Foreign accent syndrome: when a brain injury steals part of your identity
On September 6, 1941, during the Second World War, the city of Oslo, occupied by the Germans, was bombed.. The attack affected, among others, Astrid, a Norwegian woman in her 30s who could not reach any shelter.. He survived, but the severe injuries he sustained to his brain paralyzed the right side of his body and for months prevented him from speaking..
When he finally regained that ability, something had changed in his pronunciation.. It sounded different, with an accent that many associated with German.. Suddenly, Astrid was speaking like those men who had occupied the country since 1940, with the characteristic accent they had when they used Norwegian.. Astrid had never left Norway and had never had any kind of relationship with Germany, but from then on she was taken as a native of that country, which made life very difficult for her.. From being taken for a spy to no one wanting to serve her in stores: the hostility towards the occupying country fell again and again on this woman, who could not avoid that foreign accent in her way of speaking.
Two years after the bombing, neurologist Georg Herman Monrad-Krohn began studying his case, the most famous of the so-called foreign accent syndrome, a rare disorder that reflects the fascinating workings of the human brain.
“Foreign accent syndrome is a neurological disorder in which people who suffer from it acquire a speech disorder that resembles a foreign accent,” explains Ayoze González, head of the Neurology and Clinical Neurophysiology service at the University Hospital of Gran Canaria. Dr.. negrin. Generally, he emphasizes, “this change occurs without the person having been previously exposed to that particular language or accent.”
«It is not that those who suffer from this syndrome begin to speak in another language. They still speak the same language. What occurs are changes in the intonation or modulation of the language that, to the ears of the environment, reminds us of a foreign accent or from another region”, explains Carlos Tejero, a neurologist at the Lozano Blesa University Clinical Hospital in Zaragoza and a member of the Spanish Society of Neurology (SEN). The origin of the disorder is generally due to a lesion in the brain structures related to language, he clarifies.
Although it is the best known, Astrid's is not the first case of foreign accent syndrome reported in the medical literature. In 1907, the French neurologist Pierre Marie described the picture of a patient who, after suffering a stroke, had lost the Parisian accent that he had had throughout his life to begin to speak with the accent of the inhabitants of Alsace, a remote region with which the affected person had no ties.
Since then, dozens of cases of this curious syndrome have been described, demonstrating the intricate and elaborate process that must occur in our brain every time we speak.. Not only to articulate the words we want to pronounce, but so that they sound with the right tone, rhythm or prosody.
An Irish accent due to prostate cancer
The latest of these cases was published earlier this year in the British Medical Journal Case Reports.. In the article, researchers from Duke University (North Carolina, USA) describe the case of an American man in his 50s who, despite never having lived in Ireland or having any relationship with the European country, began to speak with a thick Irish accent after suffering metastatic prostate cancer that ended up affecting his brain. As they explain, this is the first time that foreign accent syndrome has been associated with a tumor of this type, although cases of foreign accent syndrome related to other types of cancer, such as breast or brain cancer, had previously been described. .
“Most of the people who present this syndrome do so because they have suffered a stroke, although there are other types of brain lesions, caused by inflammatory disorders, trauma or even cancer that can also cause it,” confirms Ayoze González.
For foreign accent syndrome to appear, he continues, “brain lesions must be located in regions of the brain that are important for speech production, the primary motor cortex and the premotor cortex, located in the frontal lobe of the brain, being the most frequently associated.” brain. In addition, they are more typical if the lesions affect the left cerebral hemisphere”, he specifies.
How speech is produced
For people to be able to speak, Tejero and González explain, different areas of the brain must be activated. This allows words to be pronounced fluently, but also allows us to use a certain intonation, to emphasize certain syllables or to lengthen or join several vowels.. Not only words are important to express what we want to say. Thus, the same phrase does not sound the same in an affirmative or interrogative tone, if we use sarcasm or want to highlight a threat. And all these nuances are organized in the brain, which is the one that sends the instructions to the speech apparatus so that it coordinates the necessary movements to speak the way we want.. The problem is that when any of these involved areas is injured or fails, harmony is lost, and speech can start to sound strange, as if it were typical of a foreigner.
«We assimilate some language modulations to a certain language or language, but it is something very subjective. Different people can identify different accents when they listen to another,” says Tejero, who throughout his 25-year career has treated two patients with foreign accent syndrome.. The first of them, a man from Aragon, developed an accent after a neurological problem that reminded the medical team of the Asturian. The second, he recalls, also a male born and raised in Spain, began to speak after brain damage with an accent he associated with Eastern Europe,
“These changes are often very hard for those affected,” says Tejero. «They cannot control it and suddenly they see that they are perceived as foreigners or that their environment thinks that they are inventing a new way of speaking.. They do not recognize themselves, so it can lead them to social isolation or depression, “says the specialist.
In a recent article in The Conversation, Johan Verhoeven, Professor of Experimental Phonetics at the University of London, collected the case of an American woman who, after developing foreign accent syndrome and speaking English with a British accent instead of an American one, chose to for also using more common terms in the UK (such as 'lift' instead of 'elevator' to refer to an elevator) fed up with trying to explain that her new way of speaking was the result of a stroke.
In many cases, foreign accent syndrome is accompanied by other signs of neurological disturbance, such as Astrid's aphasia and paralysis, but in others, the only sign of disorder is the change in accent. «When, as neurologists, we come across these cases, we try to study them very thoroughly, analyzing which structures the lesion is in or what its nature is because it helps us understand many things about the brain that we still don't know.. We know that there are different areas involved. It has been shown, for example, that in a person who speaks several languages, the foreign accent only occurs when they speak a certain language, not all the ones they use,” says Tejero.. In addition to brain lesions, the appearance of the syndrome has also been linked to other causes of psychiatric origin.
Foreign Accent Syndrome Recovery
Sometimes, the syndrome is reversible and the sufferer recovers his usual accent. This is the case of singer George Michael, who, according to various media outlets, woke up from a coma he suffered from pneumonia in 2011 speaking with an accent from the West of the United Kingdom, instead of the usual London one.. The upheaval, however, was temporary.
This recovery, according to Ayoze González, depends fundamentally on the cause and extent of the lesions that cause the syndrome.. “If the cause is a stroke and treatment can be instituted early, the clinical manifestations can be resolved, including foreign accent syndrome,” he says.. On the other hand, if the lesions “are localized and small,” there is also a better chance of reversing the syndrome.
Astrid's autopsy showed a severe lesion on the left side of her brain that made it impossible for her and her voice to ever be the same again.. He died in 1971.