When Words Sound Alike: Decoding Homophone Processing in Chinese Primary Progressive Aphasia
Year: 2026
Type: preprint
Study design: Observational Study
Abstract: Chinese is one of the living languages with the highest homophone densities, making homophone processing a critical component of language comprehension and orthographic decoding, as well as an ideal model for examining its cognitive mechanisms. This study assessed mono- and bi-character homophone selection function in 129 Mandarin- and Cantonese-speaking participants, including 66 cognitively healthy individuals, 17 with semantic variant (sv) primary progressive aphasia (PPA), 23 with the nonfluent/agrammatic variant (nfv) PPA, and 23 with the logopenic variant (lv) PPA. All PPA variants showed impairment in homophone selection, with most significant deficits in svPPA and lvPPA. ROC analyses demonstrated its strong diagnostic utility for distinguishing PPA from controls. Voxel-based morphometry revealed that homophone performance correlated with gray-matter volume in left anterior and inferior temporal regions, with variant-specific patterns observed. These findings described the potential role of homophone selection in diagnosing PPA syndrome in Chinese speakers, illuminate cross-linguistic influences on language impairment in PPA, and provide novel insights into the cognitive processing of homophones.
Source: medRxiv
Authors: Boon Lead Tee, Ta-Fu Chen, Lorinda Kwan-Chen Li-Ying, YuChen Chuang, Raymond Y. Lo, Joshua Tsoh, Andrew Lung-Tat Chan, Adrian Wong, Vincent Mok, Tin Yee Connie Yan, Chien Jung Lu, Yu Sun, YiChen Lee, Isabel Elaine Allen, FangDa Leng, Yu-Wen Cheng, Chin-Hsien Lin, Cheng-Hsuan Li, Yu Chen, GuoYu Zhou, Adeline Ng, Jet Vonk, Maria Luisa Gorno-Tempini
Institutions: University of California, San Francisco, Global Brain Health Institute, UCSF Edward and Pearl Fein Memory and Aging Center, National Taiwan University Hospital, Education University of Hong Kong, Taipei Veterans General Hospital, Chinese University of Hong Kong, Shatin Hospital, Prince of Wales Hospital, Queen Elizabeth Hospital, Mercy Hospital for Women, En Chu Kong Hospital, National Taiwan University, Shandong University, Qilu Hospital of Shandong University, National Neuroscience Institute
Language: English
Subfield: Cognitive Neuroscience
Field: Neuroscience
Domain: Life Sciences
Open Access status: green
OpenAlex ID: W7222931580