Boon Lead Tee1, Li Ying Lorinda Kwan-Chen2, Ta-Fu Chen2, Connie T Y Yan2, Joshua Tsoh2, Andrew Lung-Tat Chan2, Adrian Wong2, Raymond Y Lo2, Chien Long Lu2, Pei-Ning Wang2, YiChen Lee2, Fanpei G Yang2, Giovanni Battistella2, Isabel Elaine Allen2, Nina F Dronkers2, Bruce L Miller2, Maria Luisa Gorno-Tempini2. 1. From the Memory and Aging Center (B.L.T., G.B., B.L.M., M.L.G.-T.), Department of Neurology, Dyslexia Center (B.L.T., G.B., M.L.G.-T.), Global Brain Health Institute (B.L.T., M.L.G.-T.), and Department of Epidemiology and Biostatistics (I.E.A.), University of California, San Francisco; Department of Neurology (B.L.T., R.Y.L.), Buddhist Tzu Chi General Hospital, Hualien, Taiwan R.O.C.; Department of Special Education and Counselling (L.Y.L.K.-C.), The Education University of Hong Kong; Department of Neurology (T.-F.C., Y.L.), National Taiwan University Hospital, Taipei, Taiwan R.O.C.; Department of Psychiatry (C.T.Y.Y., J.T.), ShaTin Hospital, Hong Kong; Department of Medicine (C.T.Y.Y., J.T., A.W.), Chinese University of Hong Kong; Department of Medicine (A.L.-T.C.), Queen Elizabeth Hospital, Hong Kong; Department of Neurology (C.L.L.), En Chu Kong Hospital, New Taipei City; Division of General Neurology, Department of Neurological Institute (P.-N.W.), Taipei Veterans General Hospital; School of Medicine (P.-N.W.) and Brain Research Center (P.-N.W.), National Yang-Ming Chiao-Tung University, Taipei, Taiwan R.O.C.; Department of Foreign Languages and Literature (F.G.Y.), National Tsing Hua University, HsinChu, Taiwan R.O.C.; Department of Radiology (F.G.Y.), Graduate School of Dentistry, Osaka University, Japan; Department of Psychology (N.F.D.), University of California, Berkeley; and Department of Neurology (N.F.D.), University of California, Davis. boonlead.tee@ucsf.edu. 2. From the Memory and Aging Center (B.L.T., G.B., B.L.M., M.L.G.-T.), Department of Neurology, Dyslexia Center (B.L.T., G.B., M.L.G.-T.), Global Brain Health Institute (B.L.T., M.L.G.-T.), and Department of Epidemiology and Biostatistics (I.E.A.), University of California, San Francisco; Department of Neurology (B.L.T., R.Y.L.), Buddhist Tzu Chi General Hospital, Hualien, Taiwan R.O.C.; Department of Special Education and Counselling (L.Y.L.K.-C.), The Education University of Hong Kong; Department of Neurology (T.-F.C., Y.L.), National Taiwan University Hospital, Taipei, Taiwan R.O.C.; Department of Psychiatry (C.T.Y.Y., J.T.), ShaTin Hospital, Hong Kong; Department of Medicine (C.T.Y.Y., J.T., A.W.), Chinese University of Hong Kong; Department of Medicine (A.L.-T.C.), Queen Elizabeth Hospital, Hong Kong; Department of Neurology (C.L.L.), En Chu Kong Hospital, New Taipei City; Division of General Neurology, Department of Neurological Institute (P.-N.W.), Taipei Veterans General Hospital; School of Medicine (P.-N.W.) and Brain Research Center (P.-N.W.), National Yang-Ming Chiao-Tung University, Taipei, Taiwan R.O.C.; Department of Foreign Languages and Literature (F.G.Y.), National Tsing Hua University, HsinChu, Taiwan R.O.C.; Department of Radiology (F.G.Y.), Graduate School of Dentistry, Osaka University, Japan; Department of Psychology (N.F.D.), University of California, Berkeley; and Department of Neurology (N.F.D.), University of California, Davis.
