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Demichelis G, Duran D, Ciullo G, Lorusso L, Zago S, Palermo S, Nigri A, Leonardi M, Bruzzone MG, Fedeli D. A multimodal imaging approach to foreign accent syndrome. A case report. Neurocase 2022; 28:467-476. [PMID: 36682057 DOI: 10.1080/13554794.2023.2168558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
This article describes a case of Foreign accent syndrome (FAS) in an Italian woman who developed a Canadian-like foreign accent without brain damage (functional FAS). The patient underwent an in-depth neuroimaging and (neuro)psychological evaluation. Language networks in the frontotemporal-parietal areas were typically activated bilaterally through fMRI and MEG assessments based on task-based data. Resting-state fMRI showed preserved connectivity between language areas. An obsessive-compulsive personality profile and mild anxiety were found, suggesting psychological and psychiatric factors may be relevant. Accordingly with our findings, multimodal imaging is beneficial to understand FAS neurological and functional etiologies.
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Affiliation(s)
- Greta Demichelis
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Dunja Duran
- Clinical Epileptology and Experimental Neurophysiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Giuseppe Ciullo
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Lorenzo Lorusso
- Neuroscience Department, Neurology and Stroke Unit, A.S.S.T Lecco, Merate, Italy
| | - Stefano Zago
- U.O.C. Di Neurologia, IRCCS Fondazione Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Sara Palermo
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.,Dipartimento di Psicologia, Università degli Studi di Torino, Torino, Italy
| | - Anna Nigri
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Matilde Leonardi
- Department of Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Maria Grazia Bruzzone
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Davide Fedeli
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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Estrada-Orozco K, Bonilla-Vargas K, Alfonso C, Riaño F, Montañés P, Pardo R. Beyond prosody: Foreign accent syndrome in a Spanish-speaking patient. Case report. CASE REPORTS 2019. [DOI: 10.15446/cr.v5n1.75740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: Foreign accent syndrome (FAS) is a rare speech disorder. It is becoming increasingly common to find reports of cases about alterations different from the suprasegmental aspects of speech, although these reports are not frequent in Spanish-speaking patients.Case presentation: 48-year-old female patient from Colombia diagnosed with FAS, segmental and suprasegmental speech alterations, and changes in cognitive domains (executive functions and language). The woman also presented with motor and affective changes. Brain imaging studies ruled out structural involvement and follow-up at one year did not show significant changes in speech.Discussion: This case presents the neurological, neuropsychological and speech features of a Spanish-speaking patient with FAS. Greater alteration in vowels than in consonants, alteration in pronunciation time, variation in rhythm and intonation of words and phrases, decrease of time between syllables, and insertion of vowels are common elements between this patient and other cases of FAS in non-Spanish speaking subjects.Conclusions: FAS is essentially a speech alteration; however, it can be accompanied by other physical and psychological signs. This case report allows recognizing the essential components for the definition, diagnosis and intervention of this syndrome.
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Mariën P, Keulen S, Verhoeven J. Neurological Aspects of Foreign Accent Syndrome in Stroke Patients. JOURNAL OF COMMUNICATION DISORDERS 2019; 77:94-113. [PMID: 30606457 DOI: 10.1016/j.jcomdis.2018.12.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 11/28/2018] [Accepted: 12/17/2018] [Indexed: 06/09/2023]
Abstract
Foreign Accent Syndrome (FAS) is an intriguing motor speech disorder which has captured the interest of the scientific community and media for decades. At the moment, there is no comprehensive model which can account for the pathophysiology of this disorder. This paper presents a review of 112 FAS cases published between 1907 and October 2016: these were analyzed with respect to demographic characteristics, lesion location, associated neurocognitive symptoms, and comorbid speech and language disorders. The analysis revealed that organic-neurogenic FAS is more frequent in women than in men. In organic-neurogenic FAS over half of the patients acquired the foreign accent after a stroke. Their lesions are typically located in the left supratentorial regions of the brain, and generally involve the primary motor cortex and premotor cortex (BA 4 and 6), and/or the basal ganglia. Although neurocognitive data are not consistently reported, vascular FAS patients regularly suffer frontal executive dysfunctions. On the basis of a careful comparison of the cognitive and theoretical accounts of FAS, AoS and ataxic dysarthria, it is concluded that FAS should be regarded a dual component motor speech disorder in which both planning and motor execution of speech may be affected.
