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Functional Foreign Accent Syndrome in suspected Conversion Disorder: A case study
Abstract: Background and objectives: We provide a case analysis for a 28-year-old, native Dutch-speaking lady who developed Foreign Accent Syndrome (FAS), a few weeks after falling down the staircase. In addition to FAS, which gave the impression she spoke with a German accent, German(-like) words and structures occurred. Speech symptoms were aggravated by increased stress, fatigue or emotional pressure, and this triggered jargon speech. It was hypothesized her FAS and jargon developed on a functional basis. Methods: An in-depth analysis of the patient's medical background, neuropsychological and neurolinguistic tests and psychodiagnostic exams were done. The patient participated in an fMRI experiment. In a syllable repetition paradigm, motor speech activations were compared to those of healthy individuals, to see whether they were altered, which would be expected in case of a neurological etiology. Results: Medical history disclosed prior traumatic experiences for which she sought help, but no neurological incidents. Repeated neuropsychological and neurolinguistic tests showed deficits in recent memory and executive functioning. The patient demonstrated great difficulties with picture naming. Clinically, language switching and mixing as well as recurring jargon speech was found. Formal psychodiagnostic tests did not identify a clear disorder, but psychodiagnostic interviews were consistent with a DSM-5 conversion disorder. The fMRI study demonstrated that speech network activations corresponded to those found in healthy participants. Conclusion: The clinical neurolinguistic characteristics, outcome of the fMRI experiment, together with the clinical psychodiagnostic findings were strongly indicative for an underlying functional etiology for the FAS and jargon speech, presenting as symptoms of conversion disorder.
Keyword: BF Psychology; P Language and Literature; QP Physiology; RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
URL: https://doi.org/10.1016/j.ejpsy.2020.08.002
https://openaccess.city.ac.uk/id/eprint/25402/3/FINAL%20Revision%20Final%20Adapted%20Manuscript%20Keulen%20et%20al.pdf
https://openaccess.city.ac.uk/id/eprint/25402/
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2
Asymmetries in speech articulation as reflected on palatograms: a meta-study
Verhoeven, J.; Marien, P.; De Clerck, I.. - : Australasian Speech Science and Technology Association Inc., 2019
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3
Neurological aspects of foreign accent syndrome in stroke patients
Marien, P.; Keulen, S.; Verhoeven, J.. - : Elsevier, 2019
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4
Language and the cerebellum
Mariën, P.; Borgatti, R. (orcid:0000-0001-8165-4994). - 2018
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5
Cerebellar induced differential polyglot aphasia: a neurolinguistic and fMRI study
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6
Apraxia of speech and cerebellar mutism syndrome: a case study
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7
Oral and written picture description in individuals with aphasia
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8
Psychogenic Foreign Accent Syndrome: A New Case
Keulen, S.; Bastiaanse, R.; Marien, P.. - : FRONTIERS MEDIA SA, 2016
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9
Developmental Foreign Accent Syndrome: report of a new case
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10
Perceptual accent rating and attribution in psychogenic FAS: some further evidence challenging Whitaker's operational definition
Keulen, S.; Verhoeven, J.; Bastiaanse, R.. - : Frontiers, 2016
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11
Cerebellum and Apraxia
Marien, P.; van Dun, K.; Verhoeven, J.. - : Springer New York LLC, 2015
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12
Foreign accent syndrome: A typological overview
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13
Cerebellum and apraxia
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14
Accent attribution in speakers with Foreign Accent Syndrome
Verhoeven, J.; De Pauw, G.; Pettinato, M.. - : Elsevier, 2013
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15
Mastication Dyspraxia: A Neurodevelopmental Disorder Reflecting Disruption of the Cerebellocerebral Network Involved in Planned Actions
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16
Grammar disruption in a patient with Neuro-Sweet syndrome
Marien, P.; Tops, W.; Crols, R.. - : Taylor & Francis, 2012
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17
Neurogenic foreign accent syndrome: Articulatory setting, segments and prosody in a Dutch speaker
Marien, P.; Verhoeven, J.. - : Elsevier, 2010
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18
Developmental Coordination Disorder: Disruption of the Cerebello-Cerebral Network evidenced by SPECT
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19
Foreign accent syndrome as a developmental motor speech disorder
Marien, P.; Wackenier, P.; Engelborghs, S.. - : Elsevier, 2009
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20
A foreign speech accent in a case of conversion disorder
Engelborghs, S.; Marien, P.; D'Haenen, H.. - : IOS Press, 2005
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