No full-text available
To read the full-text of this research,
you can request a copy directly from the author.
Pictures as a neurological tool: Lessons from enhanced and emergent artistry in brain disease
Abstract
Pictures created spontaneously by patients with brain disease often display impaired or diminished artistry, reflecting the patient's cerebral damage. This article explores the opposite: those pictures created in the face of brain disease that show enhanced or enduring artistry, and those that emerge for the first time in artistically naïve patients. After comments on background issues relating to the patient and the viewer, the paintings and drawings are considered in relation to the heterogeneous conditions in which this artistic creativity is seen. These conditions include various dementias-most notably frontotemporal lobar dementia, stroke, Parkinson's disease, autism and related disorders and psychiatric disease, epilepsy, migraine and trauma. In the discussion, it is argued that evidence of underlying brain dysfunction revealed by these pictures often rests on the abnormal context in which the pictures are created, or on changes in artistry demonstrated by a sequence of pictures. In the former, the compulsive element and sensory and emotional accompaniments are often important features; in the latter, evolving changes are evident, and have included depiction of increasing menace in portrayal of faces. The occurrence of synaesthesia, and its relation to creativity, are briefly discussed in respect of two unusual patients, followed by considering the role of the anterior and frontal lobes, mesolimbic connections and the right hemisphere. In at least some patients, impaired inhibition leading to paradoxical functional facilitation, with compensatory changes particularly in the right posterior hemisphere, is likely to be pivotal in enabling unusual artistry to emerge; preservation of language, however, is not a prerequisite. Many patients studied have been artists, and it appears possible that some of those with an artistic predisposition may be more likely to experience pathologically obsessive creativity. The discussion concludes that occasionally pictures created by these rare individuals unexpectedly prove to be an invaluable but little studied tool for investigating the dysfunctioning brain.
... 2 Although certainly not limited to only visual artistic production (see e.g., [113,13,28]), visual art-making offers the benefit of general universality, accessibility, and the formal fact that these factors are literally fixed into the physical medium of a canvas or page. These findings may be rather wide-spread, with perhaps up to 20% of respondents with Parkinson's disease [116] or 17% with Frontotemporal dementia [158,194] reporting some manner of noticed difference in artistic activities. ...
... One area with particularly high promise for uncovering connections between behavior and the changing brain involves visual art. The past three decades have seen a number of case studies reporting changes in incidence or nature of individuals' visual art-making [37,65,71,151,161,168,194]. Ranging from world-famous professionals (e.g., [25]) to even lay and previously uninterested artists, and considering a number of main types of damage or neurological diseases, these papers have suggested a range of intriguing modulations in artistic behavior and motivation. ...
... However, as will become a theme throughout this review, Fornazzari [79] suggested the opposite movement, to dark somber color usage, and two authors noted increased use of symbolic imagery ( [54,147]; see also [6,71]). Cummings and Zarit [54] additionally judged the paintings to be of lesser artistic quality and creativity, which also tends to be argued for in general AD-artist reviews (e.g., [98,194]). ...
The past three decades have seen multiple reports of patients with neurodegenerative disorders, or other forms of putative changes in their brains, who also show changes in how they approach and produce visual art. Authors argue that these cases may provide a unique body of evidence, so-called ‘artistic signatures’ of neurodegenerative diseases that might be used to understand disorders, provide diagnosis, be employed in treatment, create patterns of testable hypotheses for causative study, and also provide unique insight into the neurobiological linkages between mind, brain, body and the human penchant for art-making and creativity itself. However—before we can begin to meaningfully build from such emerging findings, much less formulate applications—not only is such evidence currently quite disparate and in need of systematic review, almost all case reports and artwork ratings are entirely subjective, based on authors' personal observations or a sparse collection of methods that may not best fit underlying research aims. This leads to the very real question of whether we might actually find patterns of systematic change if fit to a rigorous review—Can we really ‘read’ art to illuminate possible changes in the brain? And how might we best approach this topic in future neuroscientific, clinical, and art-related research? This paper presents a review of this field and these questions. We consider the current case reports for seven main disorders—Alzheimer's and Parkinson's disease, Frontotemporal and Lewy body dementia, Corticobasal degeneration, aphasia, as well as stroke—consolidating arguments for factors and changes related to art-making, and critiquing past methods. Taking the published artworks from these papers, we then conduct our own assessment, employing computerized and human-rater based approaches, which we argue represent best practice to identify stylistic or creativity/quality changes. We suggest, indeed, some evidence for systematic patterns in art-making for specific disorders and also that case authors showed rather surprisingly high agreement with our own assessment. More importantly, through this paper, we hope to open a discussion and provide a theoretical and empirical foundation for future application and systematic research on the intersection of art-making and the neurotypical, the changed, and the artistic brain.
... Some studies have shown changes in the artistic production of patients with neurodegenerative disease (Schott, 2012), most notably in frontotemporal dementia (FTD) patients (Antérion et al., 2002;Miller et al., 1996). However, to our knowledge, no studies have examined the evolution of artistic production in PCA patients. ...
... At an advanced stage of neurodegenerative pathologies, the progression of neurovisual disorders is difficult to assess. Some studies have focused on the artistic production of patients with brain disease such as stroke, Parkinson's disease, autism, psychiatric disease, epilepsy, trauma or various dementias-most notably FTD and AD (Schott, 2012), but among these, none involved patients with PCA. In addition, these studies have highlighted enhanced or emergent artistry but few of them were intended to account for the evolution of the artistic production related to the progression of cognitive disorders (Seeley et al., 2008). ...
... On the other hand, the most common element in all published observations of art production in patients with neurodegenerative diseases is the compulsive nature or at least the irrepressible character of these events (Schott, 2012). In this respect, it is important to note that our patient did not have other compulsive behaviors. ...
A 63-year-old woman was referred for visuospatial difficulties. The clinical and neuropsychological examination in association with imaging and biomarkers led to a diagnosis of posterior cortical atrophy (PCA). The patient, an amateur watercolor artist, continued to paint throughout her disease and her paintings illustrate in an original way the progression of her disorders. At an advanced stage, the evolution of neurovisual disorders is difficult to evaluate in patients. While studies have shown changes in artistic style in neurodegenerative diseases, none of them concerned PCA. Artistic production enables a different approach to trying to understand the progression of disorders.
... Les études d'imagerie fonctionnelle ont également confirmé cette hypothèse. Pourtant, contre toute attente, la littérature médicale rapporte des cas de patients atteints de maladie neurologique dégénérative touchant le lobe frontal, montrant l'émergence ou l'exacerbation d'un talent artistique suggestif d'une créativité accrue (Schott, 2012). Ces descriptions de patients semblent en contradiction non seulement avec l'imagerie fonctionnelle, mais aussi avec quelques études expérimentales montrant une altération de la créativité après une atteinte préfrontale liée à une maladie dégénérative (de Souza et al., 2010) ou à une lésion focale Shamay-Tsoory et al., 2011). ...
... Compte tenu de l'importance du CPF dans la créativité en IRM fonctionnelle et du rôle présumé des fonctions cognitives connues du CPF dans la créativité, il est attendu qu'une atteinte du CPF entraîne une altération de la créativité chez les patients. Pourtant, de façon surprenante, il existe dans la littérature médicale plus d'une trentaine de cas de patients ayant présenté l'émergence ou l'exacerbation d'un talent artistique au cours de l'évolution d'une maladie touchant les lobes frontaux (pour revues Gretton & Ffytche, 2014 ;Palmiero, Giacomo, & Passafiume, 2012 ;Schott, 2012). La dégénérescence lobaire fronto-temporale (DLFT) a été particulièrement rapportée dans ce contexte. ...
... Or les tâches créatives utilisées dans les études en neuroimagerie n'évaluent pas ou peu les aspects motivationnels, conatifs, sociaux et affectifs susceptibles d'influer sur la production créative, incluant la création artistique. Ces facteurs peuvent être importants chez les patients artistes des articles mentionnés, comme le rappellent plusieurs observations ou les patients sont décrits comme très motivés, « obsédés par leur art, avec un besoin de créer » (Liu et al., 2009 ;Lythgoe et al., 2005 ;Mendez, 2004 ;Miller & Hou, 2004 ;Miller et al., 1998 ;Schott, 2012 ;Serrano et al., 2005;Thomas-Antérion, 2009 ;Thomas-Anterion et al., 2010). ...
... This de novo generative capacity often manifests in the visual and musical arts and is associated with various conditions, including frontotemporal dementia (FTD), ¶ migraine, epilepsy, and traumatic brain injury. 228 The single most common case studies of individuals with specific neurological damage have been examinations of neurological patients with specific forms of FTD who develop de novo creative abilities or individuals who have savant-like capabilities. 211,217,[224][225][226][227] In the first research study of its kind, Miller et al. 226 reported on three patients who became accomplished painters following the onset of FTD. ...
... It is also highly probable that the appearance of such features is underreported. 228 Because most individuals beset with such conditions do not display enhanced musical skills, and because of the heterogeneity regarding the brain correlates of such disorders and the extensive networks involved, 229 it is not yet possible to specify which regions of the brain are especially significant in the sudden emergence or unexpected presence of musical capacity. Although brain injury causes flaws in certain facets of functioning (such as loss of semantic understanding, social awareness, or speech production), it can also result in enhanced de novo abilities relevant to visual art or music, as shown in the previously mentioned case studies of individuals with FTD. ...
Can we better understand the unique mechanisms of de novo abilities in light of our current knowledge of the psychological and neuroscientific literature on creativity? This review outlines the state‐of‐the‐art in the neuroscience of creativity and points out crucial aspects that still demand further exploration, such as brain plasticity. The progressive development of current neuroscience research on creativity presents a multitude of prospects and potentials for furnishing efficacious therapy in the context of health and illness. Therefore, we discuss directions for future studies, identifying a focus on pinpointing the neglected beneficial practices for creative therapy. We emphasize the neglected neuroscience perspective of creativity on health and disease and how creative therapy could offer limitless possibilities to improve our well‐being and give hope to patients with neurodegenerative diseases to compensate for their brain injuries and cognitive impairments by expressing their hidden creativity.
... Amygdala dysfunction may explain the preference for concrete and mechanical cognition in ASD, a feature which is evidenced by multiple findings (Baron-Cohen and Wheelwright, 1999;Klin and Jones, 2006;Klin et al., 2007Klin et al., , 2009Ropar and Peebles, 2007;Wang et al., 2015). Generally, an impaired brain system can facilitate enhanced use and development of brain systems remaining intact, and this has been reported for diverse brain diseases that affected disparate brain regions (Kapur, 1996;Miller et al., 1998Miller et al., , 2000Thomas-Anterion et al., 2010;Schott, 2012;Midorikawa and Kawamura, 2015). For example, anterior temporal lobe degeneration, which manifests in social and language impairments, can co-occur with posterior parieto-occipital enhancement, which is associated with outstanding artistic development (Miller et al., 2000;Schott, 2012;Midorikawa and Kawamura, 2015). ...
... Generally, an impaired brain system can facilitate enhanced use and development of brain systems remaining intact, and this has been reported for diverse brain diseases that affected disparate brain regions (Kapur, 1996;Miller et al., 1998Miller et al., , 2000Thomas-Anterion et al., 2010;Schott, 2012;Midorikawa and Kawamura, 2015). For example, anterior temporal lobe degeneration, which manifests in social and language impairments, can co-occur with posterior parieto-occipital enhancement, which is associated with outstanding artistic development (Miller et al., 2000;Schott, 2012;Midorikawa and Kawamura, 2015). Correspondingly in ASD, impaired neural systems for intangible cognition are suggested to facilitate enhanced use and development of preserved systems for concrete and mechanical cognition. ...
