Biology 202

2006 First Web Paper

On Serendip

Imagine suffering a terrible, debilitating stroke. You must relearn everything,
how to walk, how to dress yourself, and even more serious, how to speak. Your words
are slow at first, halting, but gradually over time they become stronger, more sure. And
yet there seems to be something different about them. Your friends and neighbors
question whether you've taken a long vacation or perhaps you grew up in some other
country. Your speech has taking the pattern unlike the language you've grown up
speaking and has transitioned to something different, as if your primary language was in
fact your second. This condition you have been struck with is known as "foreign accent
syndrome," and has lead to your sounding as if from some distant, unknown county.

The first recorded case of foreign accent syndrome involved a French patient in
the early 1900's who began speaking with an Alsatian accent (1). In 1941, the first extensively chronicled report of foreign accent syndrome occurred, when a woman in Norway suffered an intense brain injury after being hit by shrapnel. When she recovered, she had developed what appeared to be a strong German accent, leading those who had not known her prior to her accent to shun her (2). While the majority of cases appear to be caused by strokes, traumatic brain injury and even multiple sclerosis have been shown to cause foreign accent syndrome (7). Only about twenty cases of foreign accent syndrome have been recorded in scientific literature, with the majority of them being about English speakers who seem French, Slavic, Spanish, or English (2); however other languages have reported the same phenomena, for example, a native Japanese woman who began speaking in what appeared to be a Korean accent (3). New cases are being recorded as well, with two cases reported at the University of Oxford in 2002 (2) leading to a better understanding of the disease and the mechanism by which it occur.

It is important to emphasize that though these patients appear to have a foreign
accent, linguists and native speakers are not fooled, and observers are often confused. A
study in 1987 found that the same accent on an English speaker was perceived as Eastern
European, French, Dutch, or Scandanavian, and in 1992 an Australian patient was
thought of as having an Asian, Swedish, or German accent (5). For a patient who developed a Scottish accent after a stroke, researchers discovered that only a few vocal traits seemed Scottish, such as slurred diphthongs, while the rest of her speech patterns remained like that of her native British (2). What often happens is that brain injury causes the patient to lengthen syllables, mispronounce sounds, or alter the pitch of their voice, all of which combine to give the perception of a foreign accent (4).

This syndrome, however, is not a sort of compensation for or adaptation to a
stroke, but is rather a "manifestation of damage to underlying brain mechanisms involved
in speech production" (5). The patients are still able to observe the general rules of pronunciation for various world languages, just not those for their prior spoken language (5). This is in a direct contrast to those patients with other speech production problem such as Broca's aphasia (5). It is interesting to note that some scientists wish to specify that the accent acquired is a "generic" foreign accent because the characteristics of the language spoken occur as phonetic characteristics of natural "world" language but do not display the characteristics of any one particular language (5). It appears that many cases of foreign accent syndrome appear to resolve themselves over a period of two to three years (8), though some patients are left with long term affects from their stroke or brain injury.

Scientists are torn on the proposed location of stroke or brain injury that would
cause this condition to occur. Research recently done in Japan suggests that damage in
the left precentral gyrus (3), something that expands on research at Oxford, stating that "injuries deep within the left side of the brain" cause speech to appear to foreign (2). A detailed analysis of the syndrome undertaken at Brown remarks that lesions causing damage have all been less than 3 centimeters and have been located in the prerolandic motor cortex, the frontal motor association cortex, or the striatum, all in the left hemisphere (5). It has also been recently suggested that foreign accent syndrome could be caused by damage to the cerebellum, leading to a difficulty in the motor control of speech (6). Many scientists hesitate to conclude that a single location of damage can cause such a wide constellation of deficits, however (5). This uncertainty comes from the vast differences in speech patterns and changes seen in patients with foreign accent syndrome over time and place. It is certain, however, that the mechanism of foreign accent syndrome is distinct from that of Broca's aphasia, due to the distinctness of the symptoms of both disorders.

Foreign accent syndrome offers a series of interesting issues regarding the basis of language and the origins of speech. Unfortunately, the small number of cases and wide
variety of symptoms it has been extremely difficult thus far to isolate a specific
mechanism that would lead to such specific changes in language. It also raises questions
about the link between brain and behavior, how a small change in the brain can cause
such a seemingly specific change in perceived action. Hopefully more in-depth research
will continue to be done in this field, leading to better answers to these perplexing
questions.

WWW Resources
1)University
Of Central Florida Clinic Diagnoses Rare Foreign Accent Syndrome, Science
Daily Article, Nov 19, 2003

2)"Researchers, Long Baffled by
'Foreign-Accent Syndrome,' Are Now Closer to Understanding the Disorder", Chronicle of Higher Education article, Nov 15 2002

3) Takayama K et al. "A case of foreign accent syndrome without aphasia caused by a lesion of the left precentral gyrus" Neurology. 1993 Jul;43(7):1361-3

4)"Stroke gives woman British accent", BBC health article, Nov 25 2003

5) Kurowski, K et al. "Foreign accent syndrome: a Reconsideration" Brain and
Languages (54) 1-25 1996

6) Marien P et al. "A role for the cerebellum in motor speech planning: Evidence from foreign accent syndrome" Clinical Neurology and Neurosurgery Jul 28
2005

7) Bakker JI et al. "Foreign accent syndrome in a patient with multiple sclerosis" Canadian Journal of Neurological sciences 2004 May; 31(2):271-2.

8)"Woman has accent after stroke", Kansas City Star article, December 18, 2005


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