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Affiliation(s)
- Peter Mariën
- Clinical and Experimental Neurolinguistics, CLIN, Vrije Universiteit Brussel, Pleinlaan 2, B-1050, Brussels, Belgium; Department of Neurology and Memory Clinic, ZNA Middelheim Hospital, Antwerp, Belgium; Royal Flemish Academy of Belgium for Science and the Arts, Paleis der Academiën, Hertogsstraat 1, B-1000, Brussel, Belgium
| | - Stefanie Keulen
- Clinical and Experimental Neurolinguistics, CLIN, Vrije Universiteit Brussel, Pleinlaan 2, B-1050, Brussels, Belgium
| | - Jo Verhoeven
- Royal Flemish Academy of Belgium for Science and the Arts, Paleis der Academiën, Hertogsstraat 1, B-1000, Brussel, Belgium; Division of Language and Communication Science, City, University of London, Northampton Square, London, EC1V 0HB, UK; Computational Linguistics and Psycholinguistics Research Centre, University of Antwerp, Prinsstraat 13, B-2000, Antwerp, Belgium.
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Gopinath K, Krishnamurthy V, Lacey S, Sathian K. Accounting for Non-Gaussian Sources of Spatial Correlation in Parametric Functional Magnetic Resonance Imaging Paradigms II: A Method to Obtain First-Level Analysis Residuals with Uniform and Gaussian Spatial Autocorrelation Function and Independent and Identically Distributed Time-Series. Brain Connect 2018; 8:10-21. [PMID: 29161884 DOI: 10.1089/brain.2017.0522] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In a recent study Eklund et al. have shown that cluster-wise family-wise error (FWE) rate-corrected inferences made in parametric statistical method-based functional magnetic resonance imaging (fMRI) studies over the past couple of decades may have been invalid, particularly for cluster defining thresholds less stringent than p < 0.001; principally because the spatial autocorrelation functions (sACFs) of fMRI data had been modeled incorrectly to follow a Gaussian form, whereas empirical data suggest otherwise. Hence, the residuals from general linear model (GLM)-based fMRI activation estimates in these studies may not have possessed a homogenously Gaussian sACF. Here we propose a method based on the assumption that heterogeneity and non-Gaussianity of the sACF of the first-level GLM analysis residuals, as well as temporal autocorrelations in the first-level voxel residual time-series, are caused by unmodeled MRI signal from neuronal and physiological processes as well as motion and other artifacts, which can be approximated by appropriate decompositions of the first-level residuals with principal component analysis (PCA), and removed. We show that application of this method yields GLM residuals with significantly reduced spatial correlation, nearly Gaussian sACF and uniform spatial smoothness across the brain, thereby allowing valid cluster-based FWE-corrected inferences based on assumption of Gaussian spatial noise. We further show that application of this method renders the voxel time-series of first-level GLM residuals independent, and identically distributed across time (which is a necessary condition for appropriate voxel-level GLM inference), without having to fit ad hoc stochastic colored noise models. Furthermore, the detection power of individual subject brain activation analysis is enhanced. This method will be especially useful for case studies, which rely on first-level GLM analysis inferences.
