Imaging Assessment of Swallowing and Speech Muscles in Inclusion Body Myositis

September 11, 2026 updated by: Johns Hopkins University

Advancing Bulbar Assessment in Inclusion Body Myositis Through a Multimodal Imaging Approach

This study will evaluate whether neuromuscular ultrasound and MRI can be used as imaging markers of bulbar involvement and swallowing dysfunction in individuals with inclusion body myositis (IBM). Researchers will compare imaging and clinical findings in participants with IBM with those in participants with other myopathies, ALS, PLS, and healthy volunteers.

The study is a one-time visit. Study procedures may include neurological assessments, swallowing questionnaires, tongue strength testing, neuromuscular ultrasound, and MRI. The goal is to identify more sensitive and objective ways to assess bulbar dysfunction biomarkers.

Study Overview

Status

Recruiting

Conditions

Detailed Description

Researchers will evaluate ultrasound and Magnetic Resonance Imaging (MRI) as imaging markers to diagnose bulbar involvement and dysphagia in patients with IBM.

Objectives

Primary Objectives:

  • Evaluate neuromuscular ultrasound as an imaging marker for assessing the presence and evaluate the severity of dysphagia and bulbar involvement in IBM
  • Evaluate MRI of the bulbar region as an imaging marker for assessing the presence and evaluate the severity of dysphagia and bulbar involvement in IBM

Secondary Objectives:

  • Evaluate ultrasound elastography (USE) as an imaging tool for assessing muscle stiffness in patients with IBM and compare the findings to motor neuron disease and healthy control cohorts
  • Evaluate which imaging modality could be used as an early indicator of dysphagia and bulbar involvement

Study Type

Observational

Enrollment (Estimated)

30

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Joseph D Niang, B.A.
  • Phone Number: 410-570-3949
  • Email: jniang1@jh.edu

Study Contact Backup

  • Name: Pamela Arrazola, M.S.
  • Phone Number: 410-955-0749
  • Email: parrazo1@jh.edu

Study Locations

    • Maryland
      • Baltimore, Maryland, United States, 21287
        • Recruiting
        • The Johns Hopkins Hospital
        • Contact:
          • Abdullah AlQahtani, MD MPH
          • Phone Number: 443-819-9480
          • Email: aalqaht3@jh.edu

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

The study population will include approximately 30 participants with inclusion body myositis (IBM), amyotrophic lateral sclerosis (ALS), or primary lateral sclerosis (PLS); non-IBM inflammatory or genetic myopathies; and healthy controls. The planned enrollment includes 10 participants with IBM and swallowing difficulties, 5 participants with IBM without swallowing difficulties, 5 participants with non-IBM inflammatory or genetic myopathies, 5 participants with bulbar ALS, and 5 healthy controls. The investigators will recruit patients primarily through the clinical practices of the principal investigator and co-investigators and through referrals. Healthy controls may be recruited from Johns Hopkins University/Johns Hopkins Hospital staff, Johns Hopkins affiliates, and family members of patients and staff. The participants will be screened to exclude pre-existing neuromuscular disorders. Healthy controls will be age-matched to the IBM cohort.

Description

Inclusion Criteria:

  • Participants must have a confirmed diagnosis of inclusion body myositis (IBM), amyotrophic lateral sclerosis (ALS), primary lateral sclerosis (PLS), or myopathy in accordance with the respective diagnostic criteria.
  • Participants with disease must have clinically relevant laboratory testing for disease biomarkers (e.g., Creatine Kinase (CK), Comprehensive Metabolic Panel (CMP), Complete Blood Count (CBC)) within the last 12 months.
  • Participants must be able to remain supine for 30 minutes or longer and cannot have significant breathing difficulties.
  • Healthy controls must not have any neuromuscular disease.

Exclusion Criteria:

  • Unable or unwilling to provide written informed consent.
  • Medical history or clinically significant physical examination or laboratory results that, in the opinion of the investigator, would render the participant unsuitable for the study.
  • Participants who are unlikely to comply with the study protocol or, in the opinion of the investigator, would not be a suitable candidate for participation in the study.
  • Patients with IBM, ALS, or myopathy who have another known neuromuscular condition with known bulbar involvement.
  • Any patient who has undergone a procedure for dysphagia, including myotomy, dilatation, or Botox.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Healthy controls
Inclusion Body Myositis
Participants with diagnosis of IBM
Inflammatory or Genetic Myopathies
other types of myopathy that is not IBM
Motor neuron disease(ALS/PLS)
Participants must have spastic dysarthria

