OBJECTIVE:To investigate the influence of tongue disability, age, and sex on motor performance for a tongue-training paradigm involving playing a computer game using the Tongue Drive System (TDS). DESIGN:Two controlled observational studies. SETTING:A neurorehabilitation center and a dental school. PARTICIPANTS:In study 1, tongue-disabled patients with symptoms of dysphagia and dysarthria (n=11) and age- and sex-matched controls (n=11) participated in tongue training. In study 2, healthy elderly persons (n=16) and healthy young persons (n=16) volunteered. INTERVENTION:In study 1 and study 2, the tongue training lasted 30 and 40 minutes, respectively. Participants were instructed to play a computer game with the tongue using TDS. MAIN OUTCOME MEASURES:Motor performance was compared between groups in both studies. Correlation analyses were performed between age and relative improvement in performance. Subject-based reports of motivation, fun, pain, and fatigue evaluated on 0-to-10 numeric rating scales were compared between groups. RESULTS:In study 1, tongue-disabled patients performed poorer than healthy controls (P=.005) and with a trend of a sex difference (P=.046). In study 2, healthy young participants performed better than healthy elderly participants (P<.001), but there was no effect of sex (P=.140). There was a significant negative correlation between age and relative improvement in performance (δ=-.450; P=.009). There were no significant differences in subject-based reports of motivation, fun, pain, and fatigue between groups in any of the studies (P>.094). CONCLUSIONS:The present study provides evidence that tongue disability and age can influence behavioral measures of tongue motor performance. TDS may be a new adjunctive neurorehabilitation regimen in treating tongue-disabled patients.