Amygdala is an intensively researched brain structure involved in social processing and multiple major clinical disorders, but its functions are not well understood. The functions of a brain structure are best hypothesized on the basis of neuroanatomical connectivity findings, and of behavioral, neuroimaging, neuropsychological and physiological findings. Among the heaviest neuroanatomical interconnections of amygdala are those with perirhinal cortex (PRC), but these are little considered in the theoretical literature. PRC integrates complex, multimodal, meaningful and fine-grained distributed representations of objects and conspecifics. Consistent with this connectivity, amygdala is hypothesized to contribute meaningful and fine-grained representations of intangible knowledge for integration by PRC. Behavioral, neuroimaging, neuropsychological and physiological findings further support amygdala mediation of a diversity of such representations. These representations include subjective valence, impact, economic value, noxiousness, importance, ingroup membership, social status, popularity, trustworthiness and moral features. Further, the formation of amygdala representations is little understood, and is proposed to be often implemented through embodied cognition mechanisms. The hypothesis builds on earlier work, and makes multiple novel contributions to the literature. It highlights intangible knowledge, which is an influential but insufficiently researched factor in social and other behaviors. It contributes to understanding the heavy but neglected amygdala-PRC interconnections, and the diversity of amygdala-mediated intangible knowledge representations. Amygdala is a social brain region, but it does not represent species-typical social behaviors. A novel proposal to clarify its role is postulated. The hypothesis is also suggested to illuminate amygdala’s involvement in several core symptoms of autism spectrum disorder (ASD). Specifically, novel and testable explanations are proposed for the ASD symptoms of disorganized visual scanpaths, apparent social disinterest, preference for concrete cognition, aspects of the disorder’s heterogeneity, and impairment in some activities of daily living. Together, the presented hypothesis demonstrates substantial explanatory potential in the neuroscience, social and clinical domains.
... In this study, the inhibition efficiency of the participants was impaired by exhaustion through the intensive practice of non-verbal non-semantic inhibition tasks (the Simon or Eriksen Flanker tasks). Altering inhibition resources led to an improvement in the number and originality of ideas in an AUT task, suggesting that inhibition is negatively related to DT. Impaired inhibition leading to paradoxical functional facilitation of artistic creative abilities has been described in neurological patients with frontal damage (De Souza et al., 2014;Schott, 2012 for reviews). A few non-invasive brain stimulation studies are consistent with this view, by demonstrating a facilitative effect of cathodal (inhibitory) transcranial direct current stimulation of the left PFC on performance in a DT task (Chrysikou et al., 2013;Mayseless & Shamay-Tsoory, 2015). ...
... How each alteration would affect the whole DT performance and how one system can compensate for the other in the ability to produce creative ideas remain open questions. The results obtained in exploring these questions may help better explain the paradoxical observation of increased artistic creativity in patients (De Souza et al., 2014;Schott, 2012). ...
Book chapter to appear in The Cambridge handbook of the neuroscience of creativity
Citation: Volle, E. (in press). Associative and controlled cognition in divergent thinking:
Theoretical, experimental, neuroimaging evidence, and new directions. In R. E. Jung &
O. Vartanian (eds.), The Cambridge handbook of the neuroscience of creativity. Cambridge:
Cambridge University Press
... Así, este autor señala que los artistas creativos, influyentes e importantes no tenían daño a nivel cerebral. Curiosamente, aun no se han publicado informes de casos neurológicos (debido a un accidente cerebrovascular o lesión encefálica) lo suficientemente representativos, de aquellos artistas no UNA APROXIMACIÓN DESDE EL DESARROLLO, EL APRENDIZAJE Y LA COGNICIÓN CREATIVA profesionales que comenzaron a practicar arte visual solamente después de haber experimentado daño neurológico (Finkelstein et al, 1991;Lythgoe et al, 2005;Chatterjee, 2006;Pollak et al., 2007;Schott, 2012;Simis et al, 2013.;Midorikawa & Kawamura, 2014). ...
Hace aproximadamente 30 años se vienen llevando a cabo una serie de intentos materializados en estudios y artículos que, de manera individual, pretenden aproximarse al tema de la innovación1 a través desde la filosofía, la psicología, la pedagogía y las neurociencias. Particularmente, se resalta el trabajo presentado por Csikszentmihalyi en The Systems Model of Creativity (El modelo sistémico de la creatividad) en 2014, quien de manera magistral desarrolla el tema de la concepción sistémica y social relacionada con la cognición creativa, imprimiendo un énfasis particular a aspectos educativos y culturales en general.
... One study applied an activation likelihood estimation meta-analysis to identify brain activation; for that purpose, the authors synthesized functional neuroimaging studies across the artistic creativities such as music improvisation, drawing, and literary creativity [14]. In addition, the rare phenomenon of de novo artistic abilities appearing for patients with traumatic brain injury was noted [15]. ...
This paper aims to introduce the value of semantics for representing knowledge related to patients with brain neurodegenerative diseases (Parkinson’s, Alzheimer’s, and dementia) or behavioral disorders (i.e., schizophrenia) and artistic behavior. The ultimate goal is to facilitate an effective and efficient study of neurological and behavioral changes of patients, analyzing semantically interlinked data related to neurological/behavioral conditions and artistic behaviors. By mapping the neurologically affected areas of the brain in healthy and unhealthy individuals, and by modeling their particular characteristics at the level of both behavioral and neurological expressions, it may be possible to identify semantic similarities in high-level behavioral and brain characteristics that justify correlation and causation between diseases/disorders and artistic behaviors. In this concept paper, we present our view on two key points related to proposed research on a novel framework that will (a) verify if early biomarkers of the neurogenerative diseases can be identified via artistic behavior observations, and (b) correlate patients with delayed onset of the diseases/disorders with artists, at the molecular level, or at the level of brain regions. The proposed framework is evaluated with the development of a proof-of-concept expert system based on the representation of the relevant knowledge.
... Cave art has been interpreted as conveying and reflecting on our most important challenges and concepts that humans of the day faced, including pondering the afterlife, cosmic contemplation and transcendental ruminations [58]. With fragmentation of the brain's circuitry such as occurs with dementia or traumatic brain injury, a return to visual art communication is sometimes more effective than language and the quality of art can be impressive [59]. The National Intrepid Center of Excellence research into art and mask painting for military related traumatic brain injury and post-traumatic stress disorder, is a good example and yields information not easily obtained through language; "When words are not enough" [60]. ...
... Así, este autor señala que los artistas creativos, influyentes e importantes no tenían daño a nivel cerebral. Curiosamente, aun no se han publicado informes de casos neurológicos (debido a un accidente cerebrovascular o lesión encefálica) lo suficientemente representativos, de aquellos artistas no profesionales que comenzaron a practicar arte visual solamente después de haber experimentado daño neurológico (Finkelstein et al, 1991;Lythgoe et al, 2005;Chatterjee, 2006;Pollak et al., 2007;Schott, 2012;Simis et al, 2013.;Midorikawa & Kawamura, 2014). ...
El capítulo aborda el lugar de las neurociencias en la comprensión del procesamiento creativo frente a algunas patologías psiquiátricas como esquizofrenia y trastorno bipolar, así como el compromiso cerebral asociado a ciertas demencias. Para ello se revisan algunos estudios poblacionales, electrofisiológicos, de neuroimagen, genéticos y moleculares que exploran la estructura/función cerebral asociada al pensamiento divergente y los efectos del daño neurológico sobre las habilidades creativas.
... Such visual illusions need to be interpreted in the context of other syndromes seen in association with the FTD conditions such as novel artistic expertise. Right hemisphererelated exceptional art and music compositions after left anterior dysfunction have also been described by Miller [8] and Schott [9]. Also relevant is the unique visuospatial capabilities related jig-saw puzzle expertise with FTD semantic variant, reported by Green [10]. ...
A 59-year-old man presented with non-fluent aphasia and behavioral variant frontotemporal lobe degeneration (FTD), volunteered unusual visual symptoms that were best described as illusory visual spread (the image spreading over a larger area). This type of visual hyperfunction, related to the palinopsia syndromes, has not been reported in association with FTD. The syndrome may be best understood in terms of a visual variant of the environmental dependency syndrome, akin to the verbal variant of forced hyperphasia syndrome.
... See Figure 2, Box 7. Disrupted brain systems are associated with enhanced development and functioning of intact brain systems, and this effect has been found across multiple brain regions that were damaged by diverse brain diseases and lesions [298][299][300][301][302][303]. Correspondingly, ASD individuals who are hypothesized to have weakness in intangible knowledge will predominantly process concrete-level knowledge thereby becoming specialized and unusually skilled in this domain. ...
Autism spectrum disorder (ASD) is a challenging neurodevelopmental disorder with symptoms in social, language, sensory, motor, cognitive, emotional, repetitive behavior, and self-sufficient living domains. The important research question examined is the elucidation of the pathogenic neurocircuitry that underlies ASD symptomatology in all its richness and heterogeneity. The presented model builds on earlier social brain research, and hypothesizes that four social brain regions largely drive ASD symptomatology: amygdala, orbitofrontal cortex (OFC), temporoparietal cortex (TPC), and insula. The amygdala’s contributions to ASD largely derive from its major involvement in fine-grained intangible knowledge representations and high-level guidance of gaze. In addition, disrupted brain regions can drive disturbance of strongly interconnected brain regions to produce further symptoms. These and related effects are proposed to underlie abnormalities of the visual cortex, inferior frontal gyrus (IFG), caudate nucleus, and hippocampus as well as associated symptoms. The model is supported by neuroimaging, neuropsychological, neuroanatomical, cellular, physiological, and behavioral evidence. Collectively, the model proposes a novel, parsimonious, and empirically testable account of the pathogenic neurocircuitry of ASD, an extensive account of its symptomatology, a novel physiological biomarker with potential for earlier diagnosis, and novel experiments to further elucidate the mechanisms of brain abnormalities and symptomatology in ASD.
... In an extensive review paper published in 2014, Zaidel presents a list of case studies that discuss the emergence of de novo creativity in people who began producing art only after brain injury. 1,[10][11][12][13][14][15][16] However, instead of deducing that tissue injury leads to artistic "enlightenment, " Zaidel came to a much more temperate conclusion: "there is a deep survival motivation to communicate through art when the communicative channel of language fails following brain damage. " In other words, art is a way for patients to adapt to their new disability by creating a new mode of communication. 1 ...
This paper discusses the relationship between various types of neurological disease and stylistic changes in painters. By first outlining the hypothesized neuroanatomical bases of creativity, the discussion then relates localized brain damage to various stylistic changes in painters and previously non-artists. It also explores artistic style in the context of more global neurological damage, such as dementias and neurotransmitter imbalances.The literature suggests that focal neurological insults (such as strokes or head injuries) may more often lead to focal deficits in painters, such as the loss of visuospatial ability or partial hemineglect. More widespread neurological damage may be associated with more global stylistic changes; for example, dopamine replacement therapy for Parkinson’s disease has been shown to produce a more impressionist painting style in numerous recorded artists. In several case studies, brain damage actually led to the emergence of de novo artistic ability.While these changes in artistic style may not be rigidly predictable based on the limited literature available, this paper demonstrates that both artists and non-artists may experience significant changes in artistic style after neurological disease. Patient narratives also suggest that painting may serve as an empowering personal coping and communication strategy, aiding patients in navigating their complex illnesses.
