Johan Verhoeven, City, University of London and Stefanie Keulen, Vrije Universiteit Brussel

An American man developed an Irish accent following treatment for metastatic prostate cancer. The man was in his 50s and had never been to Ireland.

The accent was described as “uncontrolled”, meaning the man couldn’t stop talking with an Irish brogue, even if he tried. He continued speaking this way until his death.

This is the first time a person has developed “foreign accent syndrome” linked to a prostate cancer diagnosis. And it is only the third case of foreign accent syndrome linked to cancer – the others were breast cancer and brain cancer.

Foreign accent syndrome usually happens as a result of brain damage, such as from a stroke. Stroke can cause different types of speech and language disorders, but foreign accent syndrome is one of the more unusual ones.

Other causes of the syndrome are changes to the structure of the brain, such as cancer tumours, encephalitis (brain swelling), multiple sclerosis and neurodegenerative disorders such as dementia.

The condition was first described by Pierre Marie, a French neurologist, in 1907. Marie described the case of a man who originally spoke French with a Parisian accent, but after a stroke, he started speaking with a regional French accent from the area of Strasbourg in France.

To date, around 200 cases of foreign accent syndrome have been reported in clinical studies, making it quite a rare speech disorder. Perhaps the best-known case is when George Michael briefly spoke with a West Country accent when he came out of a coma following a bout of pneumonia in 2011. The singer is from North London.

The condition can be distressing for patients because they lose an important personality characteristic that is expressed by their accent. The impact of this illness was reported in 1947 by the Norwegian neurologist Monrad-Krohn: he described a Norwegian lady who had suffered a serious head injury in a bombing raid during the second world war. As a result of this damage, she spoke Norwegian with a German foreign accent, and this was quite problematic in postwar Norway.

She was often refused service in shops because people thought she was German. Being identified as a foreigner all the time and being questioned about it can be very distressing. The effect may be so serious that some patients apply unusual methods to find peace of mind. We have heard of a lady with the syndrome saying that she enjoyed staying in hotels because it is very natural to hear a foreign accent in a hotel environment, so it goes unnoticed.

Psychological causes

Apart from damage to the central nervous system, foreign accent syndrome can also be caused by psychological factors such as extreme stress. We have identified “psychogenic foreign accent syndrome” as a separate type of foreign accent syndrome. In 2005, researchers were contacted by a native Dutch speaker who had a heavy and persistent French accent after suffering intense stress as a result of almost being hit by a car. Detailed neurological investigations did not reveal any brain abnormalities, but psychological tests identified important psychological issues. She only fully returned to her original Dutch accent after ten years.

Another version of this condition is “mixed foreign accent syndrome”. These patients first develop a foreign accent because of brain damage and then try to change their word use to create a more convincing “foreign” personality. This was noticed by researchers at the University of Central Florida who saw an American patient who developed a British accent following a stroke and who started using British English words like lift (instead of elevator) and mum (instead of mom).

The patient explained that it was easier for her to allow people to believe that she was from England, rather than trying to explain that her accent was the result of a stroke. Although she insisted that her use of “Briticisms” was not under her conscious control.

Full recovery from the accent change is difficult and often requires intensive speech therapy for a long time. But there have been cases of fairly quick recovery.

Johan Verhoeven, Professor of Experimental Phonetics, City, University of London and Stefanie Keulen, Assistant Professor/Research Leader, Vrije Universiteit Brussel

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