Complications: After a Stroke, a New Accent

By JOHN O'NEIL

ome stroke or accident victims lose the ability to produce speech; others, their ability to understand it. But in an extremely small group, the brain injuries produce a shift in pronunciation known as foreign accent syndrome.

Researchers at Oxford believe they have zeroed in on the brain region involved in the syndrome, which causes patients' accents to shift suddenly.

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The first known case was reported in 1941, involving a Norwegian woman who was ostracized when she developed what her neighbors thought was a German accent after she recovered from shrapnel injuries.

But foreign accent syndrome does not mean that patients actually speak with foreign accents, according to one of the researchers, Dr. Jennifer Gurd.

"It's all in the ear of the beholder," Dr. Gurd said, meaning that the changes in the components of accent — pacing, rhythm, intonation and stress — shift in random ways. Listeners tend to interpret the change based on the language they think it most resembles.

She cited Annie, a patient who works as a BBC producer in London. After a stroke, she spoke with what her friends and physicians thought of as a Scottish accent. But when journalists at BBC Scotland heard tapes of Annie speaking, they had a very different reaction.

"They all said, `She doesn't sound Scottish to us!' " said Dr. Gurd. (Audiotapes showing the shift in speech can be found at www.nytimes.com/health)

Most patients with the syndrome can be helped with speech therapy and are back to normal within two years, Dr. Gurd said.