... Typically, during the progression of Alzheimer's disease (AD), various stylistic changes leading to frank deterioration and eventual cessation of painting have been reported, partic- ularly evident in professional artists; however, surprisingly, preservation of artistic skills in the face of severe dementia has also been described. 14 In many patients with AD, artistic skills dissipate rapidly associated with diminished function in poster- ior parietal and temporal regions, brain areas that contribute to visuoconstructive, linguistic, and musical skills. 6 According to Gretton et al, 15 the art of AD is characterized in early stages of the disease by prominent changes in spatial constructional quality and, to a lesser degree, visual perceptual attributes such as color and contrast, and a simplification due to reduced plan- ning ability. ...
Art is a system of human communication arising from symbolic cognition, conveying ideas, experiences, and feelings. The goal of this review is to describe the link between painting and dementia. Individuals with neurodegenerative diseases inevitably experience cognitive dysfunction that has the potential to limit and impair the artist’s ability to realize their creative and expressive intentions through painting. The strategy to advance our understanding of the neural bases for art is to map locations and nature of neural damage to changes onto artistic production.
... Fascinating examinations of people who develop de novo artistic capabilities post neurological insult have been reported in a small subset of patients with the temporal lobe variant of FTD where brain damage is seen in temporal regions 5 whereas frontal regions remain relatively intact (Liu et al., 2009;Miller et al., 1998;Miller & Hou, 2004;Miller & Miller, 2013). The characterization of 'de novo' is warranted in this context as these (predominantly visual and musical) artistic abilities appear suddenly following brain injury or degeneration and they are unexpected given that the person did not exhibit such tendencies prior to the onset of FTD (Schott, 2012;Zaidel, 2010). This tendency to engage in artistic expression is not short-lived, but tends to be compulsive and highly sustained. ...
The neuropsychological approach has been instrumental in delivering key insights that have enabled a clearer understanding of the human mind and its workings. Despite the promise of this approach and the unique perspective it affords, it has only been limitedly utilized when exploring creative cognition. This papers an overview of three methodologies – single case studies, case series investigations on neurological populations, and case series investigations on psychiatric populations – that have been employed within the neuropsychology of creativity and highlights some of the important revelations that each direction of study has delivered. In doing so, the aim is to make a case for the utility of the neuropsychological approach in allowing for a better understanding of the creative mind.
... This test has been employed in both clinical and research contexts and provides scores of fluency (the number of productions), flexibility (the ability to provide different categories of productions), originality (the ability to 385 create rare productions), and elaboration (the ability to enrich productions with details); all these creative domains being affected in ASP. It has been demonstrated that brain diseases can impair creative production (de Souza et al., 2014;Schott, 2012). More specifically, reduced creative performance has 390 been related to prefrontal damages (de Souza et al., 2010). ...
Klüver-Bucy syndrome (KBS) leads to important behavioral symptoms and social maladaptation. Rarely described, no previous study has investigated its social and affective cognitive profile. We report the case of ASP, a patient who developed a complete KBS at 9 years that evolved into an incomplete KBS. Orbitofrontal and temporal damages were evidenced. While a classic neuropsychological assessment showed a preserved global functioning, an extensive evaluation of her social and affective cognition (reversal learning, decision-making, emotion recognition, theory of mind, creative thinking) showed remarkable deficits. The relevancy of such findings for the characterization KBS and the field of neuropsychology are discussed.
... However, although certain aspects of idea production during open-ended tasks may, in fact, benefi t from such lateral PFC disengagement, the potential for self-generated, creative thinking that is both novel and goal-appropriate in context requires the contribution of top-down, regulatory mechanisms as guided by these same lateral prefrontal cortical networks. For example, the emergence of paradoxical de novo artistic production in non-professional artists following brain injury (e.g., Chatterjee, 2006 ;Schott, 2012 ;Simis et al., 2014 ) or degenerative brain diseases typically aff ecting PFC (e.g., Chakravarty, 2011 ;Miller et al., 1998 ;Miller & Hou, 2004 ;Shamay-Tsoory, et al., 2011 ;Viscontas & Miller, 2013 ) as discussed earlier would suggest that, overall, the creative process is facilitated by the disinhibition of posterior and subcortical regions due to lateral PFC (especially left hemisphere) network impairment (Heilman & Acosta, 2013 ;Viscontas & Miller, 2013 or diminished creativity in the patients' artistic production (de Souza et al., 2010 ). Critically, a close inspection of the patient's artistic output has revealed that their work does not develop creatively with time as in healthy visual artists and is marked by obsessive-compulsive, ritualistic features (e.g., Chatterjee, 2006 ;Midorikawa & Kawamura, 2015 ;Rankin et al., 2007 ;Simis et al., 2014 ). ...
At first glance, the experimental study of a topic as complex as creativity would seem like a formidable task for a cognitive neuroscientist. For one, the methods of cognitive neuroscience are best suited for cognitive processes we can clearly isolate in space and time and which can be reliably elicited with simple experimental manipulations in the laboratory. Although creativity falls far from satisfying these methodological constraints, the status of creative thought as a hallmark of the human mind has invited numerous investigations on the neural bases of creativity for nearly two decades. Cognitive neuroscience research on creativity has provided an extensive body of work highlighting the neural underpinnings of concepts key to creativity, such as divergent thinking and insight, that are theorized to underlie our ability to generate ideas deemed novel and appropriate to satisfy current goals. On the other hand, it has also become apparent that a lack of consensus on the operationalization of these concepts and their measurement, as well as the substantial variability in the use of definitions, creativity tasks, and experimental paradigms across studies, have brought issues of interpretation of the ensuing data for our understanding of the neural mechanisms of creativity to the fore (Abraham, 2013; Chrysikou, in press). To address these concerns, modern experimental and neuroscience research on creativity has recently begun to transition from the study of hard-to-define concepts, such as divergent thinking, to investigations of specific cognitive and neural processes (e.g., attention, memory, executive function) hypothesized to underlie creative thought (Abraham, 2014; Dietrich, 2007a,2007b; Smith, Ward, & Finke, 1995; Ward, 2007; see also Kounios & Beeman, 2014; Weisberg, 2006). Cognitive neuroscience studies have revealed that creative thinking is associated with the involvement of an extensive network of regions that are widely distributed across the brain, and which reflect the complex set of diverse cognitive processes involved in creative cognition. A key question for this research pertains to the importance of executive functions or cognitive control processes for creativity and the attendant involvement of prefrontal cortical structures during creative ideation. Indeed, a point of convergence across the majority of recent work on the neural bases of creative thinking is the significance of the prefrontal cortex (PFC) for creative thought (e.g., Gonen-Yaacovi et al., 2013; see Dietrich & Kanso, 2010 for a review).
... Overall, these results support the conclusion that creativity involves an extensive network of brain regions across both hemispheres, the precise contribution of which to different aspects of creative behavior, as discussed above, is poorly understood (see Barbey, Colom, & Grafman, 2013;Dietrich & Kanso, 2010;Heilman & Acosta, 2013;Jung & Haier, 2013;Viscontas & Miller, 2013). On the other hand, cases of non-professional artists who began producing art following brain injury (e.g., Chatterjee, 2006;Schott, 2012;Simis, Bravo, Boggio, Devido, Gagliardi, & Fregni,, 2013) or degenerative brain diseases typically affecting the prefrontal cortex, (e.g., Chakravarty, 2011;Miller et al., 1998;Miller & Hou, 2004;Viscontas & Miller, 2013;Shamay-Tsoory, Adler, Aharon-Peretz, Perry, & Mayseless, 2011) have been used in support of the view that creative production is facilitated by the disinhibition of temporal, visual, and parietal cortex due to prefrontal network impairment (Viscontas & Miller, 2013), particularly if the injury originates in the left hemisphere (Heilman & Acosta, 2013). However, a close examination of the output of the artistic production of these patients reveals that the work does not develop creatively with time as in healthy visual artists and is characterized by obsessive-compulsive, ritualistic features (e.g., Chatterjee, 2006;Midorikawa & Kawamura, 2015;Rankin et al., 2007;Simis et al., 2014). ...
The purpose of this chapter is to provide an overview of some key background issues and recent trends in the experimental and cognitive neuroscience study of creativity. Despite its status as a hallmark of higher order thinking, research on creativity has not progressed with the same rigor as the study of other aspects of human cognition. Among the challenges for creativity researchers are concerns with the operational definition and measurement of this seemingly elusive ability. Research on the neurocognitive bases of creative thinking suggests that creativity is highly multifaceted and requires intricate interhemispheric interactions among a widely distributed network of brain regions. Recent theoretical and methodological perspectives highlight the importance of moving away from approaching creativity as a unitary construct, synonymous to the abstract concept of divergent thinking. Instead, they focus on specific cognitive and neural processes underlying creative thought, which may rely on trade‐offs between spontaneous and regulatory brain networks.
... Art is a unique human activity that is mainly associated with the symbolic and abstract aspects of cognition (Zaidel, 2010). Paintings produced spontaneously by patients with neurological lesions represent a fascinating opportunity to analyze some aspects of the underlying disease and the brain mechanisms involved (Schott, 2012). Many cases of artistic deterioration and/or emergent artistry associated with dementia, brain tumors, Parkinson's disease, epilepsy, head trauma, and cerebrovascular disease have been described (Bogousslavsky, 2007). ...
Paintings produced spontaneously by patients with neurological lesions represent a fascinating opportunity to analyze some aspects of the underlying disease and involved brain mechanisms. Many cases of artists who have suffered spatial neglect following a neurological disease have been reported in the literature. However, only a few studies evaluating the different subtypes of graphic neglect and aspects related to the construction of perspective (three dimensionality) in works of art have been published. In the present article, we present the case of an artist who, after resection of a central neurocytoma that affected the right thalamo-parietal connections, suffered an impairment of the ability to create perspective in his paintings and involuntary omission of only shapes in the left side of his paintings, although colors and contours were preserved.
... Much has been written about the arts in relation to dementia and about their therapeutic role in dementia care (Young et al., 2015). There have been several cases of individuals developing novel artistic abilities after developing different dementias including FTD (Miller et al., 1998) and AD (Chakravarty, 2011) among others (Schott, 2012). Additionally, studies have documented changes in artistic style of those already producing art during the progression of the condition (Crutch et al., 2001;Mell et al., 2003;Crutch and Rossor, 2006). ...
The dementias are a group of progressive symptoms that have multiple causes, usually caused by disease or injury of the brain, affecting higher brain functions such as language, perception, memory, reasoning and mood; they can also be associated with changes in personality. Arts interventions and interaction with the arts can create meaningful, positive experiences for people with a dementia, as well as improve quality of life. Qualitative research in particular, has been able to describe the emotional responses the arts can produce, but quantifiable changes have not been well documented. Physiological measurements such as stress hormone levels and galvanic skin response show promise in being able to quantify such responses. When taken together, these can give a picture of the kinds of physiological outcomes that are associated with positive affect and improvements in mental wellbeing in the context of arts interventions. This review provides a critical overview of the studies which measure some form of physiological outcome in response to the arts or an arts intervention in people with dementia, and indicates how future research in this area can help to broaden our understanding of the effects of the arts in dementia research and care.
... The second type of the condition is acquired synesthesia. This type has been reported to emerge after traumatic brain injury Brogaard, Vanni, & Silvanto, 2012), stroke (Beauchamp & Ro, 2008;Ro et al., 2007;Schott, 2012;Thomas-Anterion et al., 2010), seizures (Jacome & Gumnit, 1979), migraine (Alstadhaug & Benjaminsen, 2010), posthypnotic suggestion (Cohen Kadosh, Henik, Catena, Walsh, & Fuentes, 2009), sensory substitution (Ward & Wright, 2014), and neuropathology involving the optic nerve and/or chiasm (Afra, Funke, & Matuso, 2009;Armel & Ramachandran, 1999;Jacobs, Karpik, & Bozian, 1981). Like its developmental counterpart, the acquired form tends to be enduring and involuntary in the sense that synesthetes are unable to suppress the association between an inducer and its concurrent, although there are reports that the condition does not always persist (Afra et al., 2009;Jacome & Gumnit, 1979;Lessell & Cohen, 1979). ...
