A - 66 Non-Fluent/Agrammatic Variant of Primary Progressive Aphasia (Nappa) in a Bilingual Chinese Speaker: a Single-Case Study.

Abstract

The non-fluent/agrammatic variant of primary progressive aphasia (naPPA) is a neurodegenerative syndrome associated with agrammatism in language production and effortful speech (Gorno-Tempini et al., 2011). There is limited literature on PPA in non-English speakers and few clinical cases of bilingual naPPA have been described (Tee et al., 2022; Zanini et al., 2011). Characteristics of symptoms in orthographic languages, such as Chinese, are not well understood (Ting et al., 2017). This case describes the assessment of naPPA in a bilingual Mandarin Chinese speaker. A 66-year-old Asian male with 16years of education complained of worsening aphasia in both languages over two years with initial preferential sparing of Chinese. A comprehensive neuropsychological battery was administered mostly in Chinese with select subtests in English. Language functioning was assessed with the Bilingual Aphasia Screening Test (Paradis & Libben, 1987). Agrammatism and apraxia of speech was present in both languages. Single-word comprehension and object knowledge was preserved, while comprehension of complex commands was impaired. Lexical discrimination of real and nonsense words was preserved. Delayed memory was impaired with relative improvement upon recognition. Attention, processing speed, visuospatial skills, and motor functioning were preserved. Mood was euthymic. This case revealed deficits in both languages with slower decline of the dominant language, suggesting that the less proficient language in bilinguals is more vulnerable to degeneration in naPPA.