Home telemonitoring of bulbar function by acoustic measurement of swallowing and speech sounds in ALS

Individuals with amyotrophic lateral sclerosis (ALS, or Lou Gehrig's Disease) typically develop changes in their abilities to speak and swallow foods. This can reduce the quality of life and lead to severe complications, such as malnutrition, choking, and lung infection. Variants of ALS that begin with speech and swallowing symptoms are known to be associated with more aggressive disease. Measuring and addressing these changes in a timely manner is a limitation of the current ALS care model, as the interval between appointments can range from 3-4 months. Additionally, the increasing use of telemedicine hinders the ability for therapists to assess these changes at all.

We propose the use of a smartphone application that captures the sounds of speech and swallowing for the purpose of remote clinical monitoring. Twenty individuals with ALS and experiencing speech/swallowing symptoms will use this monitoring application to record speech and swallowing sounds in their homes for 6 months. The primary goal of the study is to show that these sounds are sensitive to standard assessments of disease progression. Patients' experience with the application will inform its future deployment as a clinical tool.

This proposal features the cross-discipline collaboration of content experts in ALS quality of life, mobile health technologies, and the collection, analysis, and interpretation of speech/swallow sounds. Successful completion of this study will expand the library of patient-administered tools for monitoring the signs and symptoms of ALS. This fits within our long-term vision to transform the multidisciplinary ALS model by enhancing its level of care personalization through the use of mobile health technologies.