Foreign Accent Syndrome: a Curious and Extremely Rare Brain Condition

Foreign Accent Syndrome (FAS) is a rare speech disorder that can happen after a head injury, stroke, or some other form of damage to the brain and sees you suddenly start speaking with a different accent beyond your control.

This condition is extremely rare, with only around 100 people known to have been diagnosed since the first recorded case in 1907. But what causes this little known condition that causes the adoption of a new accent and the loss of part of a person’s identity in the process?

In this post, we will look at what the different explanations for Foreign Accent Syndrome are, its symptoms, how it gets diagnosed, and what treatment options you have if FAS strikes.

What Is Foreign Accent Syndrome?

FAS is characterized by the patient taking on a new accent to their native language, with examples more common amongst speakers of English as a native language but not restricted to English speakers.

FAS can involve changes in pronunciation, grammar, and vocabulary as well as changes in phonological intonation. It is important to note that the person’s voice sounds foreign both to themselves and the person they are speaking to.

What Are the Causes?

As already mentioned, FAS is usually caused by some form of stress caused to the brain causing a brain lesion. Specifically, when there is damage to the left-hand side of the brain in the Broca’s area which is linked to speech production, there is a heightened risk of FAS.

However, more recently, a study by McWhirtner et al. for the BMJ found there may also be a psychological component to the disorder. Indeed, even when there has been structural damage to the brain, this study found that psychology could also be involved.

The medical literature breaks FAS down into 3 main types which each have unique characteristics:

1. Neurogenic (eg. linked to structural damage caused to the brain from things like a stroke, brain injury, aneurysms, etc.)
2. Psychogenic (eg. where there is no apparent structural damage to the brain but where the person may have suffered emotional or mental stress or psychological or psychiatric disorders such as schizophrenia)
3. Mixed (where there is structural damage to the brain but there seems to be a psychogenic component).

What Are the Symptoms of Foreign Accent Syndrome?

Examples of FAS include a British lady called Julia Matthias who started speaking with an accent somewhere between French and Chinese after she was involved in a car accident.

An American woman suffered a headache one night and woke up speaking in a combination of British, Irish and Australian accents.

However, cases have also been reported of a 44-year-old Japanese lady speaking with a Korean accent and a Spanish person taking on a Hungarian one.

Other common symptoms include things like:

• Difficulty pronouncing certain sound clusters, particularly consonant clusters, such as S-P-L in words like “Splash”
• Vowels and consonants may be reduced, made simpler, or appear unarticulated or broken.
• Intonation and stress on words may become more frequent, ie. rather than highlighting some words through stress or tone, someone with FAS may highlight every word
• Sounds requiring the tongue to tap against the roof of your mouth can become problematic
• The “uh” sound can frequently be added within words

Can This Syndrome Be Medically Diagnosed?

If you notice symptoms like the ones above or any other changes in your normal speech, it is a good idea to seek medical help. Changes in the way you speak can be a sign of more serious issues so you should not put off seeing a doctor when you notice a change.

Doctors can diagnose FAS using a variety of tools, such as SPECT, PET, MRI, or CT scans which provide detailed images of activity inside your brain.

As mentioned, FAS is incredibly rare. For this reason, if you do present with symptoms, you will need to see a variety of specialists to confirm a diagnosis. A speech and language pathologist can record your new accent and look into where the changes have occurred in order to rule out other types of speaking disorders.

A neurologist can interpret the CT and MRI scans, whilst a psychologist can help you deal with the potential emotional stress caused by the changes and seek to explore any psychological causes of FAS.

Going to sleep and waking up with a new accent can have a profound effect on people’s sense of self and make it feel like they have lost a vital part of their own identity. Indeed, the accent can sound strange and be unconnected to our class, educational level, and where we come from so it is easy to see how challenging this can be.

Can Foreign Accent Syndrome Be Treated?

Given the 3 different variants of FAS, there is a range of treatment options that people can try.

In terms of targeting psychogenic causes and effects, these include speaking to a speech and language therapist who can give you targeted exercises targeting past pronunciation, counseling, and therapy to help you deal with your new identity.

You can also practice things like Psychological First Aid and positive affirmation to help you cope with the challenges thrown up by FAS.

On the neurogenic side, medication to prevent strokes, anti-seizure medication, and even surgery may be suitable treatment options. However, because the condition is so rare, more work needs to be done to understand the various treatment options and the causes of the condition itself.

Foreign Accent Syndrome is a very rare condition that can cause those who suffer it serious emotional distress due to the loss of identity associated with a change of accent.

It is important to seek medical advice if you notice any of the symptoms even if you are unaware that you may have suffered physical damage to the brain. Treatment is possible, as is a full recovery, however, more research needs to be done to better understand both the causes and treatments for FAS.

References

1. https://www.utdallas.edu