Foreign accent syndrome: Behavioural and anatomical findings in recovered and non-recovered patients

Abstract

Abstract Four right-handed monolingual Spanish-speaking patients who developed a foreign accent syndrome (FAS) during the recovery period from a non-fluent aphasia or an aphemia are reported. The FAS resolved rapidly (within 2 months) in two patients, both with small stroke lesions in the posterior margin of the left middle frontal gyrus. In the other two patients, who had lesions involving the middle portion of the left precentral gyrus and the white matter underlying the right sensory-motor cortex, the FAS lasted more than 1 year. Phonetic and fundamental frequency (F0) analysis showed atypical articulatory and prosodic patterns in the two patients with a long-lasting FAS, but only abnormal prosodic features in the two recovered cases. These findings suggest that: (1) a selective involvement of specific portions of Brodmann's areas 4 and 6, and/or its subcortical projections, may account for the peculiar combination of segmental and prosodic deficits underlying the FAS; and (2) recovery seems to be related to small variations in lesion location, since a transient FAS was associated with damage to cortical areas implicated in the modulation of speech prosody (i.e. premotor cortex), while a longer-lasting FAS was associated with damage restricted to areas mainly related to articulation (i.e. precentral gyrus).