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Spatial representations, distortions and alterations in the graphic and artistic production of brain-damaged patients and of famous artists
Abstract
The authors review the drawing disorders that can be observed in patients with brain damage (in particular, those with constructional apraxia and unilateral spatial neglect), the impact of brain damage on the output of professional artists, and the distortions of body image that characterise the work of many great artists, from Rubens to Lucien Freud. These different perspectives share the basic assumption that the graphic and artistic output of patients, normal subjects, and exceptionally gifted individuals may represent a window onto the neural organisation of body image.
... The study of brain-behavior relationship in artists with brain damage has so far constructed the basis of our knowledge regarding the source of human creativity and artistic skills in brain. In this context, the changes in artistic style of some renowned artists over the last century have been studied thoroughly (Berti, Cappa &Folegatti, 2007;Bogousslavsky, Hennerici, B€ azner & Bassetti, 2010). It has been observed that the side of brain injury in different artists has affected their artistic skills in different ways (Bazner & Hennerici, 2007). ...
... Several contemporary papers have examined the effect of stroke in painters (Annoni et al., 2005;Bazner & Hennerici, 2006;Berti, Cappa & Folegatti, 2007;Bogousslavsky, Hennerici, B€ azner & Bassetti, 2010;Chatterjee et al., 2011;Petcu et al., 2016). It has been observed that right and left hemispheric stroke affect the style and content of artwork in contrasting ways. ...
Several papers have investigated the effect of stroke on creativity. While initial evidence favored right hemispheric dominance in artwork creation, subsequent well-founded research has established the left hemispheric participation in creativity, supporting the idea of bi-hemispheric role in artistic production. We here describe the case of a renowned artist who suffered a left hemispheric ischemic stroke involving the occipito-temporal region and subsequently manifested several difficulties in producing visual artworks. We documented his recovery phases in a prospective way during the initial months following stroke and observed that, although his constructional abilities recovered to a significant extent over 3 months, spontaneous creation was persistently impaired. The right hemispheric role in visual art is linked mainly to visuo-spatial skills and global attention, while left hemispheric participation is thought to be related to focal attention and visual imagery. Our case study lends support to the idea that art is a bi-hemispheric function with important complementary contributions from both the right and left hemisphere.
... Plusieurs études montrent que des artistes qui ont continué leur production artistique après une lésion cérébrale ont pu modifier leur style pictural mais qu'ils gardent leur expressivité artistique malgré le retentissement de l'atteinte de leurs fonctions instrumentales (Figure 8) 27 . ...
Chapter published in the book in French "Epistemologie du dessin", edited by Agnès Callu, who is an historian, expert and critic in Fine Arts (Ecole des Chartes).
The chapter summarizes some aspects of physiological and neuropsychological human motor control than can be relevant for the analysis of drawing.
... Plusieurs études montrent que des artistes qui ont continué leur production artistique après une lésion cérébrale ont pu modifier leur style pictural mais qu'ils gardent leur expressivité artistique malgré le retentissement de l'atteinte de leurs fonctions instrumentales (Figure 8) 27 . ...
... Other cases of spared artistic capacities after right hemisphere stroke include painters who developed visual neglect. They did not draw or did not put colour on the left side of the canvas, but perfectly painted the right side [16]. ...
The novelist Henry James shared with his brother William, the author of the Principles of Psychology, a deep interest in the ways in which personal identity is built through one's history and experiences. At the end of his life, Henry James suffered a vascular stroke in the right hemisphere and developed a striking identity delusion. He dictated in a perfectly clear and coherent manner two letters as if they were written by Napoleon Bonaparte. He also showed signs of reduplicative paramnesia. Negative symptoms resulting from right hemisphere damage may disrupt the feelings of "warmth and intimacy and immediacy" and the "resemblance among the parts of a continuum of feelings (especially bodily feelings)", which are the foundation of personal identity according to William James. On the other hand, a left hemisphere receiving inadequate input from the damaged right hemisphere may produce positive symptoms such as delusional, confabulatory narratives. Other fragments dictated during Henry James's final disease reveal some form of insight, if partial and disintegrated, into his condition. Thus, even when consciousness is impaired by brain damage, something of its deep nature may persist, as attested by the literary characteristics of the last fragments of the Master.
... This is in-line with findings from Harrington et al. (2006) and from lesion studies on artists suffering from righthemispheric distortions (e.g. Berti et al. 2007;Kleiner-Fisman et al. 2003;Kleiner-Fisman and Lang 2004). Moreover, most effects were localized within temporal areas. ...
Brain mechanisms associated with artistic talents or skills are still not well understood. This exploratory study investigated differences in brain activity of artists and non-artists while drawing previously presented perspective line-drawings from memory and completing other drawing-related tasks. Electroencephalography (EEG) data were analyzed for power in the frequency domain by means of a Fast Fourier Transform (FFT). Low Resolution Brain Electromagnetic Tomography (LORETA) was applied to localize emerging significances. During drawing and related tasks, decreased power was seen in artists compared to non-artists mainly in upper alpha frequency ranges. Decreased alpha power is often associated with an increase in cognitive functioning and may reflect enhanced semantic memory performance and object recognition processes in artists. These assumptions are supported by the behavioral data assessed in this study and complement previous findings showing increased parietal activations in non-artists compared to artists while drawing. However, due to the exploratory nature of the analysis, additional confirmatory studies will be 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.