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Bulbar Muscle Thickness Assessed by Neuromuscular Ultrasound
Time Frame: Day 1 (one-time study visit)
Bulbar muscle thickness will be measured using B-mode neuromuscular ultrasound in short- and long-axis views.
Day 1 (one-time study visit)
Bulbar Muscle Cross-Sectional Area Assessed by Neuromuscular Ultrasound
Time Frame: Day 1 (one-time study visit)
Cross-sectional area of the assessed bulbar muscles will be measured using neuromuscular ultrasound.
Day 1 (one-time study visit)
Bulbar Muscle Echogenicity Assessed by Quantitative Grayscale Ultrasound
Time Frame: Day 1 (one-time study visit)
Bulbar muscle echogenicity will be evaluated using quantitative grayscale analysis of neuromuscular ultrasound images.
Day 1 (one-time study visit)
Bulbar Muscle Echogenicity Assessed by the Heckmatt Grading Scale
Time Frame: Day 1 (one-time study visit)
Bulbar muscle echogenicity will be assessed using the Heckmatt grading scale on neuromuscular ultrasound images. Scale 1-4, lower score better.
Day 1 (one-time study visit)
Bulbar Muscle Volume Assessed by Magnetic Resonance Imaging
Time Frame: Day 1 (one-time study visit)
Bulbar muscle volume will be measured from magnetic resonance imaging and reported in cubic centimeters (cm³).
Day 1 (one-time study visit)
Bulbar Muscle Cross-Sectional Area Assessed by Magnetic Resonance Imaging
Time Frame: Day 1 (one-time study visit)
Bulbar muscle cross-sectional area will be measured from magnetic resonance imaging and reported in square centimeters (cm²).
Day 1 (one-time study visit)
Bulbar Muscle Fat Content Assessed by Magnetic Resonance Imaging
Time Frame: Day 1 (one-time study visit)
Bulbar muscle fat content will be measured using magnetic resonance imaging and reported as a percentage (%).
Day 1 (one-time study visit)
Tongue Muscle Stiffness Assessed by Ultrasound Elastography
Time Frame: Day 1 (one-time study visit)
Tongue muscle stiffness will be quantitatively assessed using shear-wave ultrasound elastography.
Day 1 (one-time study visit)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Center for Neurologic Study Bulbar Function Scale Score
Time Frame: Day 1 (one-time study visit)
Bulbar function will be assessed using the Center for Neurologic Study Bulbar Function Scale (CNS-BFS), a 21-item patient-reported questionnaire evaluating speech, swallowing, and salivation. Score ranging from 21 to 112, where a score of 21 indicates no symptoms of bulbar dysfunction.
Day 1 (one-time study visit)
Neuromuscular Disease Swallowing Status Scale Score
Time Frame: Day 1 (one-time study visit)
Swallowing function will be assessed using the Neuromuscular Disease Swallowing Status Scale (NdSSS), an 8-stage clinician-rated scale ranging from normal oral intake to complete dependence on non-oral feeding. Stage 8 represents normal function, while Stage 1 represents the most severe impairment.
Day 1 (one-time study visit)
Eating Assessment Tool-10 Score
Time Frame: Day 1 (one-time study visit)
Dysphagia symptoms and the symptoms impact on quality of life will be assessed using the 10-item Eating Assessment Tool (EAT-10). Total score ranges from 0 to 40, with a score of 3 or higher indicating a potential swallowing problem.
Day 1 (one-time study visit)
Sydney Swallow Questionnaire Score
Time Frame: Day 1 (one-time study visit)
Severity of oropharyngeal dysphagia symptoms will be assessed using the 17-item Sydney Swallow Questionnaire (SSQ). Score range 0 to 1,700, with higher scores indicating more severe swallowing problem.
Day 1 (one-time study visit)
Maximum Tongue Strength Assessed by the Iowa Oral Performance Instrument
Time Frame: Day 1 (one-time study visit)
Maximum tongue strength will be measured using the Iowa Oral Performance Instrument (IOPI). Three trials will be performed, and the highest pressure will be recorded in kilopascals (kPa).
Day 1 (one-time study visit)
Tongue Endurance Assessed by the Iowa Oral Performance Instrument
Time Frame: Day 1 (one-time study visit)
Tongue endurance will be measured using the Iowa Oral Performance Instrument (IOPI) as the amount of time, in seconds, the participant can maintain 50% of their maximum tongue pressure.
Day 1 (one-time study visit)
Inclusion Body Myositis Functional Rating Scale Score
Time Frame: Day 1 (one-time study visit)
Functional status in participants with inclusion body myositis will be assessed using the Inclusion Body Myositis Functional Rating Scale (IBMFRS), including swallowing-related function. Score ranges from 0 to 40, higher score better.
Day 1 (one-time study visit)
Amyotrophic Lateral Sclerosis Functional Rating Scale Score
Time Frame: Day 1 (one-time study visit)
Functional disability and disease severity in participants with amyotrophic lateral sclerosis will be assessed using the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS). Score ranges from 0 (maximum disability/worst performance) to 48 (normal function).
Day 1 (one-time study visit)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Abdullah Z AlQahtani, MD MPH, the Johns Hopkins School of Medicine

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

October 1, 2026

Primary Completion (Estimated)

December 31, 2027

Study Completion (Estimated)

December 31, 2027

Study Registration Dates

First Submitted

September 11, 2026

First Submitted That Met QC Criteria

September 11, 2026

First Posted (Actual)

September 16, 2026

Study Record Updates

Last Update Posted (Actual)

September 16, 2026

Last Update Submitted That Met QC Criteria

September 11, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • IRB00553575

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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