A Mysterious Speech Condition – Foreign Accent Syndrome

Foreign Accent Syndrome (FAS) is a medical condition in which the patient speaks his or her native language with a speech impediment similar to a foreign accent [1]. It is a very rare condition with only around 50 known cases, the first case being described and reported in 1907 in France [2]. In some cases, the speech impediment resolved itself after few weeks or months; in others, it has persisted for years [2].

Although, at first the syndrome was largely thought to be neurogenic caused by damage to the brain arising from stroke, head trauma, multiple sclerosis or brain haemorrhage, recent studies have shown that psychogenic causes can contribute to the perceived outcome as well and the brain damage is not always a prerequisite for the syndrome to occur. The case of a Dutch patient developing a strong French accent after a near car accident proved that FAS can be only psychogenic [1]. In addition, there have been reports of patients who have developed FAS through neurogenic reasons, then suffered a severe identity loss, recompensating for it by adjusting their use of words to the new accent [1]. In 2004, an American woman who suffered a cerebral insult, obtained a perceived  British English accent and started using British words such as “lift” and “mum” instead of the American “elevator” and “mom.”

The Foreign Accent Syndrome affects the sounds, stress, rhythm and intonation of the speech [3]. Frequently recorded modifications in sounds include changes in the vowel length and tenseness, consonant manner and place of articulation, and voicing of plosives and fricatives [3]. The vowel changes are usually more dominant than the consonant alterations and have a larger impact on the foreign perception of FAS patients. The syndrome also causes modifications to the syllabic structures of words, leading to the change in rhythm, and stress is often equalised over the syllables. The changes in intonation include inappropriate use of it to indicate statements, lowering or raising the tone in situations, where the opposite should have been appropriate, higher mean pitch, large and sharp pitch excursions and reduced pitch range [3]. Many FAS patients have also witnessed a slower speech rate [2]. The alterations in rhythm and intonation are the main contributors to the perceived foreign accent [3].

The exact mechanisms behind this motor speech disorder are relatively unknown, yet most of the neurogenic causes, the syndrome has resulted from abnormalities on the left hemisphere anterior of the brain . The MRI images and diffusion tensor tractography for one FAS patient in Spain showed lesions affecting the connectivity in the left deep frontal operculum and dorsal anterior insula [4]. Increase in metabolic activities was noted in cortical areas associated with necessary processes for monitoring and altering verbal utterances . However, lesions in the right hemisphere of the brain have been reported to cause FAS as well, so making generalisations is difficult [2]. It is thought that for the psychogenic causes the syndrome might be a milder version of another speech disorder, apraxia, but on the contrary to people suffering from that disease, listeners find FAS patients intelligible and broadly fluent. According to some reports, speech therapy can be helpful for FAS patients, providing some improvement in lips and jaw movement [2].  However as of yet, there are no neurologically-driven treatments to cure the condition [4].

A recent research in 2013 showed that the speech of a Foreign Accent Syndrome patient is somewhat distinguishable from the speech of a non-native speaker [1]. The listeners of non-native speakers and people with FAS were less confident in labelling the speech of the FAS patients as “foreign,” and found some native elements in their talk [1]. It is proposed, that the people who suffer from FAS have more of a generic foreign accent than a specific one and the listeners relate this to a certain nation according to their exposure to non-native speakers. The foreign accents perceived are usually widely known such as French, Chinese etc. even though the speech and its elements might have a larger resemblance to a talk of a person with a less-known origin. The listeners concentrate on salient parts of speech and interpret them to their own experience; thus, the foreign accent actually relies in the assumptions of the listener [1].

It is difficult to make solid generalisations about the Foreign Accent Syndrome due to its largely varying causes, different social perceptions of accents, and low number of patients reported and examined. The neuro- and psychogenic reasons, and the mechanisms behind the syndrome require more research to solve the mystery of this rare condition.


  1. Verhoeven, J., De Pauw, G., Pettinato, M., Hirson, A., Van Borsel, J. and Marien, P. 2013. Accent Attribution in Speakers with Foreign Accent Syndrome. Journal of Communication Disorders, 46/2 pp156-16. http://www.sciencedirect.com.ezproxy.is.ed.ac.uk/science/article/pii/S0021992413000051
  2. Dankovicova, J. and Hunt, C. 2011. Perception of Foreign Accent Syndrome Speech and its Relation to Segmental Characteristics. Clinical Linguistics & Phonetics, 25/2 pp 85-120. http://informahealthcare.com.ezproxy.is.ed.ac.uk/doi/pdf/10.3109/02699206.2010.513027
  3. Kuschmann, A., Lowit, A., Miller, N. and Mennen I. 2012. Intonation in Neurogenic Foreign Accent Syndrome. Journal of Communication Disorders, 45/1 pp1-11. http://informahealthcare.com.ezproxy.is.ed.ac.uk/doi/pdf/10.3109/02699206.2010.513027
  4. Moreno-Torres, I., Berthier, M. L. and del Mar Cid, M. 2013. Foreign Accent Syndrome: A Multimodal Evaluation in the Search of Neuroscience-Driven Treatments. 2013. Neuropsychologia, 51/3 pp 520-537.http://www.sciencedirect.com.ezproxy.is.ed.ac.uk/science/article/pii/S0028393212004770

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Ralf Ahi is a 2nd-year student at the University of Edinburgh studying Chemical Engineering with Management MEng.  Follow The Triple Helix Online on Twitter and join us on Facebook.