Studies have shown that both serotonin and glutamate receptor systems play a crucial role in the mechanisms underlying drug-induced synesthesia. The specific nature of these mechanisms, however, continues to remain elusive. Here we propose two distinct hypotheses for how synesthesia triggered by hallucinogens in the serotonin agonist family may occur. One hypothesis is that the drug-induced destabilization of thalamic projections via ?-aminobutyric acidergic neuronal circuits from sensory areas leads to a disruption of low-level, spontaneous integration of multisensory stimuli. This sort of integration regularly occurs when spatial and temporal attributes match. Destabilization of feedback loops, however, can result in incongruent experiences or binding of random thalamus activation with sensory input in a particular sensory modality. The second hypothesis builds on embodied cognition, cases in which visual images of external stimuli activate task-related neural regions. In this proposal, binding processes that do not normally generate awareness become accessible to consciousness as a result of decreased attentional discrimination among incoming stimuli.
... This approach has been used in artists who went on to develop dementia, e.g., de Kooning, Carolus Horn, Utermohlen. Interestingly, there have also been reports of people in whom artistic abilities emerged anew or became enhanced after they developed dementia (Liu et al., 2009;Schott, 2012). ...
This paper describes the diagnostic and treatment utility of visual art therapy in a case of sporadic Creutzfeldt–Jakob disease. Visual art therapy was compared longitudinally with clinical and neuroimaging data over five-month period in an autopsy-confirmed case of sporadic Creutzfeldt–Jakob disease of MM2-cortical subtype. Art therapy sessions and content were useful in ascertaining neuropsychiatric symptoms during the course of her illness. Art therapy offered a unique emotional and cognitive outlet as illness progressed.Patients and families affected by sporadic Creutzfeldt–Jakob disease may benefit from art therapy despite the rapidly progressive nature of the illness. Art therapy can also be useful for assessment of patients with sporadic Creutzfeldt–Jakob disease by healthcare professionals.
... In some neuroscience handbooks, the self-portraits of Anton Räderscheidt after his right hemisphere stroke (1968) serve as an illustration of the effect of such disease. Careful study of the impact of neurological disease on famous artists may give a better understanding of both the pieces of art and the brain itself (Andreasen, 2005;Bogousslavsky & Boller, 2005;Schott, 2012). Parkinson's disease (PD) is a disorder of the basal ganglia with a decrease in dopamine levels, and is associated with tremor, rigidity, and decline of motor function. ...
A professional right-handed painter with Parkinson's disease (PD) broke his right arm and continued to paint with his left hand, showing an intact intermanual transfer of skills. This neurocognitive process is related to the supplementary motor area, a brain region that has also been shown to be involved in PD. This observation raises questions about the exact neural underpinnings of intermanual transfer and the possible impact of neurodegenerative disease and medication.
... There are some accounts of emergent creativity experienced as an urge to create, which has been previously described as compulsive (Miller and Hou, 2004), obsessive (Lythgoe et al., 2005), impulsive (Finkelstein et al., 1991) and irrepressible (Thomas-Anterion et al., 2010). In line with this, it has been recently suggested that this compulsion to create art is an integral part of the neurological phenomena and can be seen as a compulsive behavior (Schott, 2012). Creative compulsive behavior can be seen in many diseases and neurological disorders, ranging from Parkinson's disease (Kulisevsky et al., 2009) to subarachnoid hemorrhage (Lythgoe et al., 2005) and brain lesions affecting both hemispheres (Finger et al., 2013;Miller et al., 2000). ...
Human creativity is thought to entail two processes. One is idea generation, whereby ideas emerge in an associative manner, and the other is idea evaluation, whereby generated ideas are evaluated and screened. Thus far, neuroimaging studies have identified several brain regions as being involved in creativity, yet only a handful of studies have examined the neural basis underlying these two processes. We found that an individual with left temporoparietal hemorrhage who had no previous experience as an artist developed remarkable artistic creativity, which diminished as the hemorrhage receded. We thus hypothesized that damage to the evaluation network of creativity during the initial hematoma had a releasing effect on creativity by "freeing" the idea generation system. In line with this hypothesis, we conducted a subsequent fMRI study showing that decreased left temporal and parietal activations among healthy individuals as they evaluated creative ideas selectively predicted higher creativity. The current studies provide converging multi-method evidence suggesting that the left temporoparietal area is part of a neural network involved in evaluating creativity, and that as such may act as inhibitors of creativity. We propose an explanatory model of creativity centered upon the key role of the left temporoparietal regions in evaluating and inhibiting creativity.
This narrative review addresses the complex relationship between neurological diseases and artistic expression, which can have a profound impact on a painter´s works. This exploration highlights the dynamic and ever-evolving connection between neuroscience and art, offering insights into the extraordinary ways in which the human brain and artistic expression intersect and evolve. Following brain damage, there may be the emergence of sudden artistic talents, intriguing changes in the styles of established artists, the paradoxical facilitation of artistic abilities despite the cognitive decline consequent to these injuries, besides coping strategies that artists adopt in response to the challenges of health. Therefore, this article investigates different scenarios where brain injuries and disorders have had a profound impact on artists, leading to the emergence of new talents, changes in artistic styles, and unexpected improvements in their work, as well as adaptations in their artistic practices, as represented by some painters such as Tommy McHugh (1949 -2012), Francisco Goya (1746-1828), Otto Dix (1891-1969), Willem de Kooning (1904-1997), William Charles Utermohlen (1933-2007) and Charles Meryon (1821-1868). Consequently, works of art can be valuable but understudied tools for understanding brain dysfunction, although they must be interpreted with great care.
This narrative review addresses the world of artists who linked their creative journeys alongside their battles with epilepsy, a neurological condition engineered by recurrent epileptic seizures, with multifaceted implications in biopsychosocial domains. By examining the lives and works of celebrated artists such as Vincent Van Gogh and contemporary painters, particularly those possibly affected by epilepsy, a narrative transcends clinical elucidations, investigating historical contexts, artistic expressions, and therapeutic interventions. The focus is on uncovering the transformative influence of engaging in artistic activities for individuals struggling with epilepsy. It investigates the profound impact of artistic pursuits on people affected by epilepsy, showing the resilience of the human spirit in harnessing adversity as a source of creativity. This exploration illuminates the potential of art, not only as a means of self-expression, but also as a therapeutic medium in the setting of epilepsy and associated neurorehabilitation.
De fundamenten voor de neurorevalidatie zijn de afgelopen twintig jaar zeer robuust geworden: neurale plasticiteit is een realiteit: vele menselijke functies kunnen tegenwoordig door beeldvormende technieken zichtbaar worden gemaakt. Zo ook het herstel na hersenbeschadiging en de invloed van therapie en training daarop. Mechanismen achter het soms opmerkelijke herstel beginnen duidelijk te worden. Neurorevalidatie groeit uit tot een vakgebied dat veel meer inhoudt dan alleen maar motorische revalidatie. Cognitieve revalidatie en gedragsrevalidatie zijn in ontwikkeling. We realiseren ons dat de fragmentarisering in talrijke disciplines (arts, psycholoog, fysiotherapeut, logopedist enz.) niet ideaal is en zoeken naar methodes om de patiënt op een consistente manier te benaderen. De werkwijze volgens de empirische cyclus kan een verbindende schakel vormen binnen een interdisciplinair team.
With usually preserved communication, unlike left hemisphere aphasia–related communication impairment, right hemisphere (RH) lesions reveal a manifold of cognitive disorders. Each of these may be the key to monitoring an improvement or deterioration of the clinical status or disease pathophysiology. Furthermore, the RH is dominant for more known entities (at least measurable by us thus far) than the left hemisphere (Table 9.1).
We performed examinations of a 73-year-old, right-handed man who developed herpes simplex encephalitis, with cognitive dysfunction including severe Wernicke’s aphasia. Although he had never previously been interested in arts, use of a coloring book, recommended by his wife, led him to start drawing. A few years after the onset of brain disease, the patient began to copy pictures of landscapes. The lesion was in the left hemisphere and his work showed a strongly realistic tendency, thus we think that this case demonstrated characteristics of acquired savant syndrome. Along with the increase in drawing ability, instrumental activities of daily living (IADL), such as shopping and use of public transport, were also considerably improved in this patient. On the other hand, results of neuropsychological tests, such as the Standard Language Test of Aphasia, were not improved. We concluded that a sense of accomplishment from the drawing activity and communication with supporters might have led to improvement of IADL in this case.
Visual imagery, like vision as such, is widely thought to be supported by two distinct and dissociable processing streams, dedicated to object representation and spatial analysis respectively. However, this simple dichotomy has been contested, with recent studies suggesting that impairments in perception-for-action and visuo-spatial imagery may reflect a more general deficit in space-based attention. Although previous studies have revealed the impact of brain damage on artistic expression, few have examined the impact on artistic expression in terms of the perceptual and spatial components of either visual processing or visual imagery. Here we present the case of an artist whose artistic expression was dramatically affected following devastating posterior brain damage. Of particular interest, we demonstrate how these changes relate to impairments in integrating and aligning different spatial features in both visual processing and visual imagery, suggestive of a general simultanagnosia not previously described.
This paper presents a mathematical model of the dynamic interrelationships between education, creativity and happiness based on both theoretical insights and evidence from recent empirical neurological studies. In this context, the results are conditional on an individual’s learning effort and risk‐aversion. Specifically, I focus on two main determinants of creativity (divergent and convergent thinking) and compare two main educational policies (scholarships versus unstructured training) with regard to their impacts on the happiness gained from creativity in the general and healthy population. A test is provided by matching the model’s predictions with the results of recent neuroscience research. Numerical simulations suggested that improving convergent thinking is more important than improving divergent thinking for creativity to generate happiness throughout an individual’s life, provided that both divergent and convergent thinking have been achieved to a sufficiently large degree, and that unstructured training (i.e., extra‐curricular activities) in divergent thinking (e.g., in accounting schools) is necessary to reach wealthier students who have more difficulty learning. In contrast, scholarships or unstructured training in convergent thinking (e.g., in art schools) are necessary to reach students who learn easily but who are less wealthy.
A writer’s manifesto is a statement outlining a writer’s philosophy of life, writing goals and intentions, motives, and sources of inspiration. It is also an ongoing self-reflection on how a writer learns to write well. A writing manifesto demands an interrogation of the literary, political, philosophical and material contexts of a writer’s practice. This paper demonstrates how both undergraduate and post-graduate students can steer their own writing growth by writing a manifesto through an exploration of various methods of writing practice.
Cambridge Core - Neurology and Clinical Neuroscience - Assembly of the Executive Mind - by Michael W. Hoffmann
What happens in our brains when we compose a melody, write a poem, paint a picture, or choreograph a dance sequence? How is this different from what occurs in the brain when we generate a new theory or a scientific hypothesis? In this book, Anna Abraham reveals how the tools of neuroscience can be employed to uncover the answers to these and other vital questions. She explores the intricate workings of our creative minds to explain what happens in our brains when we operate in a creative mode versus an uncreative mode. The vast and complex field that is the neuroscience of creativity is disentangled and described in an accessible manner, balancing what is known so far with critical issues that are as yet unresolved. Clear guidelines are also provided for researchers who pursue the big questions in their bid to discover the creative mind.