Abstract
BACKGROUND AND OBJECTIVES: Most primary progressive aphasia (PPA) literature is based on English language users. Linguistic features that vary from English, such as logographic writing systems, are underinvestigated. The current study characterized the dysgraphia phenotypes of patients with PPA who write in Chinese and investigated their diagnostic utility in classifying PPA variants. METHODS: This study recruited 40 participants with PPA and 20 cognitively normal participants from San Francisco, Hong Kong, and Taiwan. We measured dictation accuracy using the Chinese Language Assessment for PPA (CLAP) 60-character orthographic dictation test and examined the occurrence of various writing errors across the study groups. We also performed voxel-based morphometry analysis to identify the gray matter regions correlated with dictation accuracy and prevalence of writing errors. RESULTS: All PPA groups produced significantly less accurate writing responses than the control group and no significant differences in dictation accuracy were noted among the PPA variants. With a cut score of 36 out of 60 in the CLAP orthographic dictation task, the test achieved sensitivity and specificity of 90% and 95% in identifying Chinese participants with PPA vs controls. In addition to a character frequency effect, dictation accuracy was affected by homophone density and the number of strokes in semantic variant PPA and logopenic variant PPA groups. Dictation accuracy was correlated with volumetric changes over left ventral temporal cortices, regions known to be critical for orthographic long-term memory. Individuals with semantic variant PPA frequently presented with phonologically plausible errors at lexical level, patients with logopenic variant PPA showed higher preponderance towards visual and stroke errors, and patients with nonfluent/agrammatic variant PPA commonly exhibited compound word and radical errors. The prevalence of phonologically plausible, visual, and compound word errors was negatively correlated with cortical volume over the bilateral temporal regions, left temporo-occipital area, and bilateral orbitofrontal gyri, respectively. DISCUSSION: The findings demonstrate the potential role of the orthographic dictation task as a screening tool and PPA classification indicator in Chinese language users. Each PPA variant had specific Chinese dysgraphia phenotypes that vary from those previously reported in English-speaking patients with PPA, highlighting the importance of language diversity in PPA.
BACKGROUND AND OBJECTIVES: Most primary progressive aphasia (PPA) literature is based on English language users. Linguistic features that vary from English, such as logographic writing systems, are underinvestigated. The current study characterized the dysgraphia phenotypes of patients with PPA who write in Chinese and investigated their diagnostic utility in classifying PPA variants. METHODS: This study recruited 40 participants with PPA and 20 cognitively normal participants from San Francisco, Hong Kong, and Taiwan. We measured dictation accuracy using the Chinese Language Assessment for PPA (CLAP) 60-character orthographic dictation test and examined the occurrence of various writing errors across the study groups. We also performed voxel-based morphometry analysis to identify the gray matter regions correlated with dictation accuracy and prevalence of writing errors. RESULTS: All PPA groups produced significantly less accurate writing responses than the control group and no significant differences in dictation accuracy were noted among the PPA variants. With a cut score of 36 out of 60 in the CLAP orthographic dictation task, the test achieved sensitivity and specificity of 90% and 95% in identifying Chinese participants with PPA vs controls. In addition to a character frequency effect, dictation accuracy was affected by homophone density and the number of strokes in semantic variant PPA and logopenic variant PPA groups. Dictation accuracy was correlated with volumetric changes over left ventral temporal cortices, regions known to be critical for orthographic long-term memory. Individuals with semantic variant PPA frequently presented with phonologically plausible errors at lexical level, patients with logopenic variant PPA showed higher preponderance towards visual and stroke errors, and patients with nonfluent/agrammatic variant PPA commonly exhibited compound word and radical errors. The prevalence of phonologically plausible, visual, and compound word errors was negatively correlated with cortical volume over the bilateral temporal regions, left temporo-occipital area, and bilateral orbitofrontal gyri, respectively. DISCUSSION: The findings demonstrate the potential role of the orthographic dictation task as a screening tool and PPA classification indicator in Chinese language users. Each PPA variant had specific Chinese dysgraphia phenotypes that vary from those previously reported in English-speaking patients with PPA, highlighting the importance of language diversity in PPA.
Authors: Boon Lead Tee; Jessica Deleon; Lorinda Kwan Chen Li Ying; Bruce L Miller; Raymond Y Lo; Eduardo Europa; Swati Sudarsan; Stephanie Grasso; Maria Luisa Gorno-Tempini Journal: Neurocase Date: 2021-08-17 Impact factor: 0.781
Authors: Marilyne Joyal; Simona M Brambati; Robert J Laforce; Maxime Montembeault; Mariem Boukadi; Isabelle Rouleau; Joël Macoir; Sven Joubert; Shirley Fecteau; Maximiliano A Wilson Journal: Front Psychol Date: 2017-04-05