He Foreign accent syndrome ( SAE ) Is a rather rare alteration in which a person begins to show a foreign or different pronunciation to their native dialect without having to have Had previous experience with the language from which the accent acquires (Vares, 2015).
It is a rare disorder of language production in which the patient's pronunciation is perceived as foreign by the listeners of his Community of speakers (Vares, 2015) due to an inability to produce the phonetic and phonological contrasts of the native dialect itself (Pyun et al. 2013).
Cases of foreign accent syndrome have been documented around the world, including changes in Japanese to Korean accent, from English to French, From American English to British, and from Spanish to Hungarian (UTD, 2016).
Foreign accent syndrome is a neurological disorder that in most cases occurs as a consequence of some type of injury or brain damage. In addition, the existence of this pathology linked to development has also been observed.
Characteristics of foreign accent syndrome
Foreign-accent syndrome, also called pseudo-foreign accent, is defined as a type of speech impairment acquired as a consequence Of the presence of some type of injury in the central nervous system that will produce the appearance of a foreign accent when speaking the native language (González-Alvarez, 2003).
The first case of this syndrome was described in 1917 by Marie and Foix, in the one native patient of Paris acquired an accent of another region of France (Alsace) after recovering from an injury in the left hemisphere (Vares, 2015).
This phenomenon came to be described as"abnormal prosody"by Monrad-krohn who described the best known case of this pathology in the journal Brain (1974) (González-Alvarez, 2003).
This so-called house was about a woman of Norwegian origin who was hit by a Nazi projectile in the Second World War, which caused her to severe Traumatic brain injury . As a result of brain injury, he began or showed a clear German accent (González-Alvarez, 2003).
Due to the temporal moment in which the presence of this alteration occurred, this caused important problems in his daily life to be Related to a German origin (González-Alvarez, 2003).
In the year 2008 only scientific references of about 50 cases of syndrome of the foreign accent were found, being increased of important form the Report of this type of pathologies in recent years (Vares, 2015).
From the clinical description of the different cases, it has been concluded that the modification of the accent arises from an alteration of the individual's ability to Programming sequencing and positioning of movements that are essential for language production (Vares, 2015).
There are therefore abnormalities in accentuation, rhythm, intonation, mode of articulation, sound of consonants or articulation of Vowels and different alterations in syllabic structure (Vares, 2015).
Pinillos (2014) describes the most characteristic deficits that appear in patients with SAE according to the description proposed by Buentello-García and collaborators:
1. Segmental alterations : Greater alteration in vowels than consonants; Modification of vowel pronunciation time (shorter or longer)
Long; Modifications and errors in the pronunciation of consonants.
2. Prosodic alterations : Variations of the thymus and intonation of words and / or phrases; Decreased time between syllables, insertion of vowels, Scarce transition between word and word, inversion of key phrases, among others.
Causes of Foreign accent syndrome
Usually, the causes of foreign accent syndrome are associated with different neurological conditions (Pinillos, 2014).
Although the pathological and neurological substrate of this pathology are not clearly delimited, it is usually produced as a consequence of Stroke , Cranioencephalic disorders or other types of disorders, such as progressive primary aphasia (Pyun et al., 2013)
Generally, the etiological mechanisms will affect frontal areas of the left hemisphere, especially in the anterior region of the Insula , without However, there is still no agreement on this implication (Pyun et al., 2013).
Different current studies using advanced neuroimaging techniques do not associate the appearance of SAE with focal lesions, but rather with several Small cortical and / or subcortical lesions that may occur in a distributed form (Pyun et al., 2013).
Most of the cases correspond to lesions in the left hemisphere (Pyun et al., 2013), however, their appearance will depend on the Localization of the dominant hemisphere for language (Vares, 2015).
On the other hand, we must bear in mind that some cases of SAE have been described in the absence of cerebral accidents, linked to development in particular to a Specific language disorder (Vares, 2015).
The presence or absence of a structural lesion does not predict the occurrence of this type of pathologies, since some techniques such as PET , Have described A hypoperfusion of different regions without presence of structural alterations associated with foreign accent Syndrome (Pyun et al., 2013),
Types Foreign accent syndrome
Depending on the nature of this pathology, Jo Verhoeven and Peter Mariën (2010) have classified the main SAE cases that have been published In three categories (Vares, 2015):
- Neurogenic foreign accent syndrome : Pathology is a consequence of the changes that occur in the nervous system Central by the presence of lesions generally in motor areas of language. This category brings together both cases acquired and linked to development and Specific language disorders.
