getting earlier access to treatment and support, enrolment in clinical trials and voice banking is the goal,” he said.

“This method could also be used to study countless existing MRI datasets, helping unlock insights into a range of other health conditions including speech disorders and cancer.”

The research is published in Computers in Biology and Medicine.

Collaborations and acknowledgements

The multidisciplinary team included researchers from UQ’s Queensland Digital Health Centre, School of Biomedical Sciences, School of Psychology and Medical School as well as the Royal Brisbane and Women’s Hospital, Griffith School of Medicine and Dentistry, Queensland Health, Neuroscience Research Australia, Google DeepMind and the University of Sydney.

Dr Shaw is also an Affiliate of the Centre for Advanced Imaging at the Australian Institute for Bioengineering and Nanotechnology and the UQ Centre for Motor Neuron Disease (MND) Research at the School of Biomedical Sciences.