The objective of this study was to identify agrammatic features in narrative production in speakers of Hindi with post-stroke non-fluent aphasia with agrammatism.  

Agrammatism, typically resulting from damage to the left frontal language areas, is marked by fragmented utterances and sentences, impaired functional morphology, and reduced verb use. It is a key feature of non-fluent aphasia, and a core diagnostic feature in non-fluent variety of Primary Progressive Aphasia (nfvPPA). While extensively studied in English, no detailed research has explored agrammatism in Hindi, despite Hindi being the 3^rd most spoken language globally with over 600 million speakers. Hindi is a pro-drop structure language with flexible word order and has rich inflectional morphology, which may lead to different manifestations. 

A cross-sectional case-control study compared narrative production in eight Hindi-speaking post-stroke non-fluent aphasia clinically presenting with “agrammatic by clinical standard” and 16 matched controls using the wordless picture book Frog, Where Are You?. Transcripts were analyzed using augmented Quantitative Production Analysis framework to capture Hindi-specific micro-linguistic features. 

Hindi agrammatic speakers showed reduced speech rate, short and incomplete sentences, limited syntactic complexity, and difficulty with pronouns and noun inflections. Unlike English, they produced more well-formed sentences and preserved verb rate and relatively better-preserved inflections, despite limited type and range of inflections. These features are likely due to Hindi’s flexible word order, pro-drop structure, and rich morphology.

This study offers the first detailed profile of agrammatism in Hindi, showing that the nature verb difficulty is not a universal, especially in morphologically rich languages and can be manifested differently from prototypical English speaking agrammatic patients. The nature of impairment varies with language structure. The findings provide significant translational opportunities for improving assessment, especially for generating diagnostic markers for nfvPPA.