When Words Sound Alike: Decoding Homophone Processing in Chinese Primary Progressive Aphasia
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.
Related
- Beyond Agrammatism: Syntax Processing in Chinese Primary Progressive Aphasia
- Differentiating nonfluent/agrammatic and logopenic primary progressive aphasia in Catalan-Spanish bilinguals by applying multilingual multimodal machine learning to connected speech
- Age-group differences in the N170 response during Chinese character processing in children aged 7–11 years: a cross-sectional event-related potential study
- Delayed recognition of primary thyroid lymphoma with progressive thyroid enlargement and cardiopulmonary symptoms.
- Pseudo-Exacerbation in Primary Progressive Multiple Sclerosis: A Case Report
BibTeX
@misc{tee2026when,
title = {{When Words Sound Alike: Decoding Homophone Processing in Chinese Primary Progressive Aphasia}},
author = {Boon Lead Tee and Ta-Fu Chen and Lorinda Kwan-Chen Li-Ying and YuChen Chuang and Raymond Y. Lo and Joshua Tsoh and Andrew Lung-Tat Chan and Adrian Wong and Vincent Mok and Tin Yee Connie Yan and Chien Jung Lu and Yu Sun and YiChen Lee and Isabel Elaine Allen and FangDa Leng and Yu-Wen Cheng and Chin-Hsien Lin and Cheng-Hsuan Li and Yu Chen and GuoYu Zhou and Adeline Ng and Jet Vonk and Maria Luisa Gorno-Tempini},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.16.26364895},
url = {https://www.medrxiv.org/content/10.64898/2026.10.16.26364895v1},
note = {CC BY-NC},
}
RIS
TY - UNPB
TI - When Words Sound Alike: Decoding Homophone Processing in Chinese Primary Progressive Aphasia
AU - Boon Lead Tee
AU - Ta-Fu Chen
AU - Lorinda Kwan-Chen Li-Ying
AU - YuChen Chuang
AU - Raymond Y. Lo
AU - Joshua Tsoh
AU - Andrew Lung-Tat Chan
AU - Adrian Wong
AU - Vincent Mok
AU - Tin Yee Connie Yan
AU - Chien Jung Lu
AU - Yu Sun
AU - YiChen Lee
AU - Isabel Elaine Allen
AU - FangDa Leng
AU - Yu-Wen Cheng
AU - Chin-Hsien Lin
AU - Cheng-Hsuan Li
AU - Yu Chen
AU - GuoYu Zhou
AU - Adeline Ng
AU - Jet Vonk
AU - Maria Luisa Gorno-Tempini
PY - 2026
DA - 2026/10/16
PB - medRxiv
DO - 10.64898/2026.10.16.26364895
UR - https://www.medrxiv.org/content/10.64898/2026.10.16.26364895v1
AB - 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.
ER -