Functional Foreign Accent Syndrome in suspected Conversion Disorder: A case study

• S. Keulen ^[7] ; P. Mariën ^[8] ; K. van Dun ^[1] ; T. D'aes ^[2] ; L. de Pages ^[2] ; L. de Vroege ^[3] ; P. Van Schuerbeek ^[2] ; H. Raeymaekers ^[2] ; J. De Mey ^[2] ; R. Bastiaanse ^[4] ; C. van der Feltz-Cornelis ^[5] ; P. Paquier ^[9] ; F. Van Overwalle ^[2] ; J. Verhoeven ^[6]
  1. [1] University of Hasselt

     University of Hasselt

     Arrondissement Hasselt, Bélgica

     
  2. [2] Vrije Universiteit Brussel

     Vrije Universiteit Brussel

     Arrondissement Brussel-Hoofdstad, Bélgica

     
  3. [3] Tilburg University

     Tilburg University

     Países Bajos

     
  4. [4] Higher School of Economics, National Research University

     Higher School of Economics, National Research University

     Rusia

     
  5. [5] University of York

     University of York

     Reino Unido

     
  6. [6] University of London

     University of London

     Reino Unido

     
  7. [7] Centre for Linguistics (Clinical and Experimental Neurolinguistics), Vrije Universiteit Brussel, Belgium/ Center for Language and Cognition (CLCG), University of Groningen, The Netherlands
  8. [8] Centre for Linguistics (Clinical and Experimental Neurolinguistics), Vrije Universiteit Brussel, Belgium/ ZNA Middelheim General Hospital (Antwerp), Belgium
  9. [9] Centre for Linguistics (Clinical and Experimental Neurolinguistics), Vrije Univ. Brussel, Belgium/Department of Translational Neurosciences, Univ. of Antwerp, Belgium / Hôpital Erasme, Univ. Libre De Bruxelles, Belgium

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• Localización: European journal of psychiatry, ISSN 0213-6163, Vol. 35, Nº 1, 2021, págs. 46-55
• Idioma: inglés
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  • 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 In-depth analyses 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.