What is Foreign Accent Syndrome?

By: Aaria Lankireddy and Nysa Vinod

The condition known as foreign accent syndrome (FAS) is a rare neurological disorder that affects how a person produces speech sounds. It is related to the brain and can occur as a result of damage to the speech center of the brain. Despite its name, foreign accent syndrome does not necessarily involve the adoption of a specific foreign accent, instead it can manifest with changes in speech patterns that may sound like a foreign accent to others.

Discovered in 1947 by the French neurologist Pierre Marie, there have been over 100 confirmed cases of foreign accent syndrome since its initial recognition. The syndrome often occurs following a stroke, head injury, or other type of brain damage and can result in alterations in the timing, intonation, and tongue placement of speech. While it is a rare condition, the impact on an individual's ability to communicate can be significant and it may require speech therapy and other forms of rehabilitation to help manage the effects of the syndrome.

“FAS can occur as a type of functional neurological disorder (FND) in which speech is affected without clearly observable brain insult. One useful analogy is that the first type of FAS (neurogenic) results from brain “hardware” issues, and the second type (functional) from “software” problems. In addition, there are “mixed” cases in which individuals have both neurogenic and functional speech challenges”. (Garst, D. & Katz, W, 2024, The University of Texas at Dallas,). 

What Is The Cause Of FAS?

The most common cause of FAS is brain damage that stems from a brain stroke or a traumatic brain injury. Strokes or brain injuries in your frontal lobe suggest that you have structural FAS. Scientists and doctors aren’t sure what causes Functional FAS. This perhaps is due to the unusual organization in the brain. It is not yet determined why Mixed FAs occur. It could just be because some people are just more prone to it or it might be that a person recently had a seizure, stroke, or another brain injury. Some causes of FAS are permanent such as frontotemporal dementia and multiple sclerosis. 

There is a possible link between “FAS and functional neurological symptom disorder (also known as “conversion disorder”). This is a condition where disruptions in your brain cause you to experience real physical symptoms that don’t have a detectable structural cause”. (Cleveland Clinic, 09/11/2023) FAS appears to be related to the Broca’s area of the brain which is linked to producing speech. Damage to Broca’s anterior area contains neurons involved in speech function, which can cause FAS.

Symptoms of FAS

• FAS mainly affects the rhythm of how you speak. Some Symptoms may include the following:

• Talking Speed

• Lengths of sounds

• Change of pitch, tone, and volume of voice

• More or longer pauses mid-word or mid-sentence.

• Wing out certain sounds longer than necessary.

• The monolingual patient is frequently mistaken for being a non-native speaker.

• The patient is aware of the accent and is unhappy 

• Consonant distortions, substitutions, deletions

• Frequent problems with alveolar tap or flap.

Detection of FAS

When patients visit a doctor, it's common for the doctor to order blood tests to check for various illnesses and infections. These tests can provide valuable insights into the patient's overall health and well-being. Additionally, if there are concerns about the brain, doctors may request brain scans such as MRIs to look for any signs of damage or lesions in the brain. These scans can help identify potential issues that may affect the patient's cognitive or neurological function. Furthermore, a lumbar puncture, also known as a spinal tap, may be performed to obtain a sample of the cerebrospinal fluid for testing. This procedure can help diagnose conditions such as meningitis, multiple sclerosis, or certain types of cancer that can affect the central nervous system. “Speech-language pathologist. A specialist in speech and communication disorders may record you reading aloud to help diagnose the exact extent of your accent changes”. (Jewell Tim, June 14, 2019, Healthline). 

Treatment Options

Your treatment options depend on what caused it. You can discuss treatment options with your healthcare provider. Some treatment options include medication, mental therapy, or both. For example, if you have speech-related problems, you might visit a speech therapist. They will help you move your jaw, correct tongue placement while speaking, and pronounce words properly. Speech-language therapists often use a mirror to help guide lip and jaw placement during speech. If you have psychiatric problems, a doctor might prescribe medications. Usually, speech therapy is the most used treatment for FAS. “When the cause of foreign accent syndrome is unclear, such as in the case of the woman who developed it following dental surgery — speech therapy may be the only treatment option”. (Villines Zawn, April 28, 2020, Medical Todays News).

References:

• Cleveland Clinic, 09/11/2023, Foreign accent Syndrome https://my.clevelandclinic.org/health/diseases/25242-foreign-accent-syndrome-fas

• MedicalTodayNews April 28, 2020, What is Foreign Accent syndrome? https://www.medicalnewstoday.com/articles/foreign-accent-syndrome

• Healthline, June 14 2019 Foreign Accent Syndrome: What Is It? https://www.healthline.com/health/neurological-health/foreign-accent-syndrome#:~:text=When%20should%20you%20seek%20help,of%20a%20more%20serious%20issue

• University of Texas at Dallas, Foreign Accent Syndrome https://sites.utdallas.edu/fas/