The foreign accent syndrome: A perspective

Abstract

Although there are now a fair number of reported case studies of the foreign accent syndrome, there is little consensus about it. We provide a perspective on the foreign accent syndrome focusing on three areas for which there is as yet disagreement in the literature. These include whether the foreign accent syndrome is indeed a syndrome in its own right, whether the features of the disorder can be explicated in terms of a single underlying mechanism, and whether there is a common neural substrate that gives rise to this disorder. Based on a review of the literature and our own work, we propose that the foreign accent syndrome is properly considered a syndrome and that it is distinct in both its characteristics and underlying mechanism from an apraxia of speech, a dysarthria, and an aphasic speech output disorder. We hypothesize that a deficit in linguistic prosody underlies the foreign accent syndrome. And finally, we argue that the foreign accent syndrome emerges as a consequence of damage to the dominant language (usually left hemisphere) speech output motor system affecting the primary motor cortex and either its cortico-cortical connections or its cortico-subcortical projections.