Some patients who suffer brain injuries occasionally lose the ability to talk in their native accent - but now scientists may know why.

The condition, called "foreign accent syndrome", affects only a tiny number of patients. about 25 in the USA It can mean that a native English speaker can end up sounding more like Spanish or French.

It can follow a stroke - or another kind of head injury, and while the problem often clears up on its own, it can be another highly upsetting blow for patients often struggling with other disabilities.

To add insult to injury, some doctors dismissed the problem as more likely to be psychiatric in origin than physical.

Now researchers at Oxford University have found that patients with "foreign accent syndrome" seem to share certain characteristics which might explain the problem.

A small number of them all had tiny areas of damage in various parts of the brain.

This might explain the combination of subtle changes to vocal features such as lengthening of syllables, altered pitch or mispronounced sounds which make a patient's pronunciation sound similar to a foreign accent.

Trauma

Dr Jennfier Gurd, who led the research with phonetician Dr John Coleman, said: "The way we speak is an important part of our personality and influences the way people interact with us.

"It is understandably quite traumatic for patients to find that their accent has changed.

"Patients derive some comfort from knowing more about the causes of their rare condition and many are happy to help scientists to understand better the nature of the brain and its role in human accents."

Dr Coleman told BBC News Online: "There is a good likelihood in time you are going to improve and become more like you used to be."

A part of me had died during the stroke   Tiffany Roberts   watch news report   Tiffany Roberts suffered a stroke four years ago Stroke gives woman British accent An American woman has been left with a British accent after having a stroke. This is despite the fact that Tiffany Roberts, 61, has never been to Britain. Her accent is a mixture of English cockney and West Country. Doctors say Mrs Roberts, who was born and bred in Indiana, has a condition called foreign accent syndrome. This rare condition occurs when part of the brain becomes damaged. This can follow a stroke or head injury. There have only been a few documented cases. A part of me had died during the stroke   Tiffany Roberts   watch British accent Mrs Roberts discovered she had a British accent after recovering her voice following a stroke in 1999. "When people first started asking me where in England I was from and a family member asked why am I talking that way, that is when I became very conscious that a part of me had died during the stroke," she said. h nes report Four years on, she still struggles to convince people that she is a born and bred American. "People in America accuse me of lying when I say I was born in Indiana. "They would say 'What are you saying that for? Where in England are you from?' "I would insist that I am not." A tape recording of her voice before the stroke shows Mrs Roberts used to speak with a broad and relatively deep accent. She now speaks in a much higher pitch. Doctors are still trying to find out exactly why foreign accent syndrome occurs. But Dr Jack Ryalls of the University of Central Florida, said it is a real medical condition, which can occur after a patient has a brain injury. "They recover to various degrees. When they don't recover or when they only have very, very residual effects left its heard as an accent. Its a real phenomenon. It just hasn't been documented very often." Scientists at Oxford University are among those trying to get to the bottom of the syndrome. Last year, they confirmed that patients can develop a foreign accent without ever having been exposed to the accent. This is because they haven't really picked up the accent. Their speech patterns have changed. Injury to their brain causes them to lengthen syllables, alter their pitch or mispronounce sounds. These changes make it sound like they have picked up an accent. They may lengthen syllables. The first case of foreign accent syndrome was reported in 1941 in Norway, after a young Norwegian woman suffered shrapnel injury to the brain during an air raid. Initially, she had severe language problems from which she eventually recovered. However, she was left with what sounded like a strong German accent and was ostracized by her community. A part of me had died during the stroke Tiffany Roberts

University Of Central Florida Clinic Diagnoses Rare Foreign Accent Syndrome

ORLANDO -- A University of Central Florida speech expert has diagnosed an extremely rare disorder in a Sarasota woman that caused her to speak with a British accent after she suffered a stroke.

The case of Foreign Accent Syndrome -- a disorder linked to stroke-related or other internal brain injuries that leaves affected people with a foreign-sounding accent -- is one of fewer than 20 reported worldwide since 1919, according to Jack Ryalls, professor of communicative disorders at UCF.

In November 1999, 57-year-old Judi Roberts of Sarasota suffered a stroke that left the right side of her body paralyzed. She was also unable to speak. After months of physical therapy, she was no longer paralyzed and was able to speak with some difficulty. Her speech gradually improved during the next year until she was speaking with the same fluency as she had before the stroke. However, instead of the familiar New York accent she once had, she spoke with a British accent.

Roberts had never traveled to Britain. She didn't recognize her own voice. Her friends and family didn't understand it, and strangers constantly asked her where she was from. One doctor told her she was not working hard enough to get her old voice back.

"At times I thought I was losing my mind," Roberts said. "Without the support of my internist and therapist, I wouldn't have been able to cope."

This year, four years after her stroke, she received an e-mail from a friend who found a New York Times article about research on language problems conducted by Jennifer Gurd, a professor at Oxford University in England. "When I read the article I realized there was a chance I had a legitimate medical problem," Roberts recalled, "and that it had a name -- Foreign Accent Syndrome."

Roberts contacted Gurd, who referred her to UCF's Ryalls, an expert on neurologically based speech and language disorders who had previously studied the syndrome.

Ryalls invited Roberts to UCF and conducted several language tests designed especially for her. He checked her ability to change word stress patterns and accentuation by having her pronounce sentences like, "I wanted to record the record onto a cassette tape." He also had her repeat words stressing the wrong syllable in sentences like, "Put the emPHAsis on the wrong sylLABle."

The tests enabled Ryalls to analyze Roberts's speech prosody, or the ability to use the appropriate syllable emphasis, and accentuation, which differs in British and American English. He wanted to determine if she was applying the wrong syllable stress as part of her accent.

After Ryalls' initial exams, Janet Whiteside, an adult neurological disorder specialist at UCF, conducted other standardized tests for language and cognitive functions in the university's Communicative Disorders Clinic.

Based on the test results, Ryalls diagnosed Roberts's mysterious acquisition of a British accent as Foreign Accent Syndrome. He has submitted a report of her case for publication in a professional journal.

The first widely known case of Foreign Accent Syndrome reported in English was in 1941, when a Norwegian woman suffered a brain injury after shrapnel hit her head during World War II. She experienced severe language problems but eventually recovered, speaking with a perceived German accent. Her community later ostracized her.

Ryalls said his research on this and other cases, including Roberts's, suggests the syndrome is associated with damage to the left hemisphere of the brain, where language processing occurs.

Ryalls said Roberts developed unique ways to cope with her new voice. "She began to respond to people's constant questions about where in England she was from by asking, 'Where do you think I'm from?'" Regardless of the city named, Roberts would say the person was right.

"In some ways, her response showed she was beginning to accept the accent," Ryalls said. "It was an ingenious coping mechanism, but it also reveals that she had begun to resign herself to the change in her speech."

Although she started to cope with her accent, she avoided most social contact and eventually developed agoraphobia, a fear of open spaces. "She suffered greatly from some particularly unsympathetic people who did not understand her changed voice," Ryalls said.

Roberts said she wants people to know about this strange syndrome that can result from a stroke and hopes she can spare others the same alienation and misunderstanding she suffered.

"If I can bring notice to this condition, especially within the medical community, doctors may be able to help others who find themselves in my situation," Roberts said.

About the Clinic

The UCF Communicative Disorders Clinic offers a variety of low-cost rehabilitation and testing services to adult clients with impaired speech or language abilities due to a stroke, traumatic brain injury or degenerative diseases like Alzheimer's and Lou Gehrig's. It also helps children with special needs in communication, language and literacy. The clinic serves more than 400 people a year. For further information about the clinic, call 407-249-4770