Background:
Art therapy is defined by the British Association of Art Therapists as: "a form of psychotherapy that uses art media as its primary mode of communication. Clients who are referred to an art therapist need not have experience or skill in art. The art therapist is not primarily concerned with making an aesthetic or diagnostic assessment of the client's image. The overall aim of its practitioners is to enable a client to change and grow on a personal level through the use of art materials in a safe and facilitating environment". Historically, drawings and paintings have been recognised as a useful part of therapeutic processes within psychiatric and psychological specialties, and this has been acknowledged within medical and neurology-based disciplines.Arts-based therapies are generally considered as interventions managing manifestations of dementia, as they may help to slow cognitive deterioration, address symptoms related to psychosocially challenging behaviours and improve quality of life.
Objectives:
To review the effects of art therapy as an adjunctive treatment for dementia compared with standard care and other non-pharmacological interventions.
Search methods:
We identified trials from ALOIS - the Cochrane Dementia and Cognitive Improvement Group's Specialised Register - on 12 May 2014, 20 March 2015, 15 January 2016, 4 November 2016, and 4 October 2017. We also handsearched the grey literature and contacted specialists in the field and authors of relevant reviews or studies to enquire about other sources of relevant information.
Selection criteria:
All randomised controlled trials examining art therapy as an intervention for dementia.
Data collection and analysis:
Two review authors independently extracted data. We examined scales measuring cognition, affect and emotional well-being, social functioning, behaviour and quality of life.
Main results:
We found two studies that met the inclusion criteria, incorporating data on a total of 60 participants (from 88 randomised), in experimental groups (n = 29) and active control groups (n = 31). One study compared group art therapy with simple calculation activities over 12 weeks. The other study compared group art therapy with recreational activities over 40 weeks. It was not possible to pool the data for analysis from the included studies, due to heterogeneity in terms of differences in the interventions, control treatments and choice of outcome measures.In both studies there were no clear changes reported between the intervention group and the control group in the important outcome measures. According to GRADE ratings, we judged the quality of evidence for these outcome measures to be 'very low'.
Authors' conclusions:
There is insufficient evidence about the efficacy of art therapy for people with dementia. More adequately-powered and high-quality studies using relevant outcome measures are needed.
Uszkodzenie mózgowia o różnej etiologii wiąże się często z następczą zmianą zdolności poznawczych, emocjonalnych i motorycznych. Dotyczy to także osób zajmujących się bardziej lub mniej profesjonalnie tworzeniem dzieł artystycznych. W związku z tym powstaje pytanie o charakter zmian w stylu artystycznym po epizodzie neurologicznym oraz neuronalne korelaty takich zmian. Neuropsychologia jest jedną z dyscyplin zajmujących się empiryczną analizą zmian artystycznych po epizodzie neurologicznym. Jak dotąd nie wypracowano spójnego modelu badań neuropsychologicznych w tym zakresie, dominują subiektywne analizy zmian artystycznych, zaś tematyka badawcza jest znacznie rozproszona. Nie ma też zadowalających odpowiedzi na fundamentalne pytania dotyczące relacji pomiędzy uszkodzonym mózgiem i zachowaniami artystycznymi. W artykule przedstawiono najpierw krytyczną analizę „koncepcji medycznej”, zgodnie z którą samo dzieło artystyczne pozwala na diagnozowanie form patologii. Następnie podejęto próbę ustalenia względnie jednolitej i adekwatnej metodologii badań zmian artystycznych po epizodzie neurologicznym. Dodatkowo przedstawiono zarys aktualnych kluczowych tendencji badawczych i wyników neuropsychologii sztuki wizualnej. Ponadto krytycznej ocenie poddano modelowe badanie określające nasilenie i zakres zmian artystycznych po uszkodzeniu mózgowia.
This paper presents an analytical model of the dynamic interrelationships between education, creativity, and happiness based on both theoretical insights and recent empirical neurological studies. In the model, the outcome is conditional on individual intelligence and risk aversion. Specifically, it focuses on two main determinants of creativity (divergent and convergent thinking), and compares two main educational policies (scholarships vs. training) in terms of their impacts on the happiness gained from creativity in the general and healthy population. An empirical test is provided by matching the model’s predictions with the results of recent neuroscience research. Numerical simulations suggested that improving convergent thinking is more important than improving divergent thinking for creativity to generate happiness throughout an individual’s life, provided both divergent and convergent thinking have achieved a sufficiently large degree; and that unstructured training in divergent thinking (e.g., in accounting schools) is necessary to reach richer but less intelligent people, whereas scholarships or unstructured training in convergent thinking (e.g., in art schools) are necessary to reach more intelligent but less rich people.
Creative Dissociation: the artist’s “trip”. A consensual hallucination experienced
by surrendering to the oblivion of consciousness: a hallucinatory “trip” into the
depths of the unconscious, undertaken by the Artist in the dangerous attempt to reach
with no certainty a state of “higher” inspiration and mystical illumination, letting
hallucinations and inner visions emerge from the lysergic mists of a chemical ecstasy
up to reveal the unfathomable mystery of the artistic creation, sublime mirage in the
obscure desert of the being. A break in the fine consciousness veil looking for an irrational,
but extremely revealing ecstasy: this paper (in Italian) discusses the effects of drugs on artistic
creativity, based on the latest findings in the field of brain biochemistry and
neuroaesthetics.
Clinically, frontal lobe syndromes, frontal network syndromes, frontal systems syndromes, executive dysfunction, and metacognition have all been used to describe disorders of frontal lobes and their extended networks although they are not all synonymous. Anatomically they refer to those parts of the brain rostral to the central sulcus. However, because the frontal lobes network with every other part of the brain, strictly speaking, frontal network syndromes constitute the most accurate neurobiological depiction. The term, frontal network syndromes (FNS) emphasizes the universal connectivity of the frontal lobes with all other brain regions. For example, the stroke literature is replete with FNS that have been reported with discreet lesions outside the anatomical boundary of the frontal lobe, such as subcortical gray matter, subcortical white matter, with isolated lesions of the brainstem, cerebellum, temporal and parietal lobes [1?8]. For the purposes of simplification, five primary, core or elementary syndromes and numerous secondary syndromes may be delineated. Impairment in working memory, executive function, conation, inhibition, and emotional control may be regarded as the elementary deficits of FNS. In addition a number of secondary manifestations may be identified such as a wide array of behavioral abnormalities such as loss of social norms, imitation behavior, compulsions, and obsessions [9, 10]. Fig. 12.1.
Cognition and the brain has a long history dating back to the Greeks, notably Hippocrates and more recently the emergence of European neurology, psychiatry, and psychology during the nineteenth century. Several disciplines have been concerned with the study of cognition or higher cortical functions of the brain and each has its unique area of expertise and important contributions, along with its own culture and language. Today the principal clinical disciplines concerned include behavioral neurology, neuropsychiatry, and neuropsychology. In addition, the disciplines of speech and language, experimental psychology, cognitive neuroscience, and physical medicine and rehabilitation are also intimately involved. Each brain discipline has its own language of describing deficits and syndromes that may be confusing at times to the general student or clinician. However each discipline also has accumulated unique insights and experience that further the insights into our understanding of cognition in a generic sense.
Reading, writing, calculation as well as literary, musical, visual, and performing arts are subsumed under this topic. However, these evolved at vastly different times in human evolution with the more ancient musical (several 100,000 years ago) and visual arts (~40,000 years ago) preceding the others and writing and reading being the most recent (~3000 years ago).
In this article, the theoretical basis and development status of art therapy are introduced, and the intervention methods and effectiveness of art therapy in patients with dementia are reviewed. To date, nursing intervention via art therapy with dementia patients in China has been rarely investigated, and the design of this type of investigation must be improved.
The aesthetic experience through art is a window into the study of emotions. Patients with behavioural variant of frontotemporal dementia (bvFTD) have early alteration of emotional processing. A new appreciation of art has been reported in some of these patients. We designed a computerized task using 32 abstract paintings that allowed us to investigate the integrity of patients’ emotions when viewing the artwork. We evaluated both conscious and explicit appraisal of emotions [aesthetic judgment (beautiful / ugly), emotional relevance (affected or not by the painting), emotional valence (pleasant / unpleasant), emotional reaction (adjective choice) and arousal] and unconscious processing. Fifteen bvFTD patients and 15 healthy controls were included. BvFTD patients reported that they were “little touched” by the paintings. Aesthetic judgment was very different between the two groups: the paintings were considered ugly (negative aesthetic bias) and unpleasant (negative emotional bias) more often by the patients than by controls. Valence and aesthetic judgments correlated in both groups. In addition, there was a positive bias in the implicit task and for explicit emotional responses. Patients frequently chose the word “sad” and rarely expressed themselves with such adjectives as "happy”. Our results suggest that bvFTD patients can give an aesthetic judgment, but present abstraction difficulties, as spectators, resulting from impairments in the cognitive processes involved. They also have difficulties in terms of emotional processes with the loss of the ability to feel the emotion per se (i.e., to feel an emotion faced with art) linked to behaviour assessment. This cognitive approach allows us to better understand which spectators are bvFTD patients and to show interactions between emotions and behavioural disorders.
This is the protocol for a review and there is no abstract. The objectives are as follows: To review the effects of art therapy as an adjunctive treatment for dementia compared with standard care and other non-pharmacological interventions.
Are creative people more likely to be mentally ill? This basic question has been debated for thousands of years, with the 'mad genius' concept advanced by such luminaries as Aristotle. There are many studies that argue the answer is 'yes', and several prominent scholars who argue strongly for a connection. There are also those who argue equally strongly that the core studies and scholarship underlying the mad genius myth are fundamentally flawed. This book re-examines the common view that a high level of individual creativity often correlates with a heightened risk of mental illness. It reverses conventional wisdom that links creativity with mental illness, arguing that the two traits are not associated. With contributions from some of the most exciting voices in the fields of psychology, neuroscience, physics, psychiatry, and management, this is a dynamic and cutting-edge volume that will inspire new ideas and studies on this fascinating topic.
Professor Joaquín M. Fuster is an eminent cognitive neuroscientist whose research over the last five decades has made fundamental contributions to our understanding of the neural structures underlying cognition and behaviour. This book provides his view on the eternal question of whether we have free will. Based on his seminal work on the functions of the prefrontal cortex in decision-making, planning, creativity, working memory, and language, Professor Fuster argues that the liberty or freedom to choose between alternatives is a function of the cerebral cortex, under prefrontal control, in its reciprocal interaction with the environment. Freedom is therefore inseparable from that circular relationship. ‘The Neuroscience of Freedom and Creativity’ is a fascinating inquiry into the cerebral foundation of our ability to choose between alternative actions and to freely lead creative plans to their goal.
Alfred Schnittke (1934-1998), a celebrated Russian composer of the twentieth century, suffered from several strokes which affected his left cerebral hemisphere. The disease, however, did not diminish his musical talent. Moreover, he stated that his illness in a way facilitated his work. The composer showed amazingly high productivity after his first and second injuries of the central nervous system. The main topic of this chapter is the effect of strokes on Schnittke's output, creativity, and style of music. A brief biography of the composer with the chronology of his brain hemorrhages is included. In addition, the influence of cerebrovascular lesions on creative potential of other prominent composers such as Benjamin Britten, Jean Langlais, Vissarion Shebalin, Igor Stravinsky, and Ira Randall Thompson is discussed.
© 2015 Elsevier B.V. All rights reserved.