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Affiliation(s)
- Kaundinya Gopinath
- 1 Department of Radiology and Imaging Sciences, Emory University , Atlanta, Georgia
| | | | - Simon Lacey
- 2 Department of Neurology, Emory University , Atlanta, Georgia
| | - K Sathian
- 2 Department of Neurology, Emory University , Atlanta, Georgia .,3 Department of Rehabilitation Medicine, Emory University , Atlanta, Georgia .,4 Department of Psychology, Emory University , Atlanta, Georgia .,5 Rehabilitation R&D Center for Visual and Neurocognitive Rehabilitation , Atlanta VAMC, Decatur, Georgia
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Berthier ML, Roé-Vellvé N, Moreno-Torres I, Falcon C, Thurnhofer-Hemsi K, Paredes-Pacheco J, Torres-Prioris MJ, De-Torres I, Alfaro F, Gutiérrez-Cardo AL, Baquero M, Ruiz-Cruces R, Dávila G. Mild Developmental Foreign Accent Syndrome and Psychiatric Comorbidity: Altered White Matter Integrity in Speech and Emotion Regulation Networks. Front Hum Neurosci 2016; 10:399. [PMID: 27555813 PMCID: PMC4977429 DOI: 10.3389/fnhum.2016.00399] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 07/26/2016] [Indexed: 11/13/2022] Open
Abstract
Foreign accent syndrome (FAS) is a speech disorder that is defined by the emergence of a peculiar manner of articulation and intonation which is perceived as foreign. In most cases of acquired FAS (AFAS) the new accent is secondary to small focal lesions involving components of the bilaterally distributed neural network for speech production. In the past few years FAS has also been described in different psychiatric conditions (conversion disorder, bipolar disorder, and schizophrenia) as well as in developmental disorders (specific language impairment, apraxia of speech). In the present study, two adult males, one with atypical phonetic production and the other one with cluttering, reported having developmental FAS (DFAS) since their adolescence. Perceptual analysis by naïve judges could not confirm the presence of foreign accent, possibly due to the mildness of the speech disorder. However, detailed linguistic analysis provided evidence of prosodic and segmental errors previously reported in AFAS cases. Cognitive testing showed reduced communication in activities of daily living and mild deficits related to psychiatric disorders. Psychiatric evaluation revealed long-lasting internalizing disorders (neuroticism, anxiety, obsessive-compulsive disorder, social phobia, depression, alexithymia, hopelessness, and apathy) in both subjects. Diffusion tensor imaging (DTI) data from each subject with DFAS were compared with data from a group of 21 age- and gender-matched healthy control subjects. Diffusion parameters (MD, AD, and RD) in predefined regions of interest showed changes of white matter microstructure in regions previously related with AFAS and psychiatric disorders. In conclusion, the present findings militate against the possibility that these two subjects have FAS of psychogenic origin. Rather, our findings provide evidence that mild DFAS occurring in the context of subtle, yet persistent, developmental speech disorders may be associated with structural brain anomalies. We suggest that the simultaneous involvement of speech and emotion regulation networks might result from disrupted neural organization during development, or compensatory or maladaptive plasticity. Future studies are required to examine whether the interplay between biological trait-like diathesis (shyness, neuroticism) and the stressful experience of living with mild DFAS lead to the development of internalizing psychiatric disorders.
