Rare Syndrome Causes Woman to Speak With a Foreign Accent

Canadian woman develops rare case of foreign accent syndrome after stroke.

ByKirk Fernandes<br>abc Medical Unit

July 10, 2008&#151; -- Rosemarie Dore didn't feel as if anything was wrong that Thursday morning. She took a shower, got dressed and headed off to the coffee and doughnut shop at which she worked.

But once she was at work, Dore felt weak, confused -- and she was acting a little funny.

"My girlfriend said I was playing with my hair, and I never do that kind of thing," said Dore, a 52-year-old Canadian resident of Hamilton, on the western shores of Lake Ontario.

Despite never feeling entirely awful, she chose to go to Hamilton General Hospital. It turned out that Dore had had a stroke on the left side of her brain; she would end up spending the entire summer and some of the fall of 2006 in stroke care.

Other stroke patients have similar stories, but what's unusual about Dore's case is what happened to her speech during her recovery -- she started to speak in a distinctively eastern Canadian accent. But Dore has never been to the Maritime region and does not know anyone from that part of the country.

Health care workers who met with Dore after the stroke assumed she was from Canada's east coast.

"[There was a] nurse that was from Newfoundland, "Dore told ABC News. "She comes down the hall, and she come into the room and she says, 'Who's the Newfie here?'" referring to Newfoundland.

"I said, 'There's nobody here like that.'"

"And she said, 'I think I'm talking to her.'"

Dore wasn't trying to speak with anything other than her native southern Ontario accent, but she couldn't help it. And she could hear the difference in her speech -- almost as if the words were coming from someone else.

"My kids, they were all teasing me," said Dore. "They say I really make the 'O' sound."

Doctors diagnosed Dore with foreign accent syndrome -- a very literal description for a rare speech condition that can happen after a brain injury, usually after a stroke.

Researchers who've studied the syndrome estimate there are only as many as 60 legitimate recorded cases.

One of the first known patients was reported after World War II by Norwegian neurologist Georg Herman Monrad-Krohn. He described a Norwegian woman who was hit on the head by a bomb fragment during the war and began to speak with a German-like accent. Due to her speech, she became the target of anti-German sentiment.

More recent cases include a Florida woman speaking with a British accent, a Japanese woman sounding to other Japanese as if she were Korean, and a South Carolina man developing a French-like accent.

"I have only seen a couple of people with [foreign accent syndrome] ... and I've seen a lot of stroke patients in my time," said Dr. Julius Fridriksson, an associate professor of neuroscience at the University of South Carolina who worked with the South Carolina patient.

While the seemingly instant change in dialect appears to be some magical transformation, to Fridriksson it's straightforward science.

"These folks have brain damage that alters the way the neurological system works," said Fridriksson. It just so happens that the new way in which these recovering stroke victims speak sounds like a foreign accent.

And not everyone hears the same accent.

"Foreign accent syndrome is a speech disorder that is completely in the ear of the listener," said Fridriksson. "So, people from different backgrounds will hear different accents."

When researchers closely examined Dore, they noted -- with the help of family members -- that the overall pacing of her speech had slowed down and she pronounced vowels differently than before the stroke.

Researchers took acoustic measurements of Dore's vowel sounds and found they compared closely but not exactly to the vowel sounds made by East Coast Canadians.

"It's not exactly a true accent," said Dr. Karin Humphreys, one of the researchers who worked with Dore and reported the case in the Canadian Journal of Neurological Sciences.

Humphreys likens Dore's new foreign accent to a trained musician playing an instrument a little out of tune.

"We're all virtuosos at speaking," said Humphreys. "If you do just a slight detuning ... it's going to shift the system around."

Humphreys, an assistant professor of psychology, neuroscience and behavior at McMaster University in Ontario, noted other linguistic differences as well: "The consonants changed, so she was [saying] 'dat' and 'dis' instead of 'that' and 'this."

What was especially interesting to researchers was that Dore still made the "th" sound on occasion, so she was clearly capable of doing so. This indicated to Humphreys that the change with Dore's speech wasn't caused by a malfunction with the muscles that moved her mouth and tongue. Instead, the problem existed in how her brain was instructing those muscles to act.

Still, the exact cause of foreign accent syndrome is not clear. Humphreys said the stroke probably affected Dore's basal ganglia -- an area deep in the brain that's involved in controlling movements. Previous research has linked the basal ganglia to speech problems such as stuttering.

"That's what we think is the most important thing going on here," said Humphreys. "This makes sense. It's all part of the speech motor circuit."

Fridriksson's patient also had brain damage in the basal ganglia.

And in addition to providing a window into how the brain plans speech, the syndrome also allows researchers to examine how the brain recovers after a stroke.

"When you have very small brain damage, the rest of the brain can sort of compensate in the long run and help you get better," said Fridriksson, whose patient in South Carolina eventually lost his French accent.

Now two years after the stroke, Rosemarie Dore still has trouble walking and can't use her right hand. The accent is still there, though she doesn't notice it anymore. In some ways, it's the least of her concerns these days: "There are some people that can't talk at all [after a stroke]. I talk, but it's different."

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