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Ojeh-Oziegbe OE. Foreign accent syndrome in a patient with posturemic encepalopathy. Ann Afr Med 2020; 19:286-288. [PMID: 33243955 PMCID: PMC8015958 DOI: 10.4103/aam.aam_59_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/06/2019] [Accepted: 03/20/2020] [Indexed: 11/25/2022] Open
Abstract
Foreign accent syndrome (FAS) is a rare, poorly understood speech disorder. It is characterized by the patient speaking their native language in a different accent foreign to both the speaker and the listener. A majority of previously reported cases have been described in patients with diagnosed organic brain damage and a handful of other psychiatric disorders. FAS was not the result of language experience in our index patient, and there is no history of the patient ever visiting the United States of America. This case is presented because it is the first-ever seen case in the environment.
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Affiliation(s)
- Odigie Enahoro Ojeh-Oziegbe
- Department of Medicine, School of Medicine, College of Medical Sciences, University of Benin, Benin City, Nigeria
- Consultant Physician, University of Benin Teaching Hospital, Benin City, Nigeria
- Consultant Physician, Yeshua Medical Centre, Benin City, Nigeria
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2
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Berthier ML, Dávila G, Torres-Prioris MJ, Moreno-Torres I, Clarimón J, Dols-Icardo O, Postigo MJ, Fernández V, Edelkraut L, Moreno-Campos L, Molina-Sánchez D, de Zaldivar PS, López-Barroso D. Developmental Dynamic Dysphasia: Are Bilateral Brain Abnormalities a Signature of Inefficient Neural Plasticity? Front Hum Neurosci 2020; 14:73. [PMID: 32265672 DOI: 10.3389/fnhum.2020.00073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 02/19/2020] [Indexed: 12/30/2022] Open
Abstract
The acquisition and evolution of speech production, discourse and communication can be negatively impacted by brain malformations. We describe, for the first time, a case of developmental dynamic dysphasia (DDD) in a right-handed adolescent boy (subject D) with cortical malformations involving language-eloquent regions (inferior frontal gyrus) in both the left and the right hemispheres. Language evaluation revealed a markedly reduced verbal output affecting phonemic and semantic fluency, phrase and sentence generation and verbal communication in everyday life. Auditory comprehension, repetition, naming, reading and spelling were relatively preserved, but executive function was impaired. Multimodal neuroimaging showed a malformed cerebral cortex with atypical configuration and placement of white matter tracts bilaterally and abnormal callosal fibers. Dichotic listening showed right hemisphere dominance for language, and functional magnetic resonance imaging (fMRI) additionally revealed dissociated hemispheric language representation with right frontal activation for phonology and bilateral dominance for semantic processing. Moreover, subject D also had congenital mirror movements (CMM), defined as involuntary movements of one side of the body that mirror intentional movements of the other side. Transcranial magnetic stimulation and fMRI during voluntary unimanual (left and right) hand movements showed bilateral motor cortex recruitment and tractography revealed a lack of decussation of bilateral corticospinal tracts. Genetic testing aimed to detect mutations that disrupt the development of commissural tracts correlating with CMM (e.g., Germline DCC mutations) was negative. Overall, our findings suggest that DDD in subject D resulted from the underdevelopment of the left inferior frontal gyrus with limited capacity for plastic reorganization by its homologous counterpart in the right hemisphere. Corpus callosum anomalies probably contributed to hinder interhemispheric connectivity necessary to compensate language and communication deficits after left frontal involvement.