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Affiliation(s)
- Marcelo L Berthier
- Cognitive Neurology and Aphasia Unit and Cathedra ARPA of Aphasia, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga Malaga, Spain
| | - Núria Roé-Vellvé
- Molecular Imaging Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga Malaga, Spain
| | | | - Carles Falcon
- Barcelonabeta Brain Research Center, Pasqual Maragall Foundation Barcelona, Spain
| | - Karl Thurnhofer-Hemsi
- Molecular Imaging Unit, Centro de Investigaciones Médico-Sanitarias, University of MalagaMalaga, Spain; Department of Applied Mathematics, Superior Technical School of Engineering in Informatics, University of MalagaMalaga, Spain
| | - José Paredes-Pacheco
- Molecular Imaging Unit, Centro de Investigaciones Médico-Sanitarias, University of MalagaMalaga, Spain; Department of Applied Mathematics, Superior Technical School of Engineering in Informatics, University of MalagaMalaga, Spain
| | - María J Torres-Prioris
- Cognitive Neurology and Aphasia Unit and Cathedra ARPA of Aphasia, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of MalagaMalaga, Spain; Department of Psychobiology and Methodology of Behavioural Sciences, Faculty of Psychology, University of MalagaMalaga, Spain
| | - Irene De-Torres
- Cognitive Neurology and Aphasia Unit and Cathedra ARPA of Aphasia, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of MalagaMalaga, Spain; Unit of Physical Medicine and Rehabilitation, Regional University Hospital, MalagaMalaga, Spain
| | - Francisco Alfaro
- Molecular Imaging Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga Malaga, Spain
| | - Antonio L Gutiérrez-Cardo
- Molecular Imaging Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga Malaga, Spain
| | - Miquel Baquero
- Service of Neurology, Hospital Universitari i Politècnic La Fe Valencia, Spain
| | - Rafael Ruiz-Cruces
- Cognitive Neurology and Aphasia Unit and Cathedra ARPA of Aphasia, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga Malaga, Spain
| | - Guadalupe Dávila
- Cognitive Neurology and Aphasia Unit and Cathedra ARPA of Aphasia, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of MalagaMalaga, Spain; Department of Psychobiology and Methodology of Behavioural Sciences, Faculty of Psychology, University of MalagaMalaga, Spain
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Berthier ML, Dávila G, Moreno-Torres I, Beltrán-Corbellini Á, Santana-Moreno D, Roé-Vellvé N, Thurnhofer-Hemsi K, Torres-Prioris MJ, Massone MI, Ruiz-Cruces R. Loss of regional accent after damage to the speech production network. Front Hum Neurosci 2015; 9:610. [PMID: 26594161 PMCID: PMC4633569 DOI: 10.3389/fnhum.2015.00610] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 10/23/2015] [Indexed: 11/18/2022] Open
Abstract
Lesion-symptom mapping studies reveal that selective damage to one or more components of the speech production network can be associated with foreign accent syndrome, changes in regional accent (e.g., from Parisian accent to Alsatian accent), stronger regional accent, or re-emergence of a previously learned and dormant regional accent. Here, we report loss of regional accent after rapidly regressive Broca's aphasia in three Argentinean patients who had suffered unilateral or bilateral focal lesions in components of the speech production network. All patients were monolingual speakers with three different native Spanish accents (Cordobés or central, Guaranítico or northeast, and Bonaerense). Samples of speech production from the patient with native Córdoba accent were compared with previous recordings of his voice, whereas data from the patient with native Guaranítico accent were compared with speech samples from one healthy control matched for age, gender, and native accent. Speech samples from the patient with native Buenos Aires's accent were compared with data obtained from four healthy control subjects with the same accent. Analysis of speech production revealed discrete slowing in speech rate, inappropriate long pauses, and monotonous intonation. Phonemic production remained similar to those of healthy Spanish speakers, but phonetic variants peculiar to each accent (e.g., intervocalic aspiration of /s/ in Córdoba accent) were absent. While basic normal prosodic features of Spanish prosody were preserved, features intrinsic to melody of certain geographical areas (e.g., rising end F0 excursion in declarative sentences intoned with Córdoba accent) were absent. All patients were also unable to produce sentences with different emotional prosody. Brain imaging disclosed focal left hemisphere lesions involving the middle part of the motor cortex, the post-central cortex, the posterior inferior and/or middle frontal cortices, insula, anterior putamen and supplementary motor area. Our findings suggest that lesions affecting the middle part of the left motor cortex and other components of the speech production network disrupt neural processes involved in the production of regional accent features.
