Kinematic analysis of lingual fatigue in myasthenia gravis

This study describes a preliminary examination of the viability and suitability of the physiologic technique electromagnetic articulography (EMA) in investigating lingual fatigue in myasthenia gravis (MG). A 52.9-year-old female diagnosed with MG at the age of 18 years, but who was in remission, participated in the study with a matched control subject. Changes in the duration, speed, and range of tongue-tip and tongue-back movements during repetition of /taka/ over two minutes were investigated. Results revealed that the MG subject did not exhibit significant changes in duration, maximum velocity, maximum acceleration, or the distance travelled by her tongue as measured by EMA over the task. The kinematic results were, in part, expected since the MG subject was in remission. The results, therefore, may not be representative of the majority of individuals with active MG. The examination of the current case did highlight, however, the potential advantages of EMA in providing detailed, objective information regarding lingual kinematics for future investigations of individuals with MG. It also showed that EMA may be sensitive in detecting subclinical kinematic features of fatigue in individuals who are in remission from MG. Finally, EMA led to the identification of possible physiologic factors underlying the CV transform effect, which was evident for the MG subject's syllable productions. In the past, the effect had been assumed to be a purely perceptual-based phenomenon.