Mizzou researchers see promise in tongue exercise for ALS

By Brian Consiglio

Oct. 19, 2026
Contact: Brian Consiglio, [email protected]

A breakthrough at the University of Missouri could lead to new therapies for people with amyotrophic lateral sclerosis (ALS) and other motor neuron diseases.

In a preclinical model, Mizzou researchers discovered that tongue exercise can improve the activity of surviving neurons that control tongue movement, helping them compensate as other neurons are lost.

The finding could eventually help people preserve critical functions such as speaking, swallowing and breathing.

ALS, also known as Lou Gehrig's disease, damages neurons that control muscle movement and currently has no cure.

But not all neurons controlling tongue movement die as ALS progresses, particularly in the early stages of the disease. Helping those surviving neurons adapt and work harder could preserve function longer.

"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," said Nicole Nichols, an associate professor in the College of Veterinary Medicine and coauthor of the study. "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."

Researchers say the findings could inform future therapies designed to mimic the effects of exercise for patients who may not be able to perform tongue training.

"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. "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? 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."

Preserving tongue function could have a profound effect on daily life for people with ALS. Beyond speech, the tongue is critical for swallowing and helps keep the airway open during sleep. As those muscles weaken, people can develop sleep apnea or have difficulty eating, sometimes requiring feeding tubes.

"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," she said. "That's incredibly meaningful for quality of life."

Nichols and her team hope to move tongue exercise toward human clinical trials within the next several years through collaborations at Mizzou's NextGen Precision Health. They want to determine whether the exercise produces the same boost in surviving neurons in people with motor neuron diseases that the researchers observed in the preclinical model.

The study brought together expertise from across Mizzou, including Teresa Lever, a swallowing researcher and professor at the School of Medicine, and Filiz Bunyak-Ersoy, an expert in artificial intelligence and assistant professor at the College of Engineering.

"This team science approach ultimately helps move foundational science from the lab bench to the clinic faster, making Mizzou the perfect place for this research to thrive," 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.