Cerebellar involvement in motor speech planning: some further evidence from foreign accent syndrome

Foreign accent syndrome (FAS) is a rare speech disorder that usually follows from damage to the motor speech areas of the language-dominant hemisphere. Recently, a vascular FAS patient was reported in whom a close parallelism was found between the infratentorial perfusional changes on SPECT and the regression of FAS symptoms. Based on the correlation between the near remission of a right cerebellar hypoperfusion and the near remission of FAS, it was hypothesized that the 'linguistic cerebellum' might be involved in the pathogenesis of motor speech planning disorders [Clin Neurol Neurosurg 2006;108:518-522].

In this article the presumed role of the cerebellum in FAS is further investigated on the basis of an additional FAS case.

Phonetic, neurobehavioral and neuroimaging data were analyzed and clinical-anatomical correlations were investigated.

In both patients, a close correspondence was found between the neurolinguistic findings and the functional neuroimaging data. (99m)Tc ECD SPECT follow-up studies demonstrated that clinical recovery of FAS symptoms was accompanied by a remission of a right cerebellar hypoperfusion.

The present study, in which the data of a new FAS patient are discussed, corroborates the view that FAS may follow disruption of a close functional interplay between the supra- and infratentorial motor speech centers.