From an early age, musicians learn complex motor and auditory skills (e.g., the translation of visually perceived musical symbols into motor commands with simultaneous auditory monitoring of output), which they practice extensively from childhood throughout their entire careers. Using a voxel-by-voxel morphometric technique, we found gray matter volume differences in motor, auditory, and visual-spatial brain regions when comparing professional musicians (keyboard players) with a matched group of amateur musicians and non-musicians. Although some of these multiregional differences could be attributable to innate predisposition, we believe they may represent structural adaptations in response to long-term skill acquisition and the repetitive rehearsal of those skills. This hypothesis is supported by the strong association we found between structural differences, musician status, and practice intensity, as well as the wealth of supporting animal data showing structural changes in response to long-term motor training. However, only future experiments can determine the relative contribution of predisposition and practice.
Outsider Art (art brut) is defined as a mode of original artistic expression which thrives on its independence, shunning the public sphere and the art market. Such art can be highly idiosyncratic and secretive, and reflects the individual creator's attempt to construct a coherent, albeit strange, private world. Certain practitioners of what may be termed autistic art are examined in the light of this definition; their work is considered as evidence not of a medical condition but of an expressive intentionality entirely worthy of the interest of those drawn to the aesthetic experience.
Neuropsychological functioning and brain morphometry in a savant (case GW) with an autism spectrum disorder (ASD) and both calendar calculation and artistic skills are quantified and compared with small groups of neurotypical controls. Good memory, mental calculation and visuospatial processing, as well as (implicit) knowledge of calendar structure and 'weak' central coherence characterized the cognitive profile of case GW. Possibly reflecting his savant skills, the superior parietal region of GW's cortex was the only area thicker (while areas such as the superior and medial prefrontal, middle temporal and motor cortices were thinner) than that of a neurotypical control group. Taken from the perspective of learning/practice-based models, skills in domains (e.g. calendars, art, music) that capitalize upon strengths often associated with ASD, such as detail-focused processing, are probably further enhanced through over-learning and massive exposure, and reflected in atypical brain structure.
I argue that savant skills are latent in us all. My hypothesis is that savants have privileged access to lower level, less-processed information, before it is packaged into holistic concepts and meaningful labels. Owing to a failure in top-down inhibition, they can tap into information that exists in all of our brains, but is normally beyond conscious awareness. This suggests why savant skills might arise spontaneously in otherwise normal people, and why such skills might be artificially induced by low-frequency repetitive transcranial magnetic stimulation. It also suggests why autistic savants are atypically literal with a tendency to concentrate more on the parts than on the whole and why this offers advantages for particular classes of problem solving, such as those that necessitate breaking cognitive mindsets. A strategy of building from the parts to the whole could form the basis for the so-called autistic genius. Unlike the healthy mind, which has inbuilt expectations of the world (internal order), the autistic mind must simplify the world by adopting strict routines (external order).
We argue that hyper-systemizing predisposes individuals to show talent, and review evidence that hyper-systemizing is part of the cognitive style of people with autism spectrum conditions (ASC). We then clarify the hyper-systemizing theory, contrasting it to the weak central coherence (WCC) and executive dysfunction (ED) theories. The ED theory has difficulty explaining the existence of talent in ASC. While both hyper-systemizing and WCC theories postulate excellent attention to detail, by itself excellent attention to detail will not produce talent. By contrast, the hyper-systemizing theory argues that the excellent attention to detail is directed towards detecting 'if p, then q' rules (or [input-operation-output] reasoning). Such law-based pattern recognition systems can produce talent in systemizable domains. Finally, we argue that the excellent attention to detail in ASC is itself a consequence of sensory hypersensitivity. We review an experiment from our laboratory demonstrating sensory hypersensitivity detection thresholds in vision. We conclude that the origins of the association between autism and talent begin at the sensory level, include excellent attention to detail and end with hyper-systemizing.
Savant syndrome is a rare, but extraordinary, condition in which persons with serious mental disabilities, including autistic disorder, have some 'island of genius' which stands in marked, incongruous contrast to overall handicap. As many as one in 10 persons with autistic disorder have such remarkable abilities in varying degrees, although savant syndrome occurs in other developmental disabilities or in other types of central nervous system injury or disease as well. Whatever the particular savant skill, it is always linked to massive memory. This paper presents a brief review of the phenomenology of savant skills, the history of the concept and implications for education and future research.
Of all the features of autism, none is more widely admired than the remarkable talent found so frequently with this condition. Yet special talents are still less researched and less well understood than other features of autism. In popular accounts of autism, the existence of extraordinary talent in
Patients presenting with left-sided FTLD syndromes sometimes develop a new preoccupation with art, greater attention to visual stimuli, and increased visual creativity. We describe the case of a 53-year-old, right-handed man with a history of bipolar disorder who presented with language and behavior impairments characteristic of FTLD, then developed motor symptoms consistent with a second diagnosis of amyotrophic lateral sclerosis. Though the patient had never created visual art before, he developed a compulsion for painting beginning at the earliest stages of his disease, and continued producing art daily until he could no longer lift a paintbrush because of his motor deficits. Upon autopsy, he was found to have ubiquitin and TDP43-positive inclusions with MND pathology. This case study details the patient's longitudinal neuropsychological, emotional, behavioral, and motor symptoms, along with structural imaging, neurologic, and neuropathologic findings. Multiple examples of the patient's art are depicted throughout all stages of his illness, and the possible cognitive, behavioral, and neurologic correlates of his new-onset visual artistry are discussed.
Neural plasticity induced by stroke can mediate positive outcomes, such as recovery of function, but can also result in the formation of abnormal connections with negative consequences for perception and cognition. In three experiments using blood-oxygen level dependent (BOLD) functional magnetic resonance imaging, we examined the neural substrates of acquired auditory-tactile synesthesia, in which certain sounds can produce an intense somatosensory tingling sensation in a patient with a thalamic lesion. Compared with nine normal controls, the first experiment showed that the patient had a threefold greater BOLD response to sounds in the parietal operculum, the location of secondary somatosensory cortex. We hypothesized that this abnormal opercular activity might be the neural substrate of the patient's synesthesia. Supporting this hypothesis, the second experiment demonstrated that sounds that produced no somatosensation did not evoke a BOLD response in the operculum, while sounds that produced strong somatosensations evoked large BOLD responses. These abnormal responses may have resulted from plasticity induced by the loss of somatosensory inputs. Consistent with this idea, in the third experiment, BOLD responses to somatosensory stimulation were significantly weaker in the patient's operculum than in normal controls. These experiments demonstrate a double dissociation in the patient's secondary somatosensory cortex (increased responses to auditory stimulation and decreased responses to somatosensory stimulation), and suggest both that stroke-induced plasticity can result in abnormal connections between sensory modalities that are normally separate, and that synesthesia can be caused by inappropriate connections between nearby cortical territories.
Some patients with frontotemporal lobar degeneration (FTLD) have been shown to develop painting abilities after the onset of the disease; however, the reported cases have all been in western countries. The purpose of this report was to investigate whether this phenomenon was unique to western countries.
2 patients participated in this study. They were nonwestern uneducated patients with FTLD, semantic dementia subtype, who developed drawing skills after the onset of the disease. We compared their drawings with drawings in previous reports.
The characteristics of their paintings matched those of paintings from previously reported cases despite the cultural differences.
These results support the assumption that the appearance of painting skills during this illness is not a reflection of learning, but instead is an expression of innate functions of the brain.
The progress made in understanding the insula in the decade following an earlier review (Augustine, Neurol. Res., 7 (1985) 2-10) is examined in this review. In these ten years, connections have been described between the insula and the orbital cortex, frontal operculum, lateral premotor cortex, ventral granular cortex, and medial area 6 in the frontal lobe. Insular connections between the second somatosensory area and retroinsular area of the parietal lobe have been documented. The insula was found to connect with the temporal pole and the superior temporal sulcus of the temporal lobe. It has an abundance of local intrainsular connections and projections to subdivisions of the cingulate gyrus. The insula has connections with the lateral, lateral basal, central, cortical and medial amygdaloid nuclei. It also connects with nonamygdaloid areas such as the perirhinal cortex, entorhinal, and periamygdaloid cortex. The thalamic taste area, the parvicellular part of the ventral posteromedial nucleus, projects fibers to the ipsilateral insular-opercular cortex. In the past decade, confirmation has been given to the insula as a visceral sensory area, visceral motor area, motor association area, vestibular area, and language area. Recent studies have expanded the role of the insula as a somatosensory area, emphasizing its multifaceted, sensory role. The idea of the insula as limbic integration cortex has been affirmed and its role in Alzheimer's disease suggested.
Frontotemporal dementia is a dementia syndrome with diverse clinical characteristics. Based upon clinical parameters and single photon emission computed tomography, we identified 47 frontotemporal dementia subjects. In 10 of these 47 the primary site of brain dysfunction was anterior temporal and orbital-frontal with other frontal regions relatively spared. In this temporal lobe variant (TLV) of frontotemporal dementia, five of the subjects had more severe left-sided, and five had more right-sided, hypoperfusion. The clinical, neuropsychological and neuropsychiatric features of predominantly left-sided (LTLV) and right-sided (RTLV) TLV subjects are discussed and contrasted with more frontal presentations of frontotemporal dementia. In LTLV, aphasia was usually the first and most severe clinical abnormality RTLV patients presented with behavioural disorders characterized by irritability, impulsiveness, bizarre alterations in dress, limited and fixed ideas, decreased facial expression and increased visual alertness. These findings suggest that: (i) frontotemporal dementia is clinically heterogeneous with bitemporal and inferior frontal lobe dysfunction contributing to the clinical presentation; (ii) behavioural disturbance and aphasia are the most prominent features of predominantly temporal subtypes of frontotemporal dementia; (iii) the right and left anterior temporal regions may mediate different behavioural functions. The results of this study suggests that TLV offers a valuable source of information concerning the behavioural disorders seen with combined anterior temporal and inferior frontal lobe dysfunction.
To describe the clinical, neuropsychological, and imaging features of five patients with frontotemporal dementia (FTD) who acquired new artistic skills in the setting of dementia.
Creativity in the setting of dementia has recently been reported. We describe five patients who became visual artists in the setting of FTD.
Sixty-nine FTD patients were interviewed regarding visual abilities. Five became artists in the early stages of FTD. Their history, artistic process, neuropsychology, and anatomy are described.
On SPECT or pathology, four of the five patients had the temporal variant of FTD in which anterior temporal lobes are involved but the dorsolateral frontal cortex is spared. Visual skills were spared but language and social skills were devastated.
Loss of function in the anterior temporal lobes may lead to the "facilitation" of artistic skills. Patients with the temporal lobe variant of FTD offer a window into creativity.
Frontotemporal lobar degeneration (FTLD) often presents with asymmetric atrophy. We assessed whether premorbid occupations in FTLD patients were associated with these hemispheric asymmetries. In a multi-center chart review of 588 patients, occupation information was related to location of tissue loss or dysfunction. Patients with atrophy lateralized to the right had professions more dependent on verbal abilities than patients with left-lateralized or symmetrical atrophy. In a subgroup of 96 well-characterized patients with quantified neuroimaging data, the lateralization effect was localized to the temporal lobes and included verbal and mathematical ability. Patients whose professions placed high demands on language and mathematics had relatively preserved left temporal relative to right temporal volumes. Thus, occupation selection occurring in early adulthood is related to lateralized brain asymmetry in patients who develop FTLD decades later in the relatively deficient hemisphere. The finding suggests that verbal and mathematical occupations may have been pursued due to developmental right-lateralized functional impairment that precedes the neurodegenerative process. Alternatively, long-term engagement of activities associated with these occupations contributed to left-lateralized reserve, right-lateralized dysfunction, or both.
