Foreign Accent Syndrome: insights from Neuroimaging and Pathophysiological mechanisms

Foreign Accent Syndrome (FAS) is a rare and complex speech disorder characterized by the sudden emergence of a foreign accent, typically following neurological events such as strokes, traumatic brain injuries, or neurodegenerative diseases. This comprehensive review explores the pathophysiology, neuroimaging findings, and prevalence of FAS. Neuroimaging studies, including MRI and fMRI, reveal significant brain reorganization predominantly in the left hemisphere, involving regions such as the superior temporal gyrus and medial frontal structures. Functional connectivity disruptions and the phenomenon of dynamic diaschisis are discussed as potential mechanisms. Additionally, the review addresses the psychogenic aspects of FAS, highlighting the role of psychological factors and functional neurological disorders. The high comorbidity of FAS with other conditions underscores the need for a multidisciplinary diagnostic and therapeutic approach. This paper aims to enhance the understanding of FAS and contribute to the development of effective treatment strategies for this unique speech disorder.