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Affiliation(s)
- Marcelo L. Berthier
- Cognitive Neurology and Aphasia Unit and Cathedra Foundation Morera and Vallejo of Aphasia, Centro de Investigaciones Médico-Sanitarias, University of MalagaMalaga, Spain
| | - Guadalupe Dávila
- Cognitive Neurology and Aphasia Unit and Cathedra Foundation Morera and Vallejo of Aphasia, Centro de Investigaciones Médico-Sanitarias, University of MalagaMalaga, Spain
- Department of Psychobiology and Methodology of Behavioural Sciences, Faculty of Psychology, University of MalagaMalaga, Spain
| | - Ignacio Moreno-Torres
- Cognitive Neurology and Aphasia Unit and Cathedra Foundation Morera and Vallejo of Aphasia, Centro de Investigaciones Médico-Sanitarias, University of MalagaMalaga, Spain
- Department of Spanish Language I, University of MalagaMalaga, Spain
| | - Álvaro Beltrán-Corbellini
- Cognitive Neurology and Aphasia Unit and Cathedra Foundation Morera and Vallejo of Aphasia, Centro de Investigaciones Médico-Sanitarias, University of MalagaMalaga, Spain
| | - Daniel Santana-Moreno
- Cognitive Neurology and Aphasia Unit and Cathedra Foundation Morera and Vallejo of Aphasia, Centro de Investigaciones Médico-Sanitarias, University of MalagaMalaga, Spain
| | - Núria Roé-Vellvé
- Molecular Imaging Unit, Centro de Investigaciones Médico-Sanitarias, General Foundation of the University of MalagaMalaga, Spain
| | - Karl Thurnhofer-Hemsi
- Molecular Imaging Unit, Centro de Investigaciones Médico-Sanitarias, General Foundation of the University of MalagaMalaga, Spain
- Department of Applied Mathematics, Superior Technical School of Engineering in Informatics, University of MalagaMalaga, Spain
| | - María José Torres-Prioris
- Cognitive Neurology and Aphasia Unit and Cathedra Foundation Morera and Vallejo of Aphasia, Centro de Investigaciones Médico-Sanitarias, University of MalagaMalaga, Spain
| | - María Ignacia Massone
- Centro de Investigaciones en Antropología Filosófica y Cultural, Consejo Nacional de Investigaciones Científicas y TécnicasBuenos Aires, Argentina
| | - Rafael Ruiz-Cruces
- Cognitive Neurology and Aphasia Unit and Cathedra Foundation Morera and Vallejo of Aphasia, Centro de Investigaciones Médico-Sanitarias, University of MalagaMalaga, Spain
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Ghazi-Saidi L, Dash T, Ansaldo AI. How native-like can you possibly get: fMRI evidence for processing accent. Front Hum Neurosci 2015; 9:587. [PMID: 26578931 PMCID: PMC4626569 DOI: 10.3389/fnhum.2015.00587] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Accepted: 10/09/2015] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION If ever attained, adopting native-like accent is achieved late in the learning process. Resemblance between L2 and mother tongue can facilitate L2 learning. In particular, cognates (phonologically and semantically similar words across languages), offer the opportunity to examine the issue of foreign accent in quite a unique manner. METHODS Twelve Spanish speaking (L1) adults learnt French (L2) cognates and practiced their native-like pronunciation by means of a computerized method. After consolidation, they were tested on L1 and L2 oral picture- naming during fMRI scanning. RESULTS AND DISCUSSION The results of the present study show that there is a specific impact of accent on brain activation, even if L2 words are cognates, and belong to a pair of closely related languages. Results point that the insula is a key component of accent processing, which is in line with reports from patients with foreign accent syndrome following damage to the insula (e.g., Katz et al., 2012; Moreno-Torres et al., 2013; Tomasino et al., 2013), and healthy L2 learners (Chee et al., 2004). Thus, the left insula has been consistently related to the integration of attentional and working memory abilities, together with fine-tuning of motor programming to achieve optimal articulation.
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Affiliation(s)
- Ladan Ghazi-Saidi
- Centre de Recherche de I’Institut Universitaire de Gériatrie de Montréal, University of MontrealMontreal, QC, Canada
| | - Tanya Dash
- Centre de Recherche de I’Institut Universitaire de Gériatrie de Montréal, University of MontrealMontreal, QC, Canada
| | - Ana I. Ansaldo
- Centre de Recherche de I’Institut Universitaire de Gériatrie de Montréal, University of MontrealMontreal, QC, Canada
- Faculté de Médecine, Université de MontréalMontreal, QC, Canada
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