Effortful speech with distortion of prosody following SARS-CoV-2 infection

Revisiting the boundaries of different altered accents profiles

A speaker's accent is regarded as an essential aspect of their identity to the extent that its abnormal modulation may have several negative consequences. Although the so-called foreign accent syndrome (FAS) is the best-known impairment, other altered accent profiles (AAPs) are likely to be more common and often go undiagnosed. Despite significant progress during the last two decades, several consequences of AAPs have yet to be systematically evaluated. Moreover, a common finding in several previous reports is the incompleteness of diagnostic work-up and the rarity of studies reporting longitudinal evolution and treatment approaches. In disorders with presumed low prevalence like AAPs, it is imperative to carry out a comprehensive analysis, documenting not only the altered accent profiles but also the neural correlates and associated disorders affecting cognition, behaviour, quality of life, and outcomes after treatment. This article highlights how to move forward in the multimodal evaluation of altered accents by integrating information from different sources.

Foreign Accent Syndrome After COVID 19 Infection: A Case Report

ABSTRACT

Foreign accent syndrome (FAS) is an extremely rare disorder characterized by the appearance of speech changes that are perceived by the speaker and listeners as an acquired foreign accent. It still remains a poorly understood condition. Three main types of FAS have been reported in the medical literature as neurogenic, psychogenic, and mixed type. Psychogenic FAS includes all cases of FAS in which an organic cause has not been identified and a clear psychological factor has been identified after careful clinical, neurological, and neuroradiological examination. Although the COVID-19 epidemic, which has been ongoing since February 2020, primarily manifests itself with upper respiratory tract infection findings, it is seen that it also causes a wide range of neurological and psychiatric signs and symptoms. In this study, a 42-year-old female patient who started to have speech disorder after COVID-19 infection is presented in the light of clinical history, diagnosis, and differential diagnosis literature findings.

A multimodal imaging approach to foreign accent syndrome. A case report

This article describes a case of Foreign accent syndrome (FAS) in an Italian woman who developed a Canadian-like foreign accent without brain damage (functional FAS). The patient underwent an in-depth neuroimaging and (neuro)psychological evaluation. Language networks in the frontotemporal-parietal areas were typically activated bilaterally through fMRI and MEG assessments based on task-based data. Resting-state fMRI showed preserved connectivity between language areas. An obsessive-compulsive personality profile and mild anxiety were found, suggesting psychological and psychiatric factors may be relevant. Accordingly with our findings, multimodal imaging is beneficial to understand FAS neurological and functional etiologies.

Foreign accent syndrome and other neuropsychological sequelae of a parieto-occipital lesion following COVID-19 associated posterior reversible encephalopathy syndrome

OBJECTIVE

We describe a previously fit and well 54-year-old female who acquired a range of severe and persisting neuropsychological impairments following a posterior reversible encephalopathy syndrome (PRES) complication of COVID-19. The initial presentation included aphasia, a neurogenic foreign accent syndrome (FAS) and a persisting complete cortical blindness from the underpinning parieto-occipital brain injury.

METHOD

Neuropsychological single clinical case report.

RESULTS

The patient retained insight and made good early progress with their adjustment to the numerous losses caused by the COVID-19 associated acquired brain injury. Comprehensive neuropsychological investigation characterised an acalculia, along with deficits in focused, sustained and divided attention impacting on verbal memory, working memory and executive functioning, amongst numerous relative strengths.

CONCLUSION

Similar to PRES from other aetiologies, COVID-19 associated PRES can in some cases cause irreversible acquired brain injury. The diverse neuropsychological effects need to be comprehensively investigated and managed. This case adds to the neuropsychological literature on PRES, FAS and acquired brain injury as a rare complication of SARS-CoV-2.

Cognitive and Neuropsychiatric Features of COVID-19 Patients After Hospital Dismission: An Italian Sample

Background and Aims

Recent studies suggest cognitive, emotional, and behavioral impairments occur in patients after SARS-CoV-2 infection. However, studies are limited to case reports or case series and, to our knowledge, few of them have control groups. This study aims to assess the prevalence of neuropsychological and neuropsychiatric impairment in patients after hospitalization.

Methods

We enrolled 29 COVID+ patients (M/F: 17/12; age 58.41 ± 10.00 years; education 11.07 ± 3.77 years, 2 left handers) who needed hospitalization but no IC, about 20 days post-dismission, and 29 COVID- healthy matched controls. Neuropsychological and neuropsychiatric assessments were conducted via teleneuropsychology using the following tests: MMSE, CPM47, RAVLT, CDT, Digit-Span Forward/Backward, Verbal fluencies; BDI-II, STAI. People with previous reported cognitive impairment and neurological or psychiatric conditions were excluded. Clinical and demographics were collected. Comparison between groups was conducted using parametric or non-parametric tests according to data distribution (T-test, Mann Withney-U test; Chi-square goodness of fit). Within COVID+ group, we also evaluated the correlation between the cognitive and behavioral assessment scores and clinical variables collected.

Results

Among COVID+, 62% had at least one pathological test (vs. 13% in COVID-; p = 0.000) and significantly worst performances than COVID- in RAVLT learning (42.55 ± 10.44 vs. 47.9 ± 8.29, p = 0.035), RAVLT recall (8.79 ± 3.13 vs. 10.38 ± 2.19, p = 0.03), and recognition (13.69 ± 1.47 vs. 14.52 ± 0.63, p = 0.07). STAI II was higher in COVID- (32.69 ± 7.66 vs. 39.14 ± 7.7, p = 0.002). Chi-square on dichotomous values (normal/pathological) showed a significant difference between groups in Digit backward test (pathological 7/29 COVID+ vs. 0/29 COVID-; p = 0.005).

Conclusions

Patients COVID+ assessed by teleneuropsychology showed a vulnerability in some memory and executive functions (working memory, learning, delayed recall, and recognition). Intriguingly, anxiety was higher in the control group. Our findings therefore confirm the impact of COVID-19 on cognition even in patients who did not need IC. Follow-up is needed to evaluate the evolution of COVID-19-related cognitive deficit.

Clinical Trial Registration

[ClinicalTrials.gov], identifier [NCT05143320].

Detection of COVID-19 from voice, cough and breathing patterns: Dataset and preliminary results

COVID-19 heavily affects breathing and voice and causes symptoms that make patients' voices distinctive, creating recognizable audio signatures. Initial studies have already suggested the potential of using voice as a screening solution. In this article we present a dataset of voice, cough and breathing audio recordings collected from individuals infected by SARS-CoV-2 virus, as well as non-infected subjects via large scale crowdsourced campaign. We describe preliminary results for detection of COVID-19 from cough patterns using standard acoustic features sets, wavelet scattering features and deep audio embeddings extracted from low-level feature representations (VGGish and OpenL3). Our models achieve accuracy of 88.52%, sensitivity of 88.75% and specificity of 90.87%, confirming the applicability of audio signatures to identify COVID-19 symptoms. We furthermore provide an in-depth analysis of the most informative acoustic features and try to elucidate the mechanisms that alter the acoustic characteristics of coughs of people with COVID-19.