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Affiliation(s)
- Marcelo L Berthier
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain
| | - Guadalupe Dávila
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain.,Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology, University of Malaga, Málaga, Spain
| | - María José Torres-Prioris
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain.,Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology, University of Malaga, Málaga, Spain
| | | | - Jordi Clarimón
- Department of Neurology and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Center for Networked Biomedical Research into Neurodegenerative Diseases, Madrid, Spain
| | - Oriol Dols-Icardo
- Department of Neurology and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Center for Networked Biomedical Research into Neurodegenerative Diseases, Madrid, Spain
| | - María J Postigo
- Neurophysiology Unit, Regional University Hospital Carlos Haya, Málaga, Spain
| | - Victoria Fernández
- Neurophysiology Unit, Regional University Hospital Carlos Haya, Málaga, Spain
| | - Lisa Edelkraut
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain.,Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology, University of Malaga, Málaga, Spain
| | - Lorena Moreno-Campos
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain
| | - Diana Molina-Sánchez
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain
| | - Paloma Solo de Zaldivar
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain
| | - Diana López-Barroso
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain.,Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology, University of Malaga, Málaga, Spain
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Argyropoulos GPD, Watkins KE, Belton-Pagnamenta E, Liégeois F, Saleem KS, Mishkin M, Vargha-Khadem F. Neocerebellar Crus I Abnormalities Associated with a Speech and Language Disorder Due to a Mutation in FOXP2. CEREBELLUM (LONDON, ENGLAND) 2019; 18:309-319. [PMID: 30460543 PMCID: PMC6517346 DOI: 10.1007/s12311-018-0989-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Bilateral volume reduction in the caudate nucleus has been established as a prominent brain abnormality associated with a FOXP2 mutation in affected members of the 'KE family', who present with developmental orofacial and verbal dyspraxia in conjunction with pervasive language deficits. Despite the gene's early and prominent expression in the cerebellum and the evidence for reciprocal cerebellum-basal ganglia connectivity, very little is known about cerebellar abnormalities in affected KE members. Using cerebellum-specific voxel-based morphometry (VBM) and volumetry, we provide converging evidence from subsets of affected KE members scanned at three time points for grey matter (GM) volume reduction bilaterally in neocerebellar lobule VIIa Crus I compared with unaffected members and unrelated controls. We also show that right Crus I volume correlates with left and total caudate nucleus volumes in affected KE members, and that right and total Crus I volumes predict the performance of affected members in non-word repetition and non-verbal orofacial praxis. Crus I also shows bilateral hypo-activation in functional MRI in the affected KE members relative to controls during non-word repetition. The association of Crus I with key aspects of the behavioural phenotype of this FOXP2 point mutation is consistent with recent evidence of cerebellar involvement in complex motor sequencing. For the first time, specific cerebello-basal ganglia loops are implicated in the execution of complex oromotor sequences needed for human speech.
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Affiliation(s)
- G P D Argyropoulos
- Cognitive Neuroscience and Neuropsychiatry Section, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - K E Watkins
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - E Belton-Pagnamenta
- Cognitive Neuroscience and Neuropsychiatry Section, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - F Liégeois
- Cognitive Neuroscience and Neuropsychiatry Section, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK
| | - K S Saleem
- Laboratory of Neuropsychology, National Institute of Mental Health, Bethesda, MD, USA
| | - M Mishkin
- Laboratory of Neuropsychology, National Institute of Mental Health, Bethesda, MD, USA
| | - F Vargha-Khadem
- Cognitive Neuroscience and Neuropsychiatry Section, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK.
- Great Ormond Street Hospital for Children National Health Foundation Trust, London, UK.
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The Posterior Fossa and Foreign Accent Syndrome: Report of Two New Cases and Review of the Literature. THE CEREBELLUM 2018; 16:772-785. [PMID: 28337694 DOI: 10.1007/s12311-017-0849-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Foreign accent syndrome is a rare motor speech disorder that causes patients to speak their language with a non-native accent. In the neurogenic condition, the disorder develops after lesions in the language dominant hemisphere, often affecting Broca's area, the insula, the supplementary motor area and the primary motor cortex. Here, we present two new cases of FAS after posterior fossa lesions. The first case is a 44-year-old, right-handed, Dutch-speaking man who suffered motor speech disturbances and a left hemiplegia after a pontine infarction. Quantified SPECT showed a bilateral hypoperfusion in the inferior lateral prefrontal and medial inferior frontal regions as well as a significant left cerebellar hypoperfusion. Further clinical investigations led to an additional diagnosis of brainstem cognitive affective syndrome which closely relates to Schmahmann's syndrome. The second patient was a 72-year-old right-handed polyglot English man who suffered a stroke in the vascular territory of the left posterior inferior cerebellar artery (PICA) and developed a foreign accent in his mother tongue (English) and in a later learnt language (Dutch). In this paper, we discuss how the occurrence of this peculiar motor speech disorder can be related to a lesion affecting the posterior fossa structures.
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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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