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Background and ObjectivesMost 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.MethodsThis 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.ResultsAll 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.DiscussionThe 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.

The current study aims to examine prosodic sensitivity in Chinese children with dyslexia and its relation to Chinese reading in children with and without dyslexia. A total of 172 Chinese children from third grade to sixth grade in Taiwanese primary schools were recruited. Thirty (14 male) children were identified as having dyslexia, and the remaining children (N = 142; 67 male) were typically developing children matched with those with dyslexia as carefully as possible with respect to school, grade, and gender. Our results indicated that group differences were found for all three types of prosodic sensitivity. Moderation analyses showed that group had no significant interaction with prosodic sensitivity in predicting Chinese reading, so the participants in the two groups were combined in the following analyses. The results of the stepwise regression analyses showed that only lexical tone awareness could significantly predict Chinese character reading after controlling for phonological awareness, while only intonation awareness could significantly predict reading comprehension after controlling for Chinese character reading. The results provide preliminary evidence on the issue of prosodic sensitivity in Chinese children with dyslexia and its role in Chinese reading, which might provide a novel approach to the teaching of Chinese languages.