Extremes in mood, thought and behavior--including psychosis--have been linked with artistic creativity for as long as man has observed and written about those who write, paint, sculpt or compose. The history of this long and fascinating association, as well as speculations about its reasons for being, have been discussed by several modern authors and investigators, including Koestler (1975), Storr (1976), Andreasen (1978), Becker (1978), Rothenberg (1979), Richards (1981), Jamison (in press) and Prentky (in press). The association between extreme states of emotion and mind and creativity not only is fascinating but also has significant theoretical, clinical, literary and societal-ethical implications. These issues, more thoroughly reviewed elsewhere (Jamison et al. 1980; Richards 1981; Jamison, in press), include the understanding of cognitive, perceptual, mood and behavioral changes common to manic, depressive and creative states; the potential ability to lessen the stigma of mental illness; effects of psychiatric treatment (for example, lithium) on creativity; and concerns raised about genetic research on mood disorders. The current study was designed to ascertain rates of treatment for affective illness in a sample of eminent British writers and artists; to study differences in subgroups (poets, novelists, playwrights, biographers, artists); to examine seasonal patterns of moods and productivity; and to inquire into the perceived role of very intense moods in the writers' and artists' work. One of the major purposes of this investigation was to look at possible similarities and dissimilarities between periods of intense creative activity and hypomania. Hypothesized similarities were based on the overlapping nature of mood, cognitive and behavioral changes associated with both; the episodic nature of both; and possible links between the durational, frequency and seasonal patterns of both experiences.
The significance of art in human existence has long been a source of puzzlement, fascination, and mystery. in Neuropsychology of Art, Dahlia W. Zaidel explores the brain regions and neuronal systems that support artistic creativity, talent, and appreciation.
The development of functional brain asymmetry during childhood is confirmed by changes in cerebral blood flow measured at rest using dynamic single photon emission computed tomography. Between 1 and 3 years of age, the blood flow shows a right hemispheric predominance, mainly due to the activity in the posterior associative area. Asymmetry shifts to the left after 3 years. The subsequent time course of changes appear to follow the emergence of functions localized initially on the right, but later on the left hemisphere (i.e. visuospatial and later language abilities). These findings support the hypothesis that, in man, the right hemisphere develops its functions earlier than the left.
Frontotemporal dementia is a dementia syndrome with diverse clinical characteristics. Based upon clinical parameters and single photon emission computed tomography, we identified 47 frontotemporal dementia subjects. In 10 of these 47 the primary site of brain dysfunction was anterior temporal and orbital-frontal with other frontal regions relatively spared. In this temporal lobe variant (TLV) of frontotemporal dementia, five of the subjects had more severe left-sided, and five had more right-sided, hypoperfusion. The clinical, neuropsychological and neuropsychiatric features of predominantly left-sided (LTLV) and right-sided (RTLV) TLV subjects are discussed and contrasted with more frontal presentations of frontotemporal dementia. In LTLV, aphasia was usually the first and most severe clinical abnormality RTLV patients presented with behavioural disorders characterized by irritability, impulsiveness, bizarre alterations in dress, limited and fixed ideas, decreased facial expression and increased visual alertness. These findings suggest that: (i) frontotemporal dementia is clinically heterogeneous with bitemporal and inferior frontal lobe dysfunction contributing to the clinical presentation; (ii) behavioural disturbance and aphasia are the most prominent features of predominantly temporal subtypes of frontotemporal dementia; (iii) the right and left anterior temporal regions may mediate different behavioural functions. The results of this study suggests that TLV offers a valuable source of information concerning the behavioural disorders seen with combined anterior temporal and inferior frontal lobe dysfunction.
Sequential behavioral and neuropsychological assessments of an artist with probable Alzheimer's disease were made over a 2 1/2-year period. His painting skills underwent dramatic deterioration and a concomitant decline in intellectual ability occurred. Psychological measures suggested that his visuoconstructive skills were relatively less vulnerable to disruption by Alzheimer's disease than were other cognitive functions and that the diminished artistic ability involved motivational, mnemonic, and organizational skills until the later stages of the disease. These observations may contribute to understanding the neurological basis of artistic creativity, as well as the more specific effects of Alzheimer's disease on neuropsychological abilities.
(JAMA 1987;258:2731-2734)
To the Editor.
—In the recent article by Drs Cummings and Zarit,1 the reproductions that are supposed to illustrate the progressive intellectual decay of the artist show in fact a progression toward better pictorial quality, if not toward genius.Figure 1 in the article, painted near the time of onset of Alzheimer's disease, is a vulgar, unskilled amateur painting with gross errors in perspective and nauseating colors.Figure 2, painted seven years after the onset of disease, is the work of a genius, recalling the best of Van Gogh.Figure 4, completed at the nadir of his Alzheimer's dementia, could compete with the best attainments of modern art.This leads to one question: Are our contemporary artists collectively suffering from advanced Alzheimer's or from another kind of dementia?
Patient PH developed retinitis pigmentosa in childhood and progressively lost his vision until he became completely blind at 40 years old. At age 42, he started experiencing vivid ‘synesthesia’+ADs- tactile stimuli on the hand evoked a vivid visual sensation of ‘movement’, ‘expansion’ or ‘jumping’. Intriguingly, the synesthesia was much more vivid when the hand was in front of the face rather than behind. The effect is unlikely to be confabulatory since touch thresholds (Semmes Monofilaments) were normal and identical for hand in front versus hand behind the head, while ‘thresholds’ for evoked visual sensations were significantly higher for the ‘behind’ condition. Also, the critical fusion frequency for the tactile sensation was much higher than the visually evoked ones. We propose three explanations. (i) ‘Remapping’ or ‘cross-talk’. As a result of de-afferentation, sensory input to the somatosensory pathways (e.g. insular cortex) also innervates extrastriate visual areas. (ii) When a person is touched, there may be spontaneously evoked tactile associative ‘memories’ that would not normally evoke actual visual qualia because of competing ‘spontaneous activity’ from the visual pathways. However, upon de-afferentation, the associations may be experienced as synesthesia. (iii) After de-afferentation, the ‘back projections’ to somatosensory areas from visual areas may be strengthened.
Here we analyze the artwork of Carolus Horn, a famous German artist. Despite developing Alzheimer’s dementia (AD), he continued to produce drawings and paintings until he died. There are impressive changes in spatial relations, in the preference of colors, in the size of objects and other aspects of his paintings. The most prominent change is the loss of 3-dimensionality, followed by a continuous simplification and finally a decay of all objects and structures. We point to the relation between these changes in his artwork and the course of neuropsychological and neuropathological processes in AD.
In a famous paper published in 1948, the French neurologist Th�ophile Alajouanine discussed the influence of aphasia on artistic realization. He used as examples three artists he had seen personally. They included the musician Maurice Ravel, the writer Valery Larbaud and a painter whose name was not mentioned. We have since found the identity of the painter. We therefore present for the first time, with the permission of his family, the works of Paul- Elie Gernez (1888-1948) before and after his stroke. We confirm that aphasia did not really interfere with this painter’s ability to produce works of art. However, we have reasons to believe that there was a change in his style which may have become less poetic, as if his ability to ’invent’ had decreased and he had experienced some loss of spontaneity. This and other published cases strongly suggest that the effect of cerebral lesions is different in some artists than in non-artists, perhaps because of an expanded cortical representation, secondary to their lifelong formal training.
To the Editor.
—The article entitled "Probable Alzheimer's Disease in an Artist" by Drs Cummings and Zarit1 in the Nov 20, 1987, issue of JAMA was one of the funniest articles I have ever read. The humor was all the more hilarious because it was unintentional and it entirely escaped the authors. They show a picture painted by the artist before the onset of Alzheimer's disease (Fig 1) that is a nice little picture, quite photographic in content and worth about $75. Figure 2 in the article shows a stunning painting done after the artist acquired Alzheimer's disease! It looks like a Van Gogh and is typical of Impressionism. I would like to buy it.
Oliver Sacks MD, Clinical Professor of Neurology at the Albert Einstein College of Medicine in New York, talked with Anthony Freeman during his visit to London in January 1995 to publicize his recently published book An Anthropologist on Mars. The interview is preceded by an overview of the book
Objective: The objectives of this study were to examine common patterns in the lives and artwork of five artistic savants previously described and to report on the clinical, neuropsychological, and neuroimaging findings from one newly diagnosed artistic savant.
Background: The artistic savant syndrome has been recognized for centuries, although its neuroanatomic basis remains a mystery.
Methods: The cardinal features, strengths, and weaknesses of the work of these six savants were analyzed and compared with those of children with autism in whom artistic talent was absent. An anatomic substrate for these behaviors was considered in the context of newly emerging theories related to paradoxical functional facilitation, visual thinking, and multiple intelligences.
Results: The artists had features of "pervasive developmental disorder," including impairment in social interaction and communication as well as restricted repetitive and stereotyped patterns of behavior, interest, and activities. All six demonstrated a strong preference for a single art medium and showed a restricted variation in artistic themes. None understood art theory. Some autistic features contributed to their success, including attention to visual detail, a tendency toward ritualistic compulsive repetition, the ability to focus on one topic at the expense of other interests, and intact memory and visuospatial skills.
Conclusions: The artistic savant syndrome remains rare and mysterious in origin. Savants exhibit extraordinary visual talents along with profound linguistic and social impairment. The intense focus on and ability to remember visual detail contributes to the artistic product of the savant. The anatomic substrate for the savant syndrome may involve loss of function in the left temporal lobe with enhanced function of the posterior neocortex. (NNBN 2000;13:29-38)
(C) 2000 Lippincott Williams & Wilkins, Inc.
The following chapter will review the current state of research into the relationship between creativity and neural processes.
The review will begin with an overview of current conceptual formulations of creativity as a cognitive ability and the proposed
role of inhibition in creative thought. The focus will then shift to more recent research on patterns of electrophysiological
activity in the brain that have been found to be associated with creativity. Studies concerning EEG frequency, EEG coherence,
EEG complexity and P300 evoked potentials will be discussed. The use of positron emmision tomography (PET) and magnetic resonance
imaging (MRI) in the study of creativity will then be reviewed, with special emphasis on studies of verbal fluency and enhanced
creativity in frontotemporal dementia. The review will finish with a discussion of hemispheric asymmetry in creativity, the
comparison of data from a range of imaging modalities, and a discussion of the role of the personality trait Openness to Experience
in the understanding of creativity.
Although creativity has been related to prefrontal activity, recent neurological case studies postulate that patients who have left frontal and temporal degeneration involving deterioration of language abilities may actually develop de novo artistic abilities. In this study, we propose a neural and cognitive model according to which a balance between the two hemispheres affects a major aspect of creative cognition, namely, originality. In order to examine the neural basis of originality, that is, the ability to produce statistically infrequent ideas, patients with localized lesions in the medial prefrontal cortex (mPFC), inferior frontal gyrus (IFG), and posterior parietal and temporal cortex (PC), were assessed by two tasks involving divergent thinking and originality. Results indicate that lesions in the mPFC involved the most profound impairment in originality. Furthermore, precise anatomical mapping of lesions indicated that while the extent of lesion in the right mPFC was associated with impaired originality, lesions in the left PC were associated with somewhat elevated levels of originality. A positive correlation between creativity scores and left PC lesions indicated that the larger the lesion is in this area the greater the originality. On the other hand, a negative correlation was observed between originality scores and lesions in the right mPFC. It is concluded that the right mPFC is part of a right fronto-parietal network which is responsible for producing original ideas. It is possible that more linear cognitive processing such as language, mediated by left hemisphere structures interferes with creative cognition. Therefore, lesions in the left hemisphere may be associated with elevated levels of originality.