- Psychogenic foreign accent syndrome : It occurs as a consequence of some type of alteration exclusively psychological, Without evidence of brain damage. In one of the cases described as psychogenic the psychiatric examination showed a history associated to the treatment of Depression with suicidal tendencies.
- Mixed foreign accent syndrome : Some authors point out the existence of a third type of pathology being the cause Neurogenic etiology, but which, after the psychological effect of this alteration, leads to psychogenic aspects, such as the emphasis on the new Achieve more coherence and more coherent identity.
Treatments
Most of the cases that have been described of Foreign Accent Syndrome have been examined from an investigational perspective, so the area Clinic has not been addressed significantly.
Little or almost nothing is known about the possible treatment of this unique pathological picture. Some authors like Duffy, in their descriptions Include the possibility of adapting different techniques used in Aphasia or Apraxia (Villaverde-Gonzalez, et al., 2003)
Recourse to a speech therapy or Neuropsychological Can be considered a good neuro-enabling strategy. These interventions should Speech rhythms, distortions of the point and mode of articulation, substitutions and variations in the production of Consonants or vowels, which contribute to substantial variations of accent (Villaverde-Gonzalez, et al., 2003)
In addition, the modification of prosody may play a crucial role in the origin of the accent. The techniques of prosodic improvement, stress, rhythm and Naturalness, will be useful in reducing the foreign accent (Villaverde-Gonzalez, et al., 2003)
On the other hand, the Jaume I University and the Neurology Service of the Hospital of Castellón (Spain), emphasize the importance of feedback Hearing. Thus, some of the techniques used in the treatment of dysaemia have been shown to be effective in SAE. Some of these techniques are:
- Masked Auditory feedback (MAF).
- Delayed Auditory Feedback (DAF).
- Frequent-Shifted Auditory Feedback (FAF).
Some cases of SAE
- Katz, Garst, and Levitt (2008) describe the case of a 46-year-old woman whose native language was American English. He began to show a similar acceptance to Own of Sweden or regions of Eastern Europe after suffering an allergic reaction that caused facial weakness, paralysis of the left side of the face Or slowness when speaking. Neuroimaging studies showed that there was an alteration in the size of the lateral cerebral ventricles and an atrophy Cortical in the Frontal lobe (Pinillos, 2014).
- One of the last cases described in the scientific literature refers to a Spanish patient. This is a 51-year-old female Province of Castellón, whose pronunciation of Spanish began to show a foreign accent after suffering a stroke. This woman Used 4 different languages (French, English, Valencian and Castilian), however, only the Castilian production was affected (Vares, 2015)
- On the other hand, the first case of SAE has recently been documented in which the affected person experiences different accents. It is a woman Native of Australia at 37 years of age, was admitted after giving a sudden difficulty in pronouncing, weakness of the right side of the body, Coordination problems, headache, among others. Neuroimaging studies relieved cerebral haemorrhage. Several days later, he began to Unintentionally and spontaneously show an accent that could be identified with French. Subsequently, on the following days, I experienced the Less 6 different accents, some of which did not last more than 24 hours (Vares, 2015).
References
- González-Álvarez, J., Parcet-Ibars, M., Ávila, C., & Geffner-Sclarsky, D. (2003). A rare neurological-origin speech disorder: Foreign accent. Rev Neurol, 36 (3), 227-237.
- Pinillos Chávez, P. (2014). This is not my voice: A review of the Foreign Accent Sydrome. Est Interlin. , 107-116.
- Pyun, S., Jang, S., Lim, S., Ha, J., & Cho, H. (2013). Neural substrate in the home of reign accent syndrome following basal ganglia hemorrhage. Journal of Neurolinguistics , 479-489.
- Vares González, E. (2015). A new case of foreign accent syndrome linked to development. Journal of Speech Therapy, Phoniatrics and Audiology, 35 , 77-83.
- Villaverde-González, R., Fernández-Villalba, E., Moreno-Escribano, A., Alías-Linares, E., & García-Santos, J. (2003). Foreign Accent Syndrome As the first manifestation of multiple sclerosis. Rev Neurol, 36 (11), 1035-1039.