PARADOXICAL FACILITATION: THE RESOLUTION OF FOREIGN ACCENT SYNDROME AFTER CEREBELLAR STROKE
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Bibliographic record
Abstract
Foreign accent syndrome (FAS) is a rare speech disorder characterized by a change in prosody and other speech variables yielding altered phonetic characteristics that are perceived as a foreign accent. Lesions associated with FAS typically involve left frontoparietal regions. However, 2 reported left-hemispheric stroke patients presenting with FAS also had hypoperfusion of the right cerebellum on 99mTc ECD SPECT imaging, presumably from diaschisis. In both cases, there was a close parallel between the normalization of the cerebellar perfusion and resolution of the clinical syndrome up to 3 years later despite continued hypoperfusion of left hemispheric structures.1,2 The authors argued that the temporal association between the clinical improvement and the right cerebellar perfusion suggested a functional role of the cerebellum in this speech disorder. We describe a unique case that provides convergent evidence for a causative role of the cerebellum in FAS. ### Case report. A right-handed English-speaking woman was 58 years of age at the time of her left frontoparietal infarct (figure, A), presenting with right upper limb paresis and aphemia. Within hours, the patient’s paresis resolved to a slight hand ataxia and her speech sounded like English spoken with an unlearned accent. Workup suggested an embolic event, and she was discharged on warfarin. The foreign accent persisted for approximately 3 years until she had a right inferior cerebellar hemorrhage (figure, B–D) from accidental excessive anticoagulation. Following this second stroke, the patient and her family noted that the foreign accent was no longer perceptible in her speech. …
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it