The prefrontal cortex (PFC) supports functions critical for creative thinking. Damage to the PFC is expected to impair creativity. Yet, previous works suggested the emergence of artistic talent in patients with frontotemporal lobar degeneration (FTLD), which was interpreted as increased creativity.
We designed a study in patients with frontal variant (fv) of FTLD in order to verify whether: (1) creativity is impaired after frontal degeneration, (2) poor creativity is associated with frontal dysfunctions, and (3) poor creativity is related to hypoperfusion in specific PFC regions.
Three groups of subjects were enrolled in the study: fvFTLD patients (n=17), non-demented Parkinson's disease (PD) patients (n=12) and healthy controls (n=17). Participants performed a standardized test of creativity, the Torrance Test of Creative Thinking (TTCT) and tests assessing frontal functions. Brain perfusion was correlated to fvFTLD patients' performance in the TTCT.
Patients with fvFTLD were strongly impaired in all dimensions of the TTCT, compared to PD patients and controls. Disinhibited and perseverative responses were observed only in fvFTLD patients, leading to "pseudo-creative" responses. Poor creativity was positively correlated with several frontal tests. Poor creativity was also correlated with prefrontal hypoperfusion, particularly in the frontal pole.
Poor creativity is associated with fvFTLD. The results also suggest that the integrity of the PFC (in particular frontopolar) is strongly associated with creative thinking. The emergence of artistic talent in patients with fvFTLD is explained by the release of involuntary behaviors, rather than by the development of creative thinking.
An epilepsy diagnosis is very verbal, relying on witness history, personal narrative and analysis of how people describe the experience. Occasionally however, non-verbal descriptions of seizures allow us to gain a fuller understanding of this complex disorder. Artists are often inspired by personal experience, so it should be no surprise to find people depicting images of ill health, both their own and people they have observed. Furthermore, an ailment or affliction may influence an artist's portfolio over their lifetime, such as de Kooning's Alzheimer's disease and Monet's glaucoma. Epilepsy (in contrast with cerebrovascular or neurodegenerative disease) may present not just with a loss of function but with unusual super-added experiences such as déjà vu, ecstatic auras or hallucinations. Here we describe some artists who were thought to have had epilepsy, and the way in which their seizures influenced their art. It appears that for some, they have succeeded despite, rather than because of, their epilepsy and that rather than be inspired by their symptoms they were ashamed of them. If there is a common theme, it is in the unwanted psychological harm of some seizures provoking dark, frustrated imagery.
We report here the case of a female patient who developed the following behavioural changes after a brain lesion involving the left posterior insula and SII cortices. She discovered de novo artistic capabilities for painting, with an episodic and compulsive need to paint ("hyperpainting"), but also exhibited changes in her ability to feel emotions. In addition, she had a typical neuropathic pain syndrome, including provoked pain and spontaneous pain, whose intensity was worsened when she painted with cold colours. This case-report suggests some kind of synaesthesiae, which has previously been reported for other sensory modalities. These findings suggest that a cross-talk between emotional, thermosensory, pain, and motivational functions may take place during recovery, at the level of the left insular-SII cortices.
A small proportion of patients with Parkinson's disease (PD) develop a dopamine dysregulation syndrome (DDS). Management of such patients can be difficult; hence, early identification and careful monitoring of at-risk individuals are important. Based on four illustrative cases, we wish to draw attention to the risk of developing DDS in PD patients engaged in a creative and artistic profession, who compulsively abuse dopaminergic drugs to maintain or enhance their artistic creativity. Balancing the drug requirement for treating motor symptoms on one hand and improving creativity on the other hand has to be carefully evaluated and early neuropsychiatric intervention may be necessary. Apart from the known risk factors-young age at PD onset, male gender, heavy alcohol consumption, illegal drug use, and history of affective disorder-engagement in a creative or artistic profession may be an additional risk factor for developing DDS.
The effect of brain injury and disease on the output of established artists is an object of much study and debate. The emergence of de novo artistic behaviour following such injury or disease, while very rare, has been recorded in cases of frontotemporal dementia, epilepsy, subarachnoid haemorrhage and Parkinson's disease. This may be an underdiagnosed phenomenon and may represent an opportunity to further understand the neural bases of creative thought and behaviour and of cognitive change after brain injury. There is clearly an important role for hemispheric localization of pathology, which is usually within the temporal cortex, upon the medium of artistic expression, and a likely role for mild frontal cortical dysfunction in producing certain behavioural and cognitive characteristics that may be conducive to the production of art. Possible mechanisms of 'artistic drive' and 'creative idea generation' in these patients are also considered.
We present a PD patient in whom dopamine agonists awoke a hidden creativity that led to a gradual increase in painting productivity evolving to a disruptive impulsive behaviour that shared many features with punding. A dramatic change in painting style related to a more emotional experience during the process of creation developed after treatment onset. This case suggests that changes in creativity in PD seem to be related to dopaminergic imbalance in the limbic system.
A 27-year-old right-handed male mosaic artisan who had not shown any interest in drawing or artistic activity was admitted to the Department of Neurology for attacks of bizarre behavior and convulsive disorder. The patient reported feeling "waves" engulfing him during the attacks, leaving him floating helplessly. During some attacks, the patient impulsively initiated drawing activity. Interictal sleep-deprivation EEG showed a left frontotemporal focus of paroxysmal discharge. Brain tomography with SPECT showed low 99Tc-HMPAO uptake in the left frontoparietal region. Psychodiagnostic tests gave evidence of dysfunction of the left frontal region, with preference of the right hemisphere. It is suggested that the attacks of altered cognitive state were, in this case, provoked by spreading depression of the left hemisphere, while the integrative functions of the right hemisphere remained intact. Thus, the impulsive artistic creativity during the attacks may represent a "release phenomenon" of the complex visuospatial skills of the right (subdominant) hemisphere. This symptomatology of transient cognitive alterations is unique and, to the best of our knowledge, has not been previously reported.
Extremes in mood, thought and behavior--including psychosis--have been linked with artistic creativity for as long as man has observed and written about those who write, paint, sculpt or compose. The history of this long and fascinating association, as well as speculations about its reasons for being, have been discussed by several modern authors and investigators, including Koestler (1975), Storr (1976), Andreasen (1978), Becker (1978), Rothenberg (1979), Richards (1981), Jamison (in press) and Prentky (in press). The association between extreme states of emotion and mind and creativity not only is fascinating but also has significant theoretical, clinical, literary and societal-ethical implications. These issues, more thoroughly reviewed elsewhere (Jamison et al. 1980; Richards 1981; Jamison, in press), include the understanding of cognitive, perceptual, mood and behavioral changes common to manic, depressive and creative states; the potential ability to lessen the stigma of mental illness; effects of psychiatric treatment (for example, lithium) on creativity; and concerns raised about genetic research on mood disorders. The current study was designed to ascertain rates of treatment for affective illness in a sample of eminent British writers and artists; to study differences in subgroups (poets, novelists, playwrights, biographers, artists); to examine seasonal patterns of moods and productivity; and to inquire into the perceived role of very intense moods in the writers' and artists' work. One of the major purposes of this investigation was to look at possible similarities and dissimilarities between periods of intense creative activity and hypomania. Hypothesized similarities were based on the overlapping nature of mood, cognitive and behavioral changes associated with both; the episodic nature of both; and possible links between the durational, frequency and seasonal patterns of both experiences.
Sequential behavioral and neuropsychological assessments of an artist with probable Alzheimer's disease were made over a 2 1/2-year period. His painting skills underwent dramatic deterioration and a concomitant decline in intellectual ability occurred. Psychological measures suggested that his visuoconstructive skills were relatively less vulnerable to disruption by Alzheimer's disease than were other cognitive functions and that the diminished artistic ability involved motivational, mnemonic, and organizational skills until the later stages of the disease. These observations may contribute to understanding the neurological basis of artistic creativity, as well as the more specific effects of Alzheimer's disease on neuropsychological abilities.
Clinical psychiatry has focused almost entirely on the psychopathology of the affective disorders. The authors studied responses of 61 patients (35 bipolar. 26 unipolar) to questions about perceived short- and long-term benefits (increased sensitivity, sexuality, productivity, creativity, and social outgoingness) they attributed to their affective illness. Bipolar patients strongly indicated positive experiences associated with manic-depressive illness; few unipolar patients perceived their disorder in such a way. Significant sex differences emerged in the attributions made by bipolar patients.
The aim in this review article is to document research findings that have shown paradoxical effects of nervous system changes, whereby direct or indirect neural damage may result in facilitation of behavioural functions. Such findings have often been ignored or undervalued in the brain-behaviour research literature. A further aim is to consider possible mechanisms and theoretical insights related to this facilitation. Analyses of relevant studies show that two major types of paradoxical functional facilitation (PFF) effects may be distinguished. (i) Situations where damage to intact brain tissue brings to normal or near normal a previously subnormal or abnormal level of functioning. I refer to improved levels of functioning in such contexts as restorative PFF effects. One of the best documented examples of such PFF effects is the 'Sprague effect', whereby collicular lesions may bring about an improvement in visual functioning following an initial occipital lesion. (ii) Situations where a subject with nervous system pathology or sensory loss performs better than normal control subjects on a particular task. I refer to improved levels of performance in these contexts as enhancing PFF effects. Restorative and enhancing PFF effects have been found in a range of domains, including memory, sensory and perceptual functions, and language functioning. A potential contribution of PFF effects is that they highlight two important neural mechanisms, i.e. inhibition and compensatory plasticity. Two broad classes of theoretical insights related to PFF effects are therefore discussed: (i) inhibitory mechanisms, which form part of an interactive view of brain function where competitive opponent-processing is a significant feature; (ii) 'compensatory augmentation', which occurs as a specific manifestation of CNS plasticity. Both of these mechanisms are considered in relation to paradoxical increases in CBF and anatomical annexation effects that are seen in neurological patients and in subjects with sensory loss. Paradoxical functional facilitation paradigms represent a powerful methodological tool for confirming or refuting hypotheses in brain-behaviour research. The counter-intuitive nature of PFF findings provides a particularly persuasive set of evidence in support of neural, conceptual or computational models of brain function that specifically predict paradoxical facilitation of cognitive functioning.
The development of functional brain asymmetry during childhood is confirmed by changes in cerebral blood flow measured at rest using dynamic single photon emission computed tomography. Between 1 and 3 years of age, the blood flow shows a right hemispheric predominance, mainly due to the activity in the posterior associative area. Asymmetry shifts to the left after 3 years. The subsequent time course of changes appear to follow the emergence of functions localized initially on the right, but later on the left hemisphere (i.e. visuospatial and later language abilities). These findings support the hypothesis that, in man, the right hemisphere develops its functions earlier than the left.
To improve clinical recognition and provide research diagnostic criteria for three clinical syndromes associated with frontotemporal lobar degeneration.
Consensus criteria for the three prototypic syndromes-frontotemporal dementia, progressive nonfluent aphasia, and semantic dementia-were developed by members of an international workshop on frontotemporal lobar degeneration. These criteria build on earlier published clinical diagnostic guidelines for frontotemporal dementia produced by some of the workshop members.
The consensus criteria specify core and supportive features for each of the three prototypic clinical syndromes and provide broad inclusion and exclusion criteria for the generic entity of frontotemporal lobar degeneration. The criteria are presented in lists, and operational definitions for features are provided in the text.
The criteria ought to provide the foundation for research work into the neuropsychology, neuropathology, genetics, molecular biology, and epidemiology of these important clinical disorders that account for a substantial proportion of cases of primary degenerative dementia occurring before the age of 65 years.