More than a piece of cake: Noun classifier processing in primary progressive aphasia

Boon Lead TEE, Li Ying Lorinda KWAN-CHEN, Ta-Fu CHEN, Connie T.Y. Yan, Joshua TSOH, Andrew Lung-Tat CHAN, Adrian WONG, Raymond Y. LO, Chien Jung LU, Yu SUN, Pei-Ning WANG, Yi Chen LEE, Ming Jang CHIU, Isabel Elaine ALLEN, Giovanni BATTISTELLA, Thomas H. BAK, Yu Chen CHUANG, Adolfo M. GARCÍA, Maria Luisa GORNO-TEMPINI

Research output: Contribution to journalArticlespeer-review


INTRODUCTION: Clinical understanding of primary progressive aphasia (PPA) has been primarily derived from Indo-European languages. Generalizing certain linguistic findings across languages is unfitting due to contrasting linguistic structures. While PPA patients showed noun classes impairments, Chinese languages lack noun classes. Instead, Chinese languages are classifier language, and how PPA patients manipulate classifiers is unknown.
METHODS: We included 74 native Chinese speakers (22 controls, 52 PPA). For classifier production task, participants were asked to produce the classifiers of high-frequency items. In a classifier recognition task, participants were asked to choose the correct classifier.
RESULTS: Both semantic variant (sv) PPA and log openic variant (lv) PPA scored significantly lower in classifier production task. In classifier recognition task, lvPPA patients outperformed svPPA patients. The classifier production scores were correlated to cortical volume over left temporal and visual association cortices.
DISCUSSION: This study highlights noun classifiers as linguistic markers to discriminate PPA syndromes in Chinese speakers.
Highlights: Noun classifier processing varies in the different primary progressive aphasia (PPA) variants. Specifically, semantic variant PPA (svPPA) and log openic variant PPA (lvPPA) patients showed significantly lower ability in producing specific classifiers. Compared to lvPPA, svPPA patients were less able to choose the accurate classifiers when presented with choices.
In svPPA, classifier production score was positively correlated with gray matter volume over bilateral temporal and left visual association cortices in svPPA. Conversely, classifier production performance was correlated with volumetric changes over left ventral temporal and bilateral frontal regions in lvPPA.
Comparable performance of mass and count classifier were noted in Chinese PPA patients, suggesting a common cognitive process between mass and count classifiers in Chinese languages. Copyright © 2024 The Authors.
Original languageEnglish
JournalAlzheimer's and Dementia
Early online dateJan 2024
Publication statusE-pub ahead of print - Jan 2024


Tee, B. L., Kwan-Chen, L. Y. L., Chen, T.-F., Yan, C. T. Y., Tsoh, J., Chan, A. L.-T., Wong, A., Lo, R. Y., Lu, C. J., Sun, Y., Wang, P.-N., Lee, Y. C., Chiu, M.-J., Allen, I. E., Battistella, G., Bak, T. H., Chuang, Y.-C., García, A. M., & Gorno-Tempini, M. L. (2024). More than a piece of cake: Noun classifier processing in primary progressive aphasia. Alzheimer's and Dementia. Advance online publication.


  • Chinese language
  • Lemma
  • Lexical syntactic attributes
  • Noun classifier
  • Primary progressive aphasia


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