球麻痺型の筋萎縮性側索硬化症患者における舌運動評価とfunctional oral intake scale（FOIS）の関係性に関する予備的検討

A preliminary study on the relationship between lingual motor function and the functional oral intake scale (FOIS) in patients with bulbar-onset amyotrophic lateral sclerosis

　筋萎縮性側索硬化症（以下，ALS）のfunctional oral intake scale（以下，FOIS）のレベルと最大舌圧，発話能力，音響分析結果を比較する予備的検討を行った．本研究では，舌運動評価とFOISの関係性を検討した．対象は，球麻痺型のALS患者25名〔中央値68歳（四分位範囲64〜74）〕でFOISレベル7〔7名：63歳（51〜69）〕，レベル6〔12名：71歳（67〜76）〕，レベル5〔6名：67歳（63〜72）〕の3群とした．最大舌圧と発話速度では，レベル7群と6群・5群，発話明瞭度ではレベル7群と5群に有意差がみられた．音響分析では，レベル7群と5群，6群と5群に高い効果量が観察された．また，FOISと音読発話/i/のF2との間に中程度の有意な相関を認めた．FOISのレベル別解析において舌の機能に違いがみられた．すなわち，舌運動の程度が食物形態の選択に影響を与える可能性があり，医療従事者がALS患者の経口摂食状況をより的確に把握し，形態変更に必要な情報を得ることが期待される．本研究結果は予備的であり，今後は大規模研究による追試が求められる．

　We conducted a preliminary study to compare maximum tongue pressure, speech ability, and acoustic measures according to the functional oral intake scale (FOIS) levels in patients with amyotrophic lateral sclerosis (ALS). The study investigated the relationship between tongue motor function and FOIS. Twenty-five patients [median age 68 years (interquartile range 64-74)] were divided into three FOIS level groups：Level 7 [7 patients：63 years (51-69)], Level 6 [12 patients：71 years (67-76)], and Level 5 [6 patients：67 years (63-72)]. Significant differences were found in maximum tongue pressure and speech rate between FOIS Levels 7 and 6, and between Levels 7 and 5. A significant difference in speech intelligibility was observed between FOIS Levels 7 and 5. Although no significant differences were found in acoustic analysis, large effect sizes were observed between Levels 7 and 5, and between Levels 6 and 5. In addition, a moderate significant correlation was found between FOIS and F2 values of /i/ in the reading task. The results indicate that tongue function may affect food consistency choices and helps healthcare professionals better assess the oral intake status of ALS patients. Further studies with larger sample sizes are needed to validate these findings.