Tongue exercise may help nerve cells compensate for damage linked to ALS

Tongue exercise may help surviving nerve cells compensate for damage associated with amyotrophic lateral sclerosis (ALS), a new study in rats suggests.

Nicole Nichols, PhD, the study’s senior author at the University of Missouri, said the findings may lead to treatments that help preserve tongue function in people with ALS, a disease that can cause problems with speaking, swallowing, and breathing.

“If we can figure out exactly how and why the tongue exercise helps the remaining neurons function better, that can help the development of treatments that mimic the benefits,” Nichols said in a university news story. “For example, for someone with a very poor prognosis who may not be able to do tongue exercise, is there an injectable that we can give them that would activate those surviving motor neurons to improve their function?”

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Based on the findings in rats, the researchers hope to move toward clinical trials in the next few years to test tongue exercises in people with ALS.

“While both tongue exercise as a therapy and an injectable would require human clinical trials in the future, this finding is a step in the right direction,” Nichols said.

The study, “Impact of tongue exercise on hypoglossal axis survival, structure, and output in a rodent model of hypoglossal motor neuron degeneration,” was published in the Journal of Neurophysiology.

ALS is a disorder that damages motor neurons, the nerve cells that control muscle movement. As the disease progresses, these cells become damaged and die, leading to symptoms such as muscle weakness.

ALS can affect muscles throughout the body, including those in the tongue. The tongue plays an important role in speaking, eating, and keeping the airway open during sleep. Weakness in these muscles may contribute to obstructive sleep apnea, a condition in which the airway becomes blocked during sleep.

“For those with ALS, preserving swallowing function not only reduces the chance of developing sleep apnea, it could also mean the difference between needing a feeding tube or continuing to eat normally,” Nichols said. “That’s incredibly meaningful for quality of life.”

Tongue strength linked to survival in people with ALS

Previous studies have linked weaker tongue muscles to shorter survival in people with ALS, suggesting that exercises to strengthen the tongue might improve outcomes.

With this in mind, Nichols and colleagues tested tongue exercise in rats with experimentally induced motor neuron loss. The researchers injected a chemical into the rats’ tongues that killed some of the nerve cells controlling tongue movement. This caused tongue weakness similar to that seen in people with ALS.

The researchers divided the rats into exercise and comparison groups. Both groups received sugar water through specially designed drinking spouts. Rats in the exercise groups had to lick with greater force to obtain the liquid, while those in the comparison groups could drink with little effort.

The researchers found that tongue exercise did not increase the number of surviving motor neurons. However, among rats with motor neuron loss, those that exercised their tongues showed significantly stronger electrical signals in the nerve controlling tongue movement than those that did not exercise. This suggests that “helping those surviving neurons adapt and work harder could preserve function longer,” according to the university release.

“This adaptation is called neuroplasticity, meaning the nervous system changes how it operates to compensate for damage, and this finding offers hope for those with motor neuron diseases,” Nichols said. “By boosting the activity of the surviving neurons, we can help preserve the quality of life for those with ALS, spinal muscular atrophy and other motor neuron diseases.”

However, the researchers cautioned that the study used a rat model that does not reproduce the progressive motor neuron loss seen in ALS. Further research is needed to confirm the findings and determine whether tongue exercise could offer similar benefits in people.