The Curious Foreign Accent Syndrome – Neuroskeptic

“Foreign Accent Syndrome” (FAS) is a rare disorder in which patients start to speak with a foreign or regional tone. This striking condition is often associated with brain damage, such as stroke. Presumably, the lesion affects the neural pathways by which the brain controls the tongue and vocal cords, thus producing a strange sounding speech.

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Yet there may be more to FAS than meets the eye (or ear). According to a new paper in the Journal of Neurology, Neurosurgery and Psychiatry, many or even most cases of FAS are ‘functional’, meaning that the cause of the symptoms lies in psychological processes rather than a brain lesion.

To reach this conclusion, authors Laura McWhirter and colleagues recruited 49 self-described FAS suffers from two online communities to participate in a study. All were English-speaking. The most common reported foreign accents were Italian (12 cases), Eastern European (11), French (8) and German (7), but more obscure accents were also reported including Dutch, Nigerian, and Croatian.

Participants submitted a recording of their voice for assessment by speech experts, as well as answering questions about their symptoms, other health conditions, and personal situation. McWhirter et al. classified 35 of the 49 patients (71%) as having ‘probably functional’ FAS, while only 10/49 (20%) were said to probably have a neurological basis, with the rest unclear.

These classifications are somewhat subjective in that there are no hard-and-fast criteria for functional FAS. None of the ‘functional’ cases reported hard evidence of neurological damage from a brain scan, but only 50% of the ‘neurological’ cases did report such evidence. The presence of other ‘functional’ symptoms such as irritable bowel syndrome (IBS) was higher in the ‘functional’ group.

In terms of the characteristics of the foreign accents, patients with a presumed functional origin often presented with speech patterns that showed inconsistency or variability. For instance, pronouncing ‘cookie jar’ as ‘tutty dar’ but being able to correctly produce ‘j’, /k/, /g/ and ‘sh’ sounds as part of other words.

But if FAS is often a psychological disorder, what is the psychology behind it? McWhirtner et al. don’t get into this, but it is interesting to note that FAS is often a media-friendly condition. In recent years there have been many news stories dedicated to individual FAS cases. To take just three:

  1. American beauty queen with Foreign Accent Syndrome sounds IRISH, AUSTRALIAN and BRITISH
  2. Scouse mum regains speech after stroke – but is shocked when her accent turns Russian
  3. Traumatic car accident victim has Irish accent after suffering severe brain injury

Perhaps the popularity of FAS has become a self-fulfilling prophecy? I wouldn’t be surprised if people who have heard of FAS through the media are more likely to develop the syndrome themselves, in response to a stressful trigger event.

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