Normative data for the Pyramids and Palm Trees Test in literate Persian adults

  • Azar Mehri Mail Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
  • Seyede Zohreh Mousavi Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
  • Mohammad Kamali Rehabilitation Research Center, Tehran University of Medical Sciences, Tehran, Iran
  • Saman Maroufizadeh Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, Academic Center for Education, Culture and Research, Tehran, Iran
Semantics, Memory and Learning Tests, Reference Values, Iran, Adult


Background: Semantic test of Pyramids and Palm Trees (PPT) is the most common test for assessing memory. Since this test is related to language and culture, normative data in different populations are needed.

Methods: This study was conducted on 270 literate men and women Persian adults aged from 20 to 69 years. Subjects must select a picture or word between two pictures or words that was closer to target.

Results: The word score was significantly positively correlated with the picture score (r = 0.508, P < 0.001). Word scores (median = 50, Q1-Q3 = 49-51) were higher than the picture scores (median = 50, Q1-Q3 = 48-51), although the difference was small (P < 0.001).

Conclusion: Demographic variables such as age, gender, and level of education were not significant predictors for both versions in Persian population.


1. Funnell E. Semantic memory. In: Hillis AE, Editor. The handbook of adult language disorders: integrating cognitive neuropsychology, neurology, and rehabilitation. New York, NY: Psychology Press; 2002. p. 185-205.
2. Anastasia M, Raymer Y, Leslie Y, Gonzalez R. Impairment of word comprehension and production. In: Chapey R, Editor. Language intervention strategies in aphasia and related neurogenic communication disorders. Philadelphia, PA: Lippincott Williams & Wilkins; 2005.
3. Jefferies E, Baker SS, Doran M, Ralph MA. Refractory effects in stroke aphasia: A consequence of poor semantic control. Neuropsychologia 2007; 45(5): 1065-79.
4. Jefferies E, Rogers TT, Hopper S, Ralph MA. "Pre-semantic" cognition revisited: Critical differences between semantic aphasia and semantic dementia. Neuropsychologia 2010; 48(1): 248-61.
5. Soni M, Lambon Ralph MA, Woollams AM. "W" is for bath: Can associative errors be cued? J Neurolinguistics 2011; 24(4): 445-65.
6. Bozeat S, Lambon Ralph MA, Patterson K, Garrard P, Hodges JR. Non-verbal semantic impairment in semantic dementia. Neuropsychologia 2000; 38(9): 1207-15.
7. Doughty OJ, Done DJ, Lawrence VA, Al-Mousawi A, Ashaye K. Semantic memory impairment in schizophrenia-deficit in storage or access of knowledge? Schizophr Res 2008; 105(1-3): 40-8.
8. Jefferies E, Hoffman P, Jones R, Ralph MA. The impact of semantic impairment on verbal short-term memory in stroke aphasia and semantic dementia: A comparative study. J Mem Lang 2008; 58(1): 66-87.
9. Corbett F, Jefferies E, Ralph MA. Exploring multimodal semantic control impairments in semantic aphasia: Evidence from naturalistic object use. Neuropsychologia 2009; 47(13): 2721-31.
10. Soni M, Lambon Ralph MA, Noonan K, Ehsan S, Hodgson C, Woollams AM. "L" is for tiger: Effects of phonological (MIS) cueing on picture naming in semantic aphasia. J Neurolinguistics 2009; 22(6): 538-47.
11. Howard D. The pyramids and palm trees test: A test of semantic access from words and pictures. Bury St. Edmunds, UK: Thames Valley Test Company; 1992.
12. Gudayol-Ferre E, Lara JP, Herrera-Guzman I, Bohm P, Rodes E, Ansaldo AI, et al. Semantic memory as assessed by the Pyramids and Palm Trees Test: The impact of sociodemographic factors in a Spanish-speaking population. J Int Neuropsychol Soc 2008; 14(1): 148-51.
13. Gamboz N, Coluccia E, Iavarone A, Brandimonte MA. Normative data for the pyramids and palm trees test in the elderly Italian population. Neurol Sci 2009; 30(6): 453-8.
14. Callahan BL, Macoir J, Hudon C, Bier N, Chouinard N, Cossette-Harvey M, et al. Normative data for the pyramids and palm trees test in the Quebec-French population. Arch Clin Neuropsychol 2010; 25(3): 212-7.
15. Guo Q, He C, Wen X, Song L, Han Z, Bi Y. Adapting the pyramids and palm trees test and the kissing and dancing test and developing other semantic tests for the Chinese population. Appl Psycholinguist 2014; 35(6): 1001-19.
16. Klein LA, Buchanan JA. Psychometric properties of the Pyramids and Palm Trees Test. J Clin Exp Neuropsychol 2009; 31(7): 803-8.
17. Ansari NN, Naghdi S, Hasson S, Valizadeh L, Jalaie S. Validation of a mini-mental state examination (MMSE) for the Persian population: A pilot study. Appl Neuropsychol 2010; 17(3): 190-5.
18. Shultz KS, Whitney DJ, Zickar MJ. Measurement theory in action: Case studies and exercises. London, UK: Routledge; 2013.
19. Raymer AM. Naming and word-retrieval impairments. In: LaPointe LL, Editor. Aphasia and related neurogenic language disorders. 4th ed. New York, NY: Thieme; 2011. p. 97.
How to Cite
Mehri A, Mousavi SZ, Kamali M, Maroufizadeh S. Normative data for the Pyramids and Palm Trees Test in literate Persian adults. Curr J Neurol. 17(1):18-23.
Original Article(s)