Unlike the concept handed down by philosophy (and by the philosophy of science), which proposes a univocal, intellectualistic vision of space, Previc's studies have shown that the relationship between consciousness and space is instead managed by a number of modules, making it possible to categorise spatial interaction on four levels which correspond to the different ways in which we project our existence in different practical and cultural scenarios. What emerges as particularly important is the fourth level of the management of spatiality, the one that sees human consciousness dealing with the great distances - the heavens, the house of the gods. This module makes use of a neural pathway involving ventral sensory structures that also manage the relationship with religion and transcendence. But these are also the structures that are activated when populations are forced to set out in search of new lands - the quest for the eternal "Promised Land". In this study of infinite spaces, the path of the gods and of men coincide and they are seen to advance along it together.
Two unselected groups of patients, affected by a mono-hemispheric cerebral lesion, were studied in two seperate services by means of various tasks of copying drawings, in order to check the hypothesis of a qualitative difference between unilateral spatial neglect (USN) of right and left brain-damaged patients. In both experimental groups drawing asymmetries were found to be of slight importance among the left hemispheric patients, consisting chiefly in a tendency to omit some figures lying on the right half of the models, and to be definitely more severe in the right braindamaged patients, where the main pattern of USN seemed to be the tendency to leave unfinished the left half of the drawings. A second aim of the study was to describe some less frequent features of USN, sometimes found in patients who were recovering from a severe damage of the minor hemisphere. These patterns of USN seemed to suggest that the core of unilateral spatial neglect consists in a peculiar disorganization of the type of synthesis of the sensory data which seems characteristic of the minor hemisphere.
Body dysmorphic disorder (BDD) is defined as a preoccupation with an "imagined" defect in one's appearance. Alternatively, where there is a slight physical anomaly, then the person's concern is markedly excessive. The preoccupation is associated with many time consuming rituals such as mirror gazing or constant comparing. BDD patients have a distorted body image, which may be associated with bullying or abuse during childhood or adolescence. Such patients have a poor quality of life, are socially isolated, depressed, and at high risk of committing suicide. They often have needless dermatological treatment and cosmetic surgery. The condition is easily trivialised and stigmatised. There is evidence for the benefit of cognitive behaviour therapy and selective serotonin reuptake inhibitors in high doses for at least 12 weeks, as in the treatment of obsessive-compulsive disorder. There is no evidence of any benefit of antipsychotic drugs or other forms of psychotherapy.
Artistic licence taps into the simplified physics used by our brain to recognize everyday scenes, says Patrick Cavanagh.
A recent cognitive model of social phobia (Clark & Wells, 1995)
suggested that negative self-images may play an important role in
maintaining the disorder. To investigate this suggestion, 30 social phobics
and 30 non-patient controls were given a semi-structured interview which
focused on spontaneously occurring images. Social phobics were significantly
more likely than controls to report experiencing images when anxious in
social situations. In addition, social phobics’ images were
significantly more negative and significantly more likely to involve seeing
oneself from an observer’s perspective. Implications of these findings for
the understanding and cognitive treatment of social phobia are discussed.
Two groups of left (N: 100) and of right (N: 100) brain-damaged patients were given a test of copying designs and of copying crosses. Qualitative differences between the two groups were specified and submitted to statistical analysis. Patients with right hemisphere damage showed a tendency to neglect the left half of the models, to orientate the drawings diagonally on the paper, to make gross errors in spatial relations, to overscore lines already drawn and to add material, e.g. signatures and spontaneous drawings, not requested by the investigator. In addition, they showed a "piecemeal' approach of strategy in copying the models. Patients with left hemispheric lesions on the other hand gave simplified and reduced copies of the drawings, and showed some difficulty in reproducing angles. A tentative interpretation of these differences is advanced.
Twenty-four subjects with positive radioactive brain scans in one of four quadrants of the brain (right anterior, right posterior, left anterior, left posterior) and 16 patients with no evidence of focal brain damage were tested on a battery of six tests to assess constructional ability over as broad a spectrum as possible. These tests included: (1) visual and auditory reaction time, (2) drawing to memory and to copy, (3) puzzle constructions, (4) stick-pattern reversals, (5) template-matching, and (6) token-patterns.
Differences were found between groups dependent upon cerebral lateralization of lesion (i.e., right versus left hemisphere damage), position of lesion site within the hemisphere (i.e., anterior versus posterior), and the nature of the task being utilized. We find that constructional disability cannot be considered a single, unitary disturbance, but is, rather, a function of various factors in combination with each other. There is evidence that lesions in right hemisphere produce more consistent disturbances in visual-spatial tasks than do similar lesions in left hemisphere, and that there is a greater consistency of performance with posterior lesions (in either hemisphere) than with anteriorly located lesions.
An historical review of research in constructional disability (apraxia) is presented, as well as some speculations pertaining to the nature of the disturbance, based on present and earlier findings.
We present examples of copying and spontaneous drawing from a patient (P.B.) with hemianopia and severe neglect. The patient's drawings of butterflies show omission of the left side when the task is undertaken with the eyes open. By contrast, full butterflies are produced when P.B. draws with his eyes closed, and when he rotates the image to draw a horizontally-aligned figure. Unless specifically cued to the "neglected" side, the patient "believes" that his half-drawings are full drawings. Interpretations of the phenomena are provided in terms of normal perceptual completion.
Several reports of cases of experienced artists showing neglect after a brain lesion can be gleaned from the literature. The analysis of their drawings might provide better insight into the symptoms of neglect than that of non-artists's production. However, most of these reports are anedoctal. We describe in some detail the case of neglect of a distinguished artist, the internationally known Federico Fellini (FF), whom we followed-up for two months after his right parietal stroke. The neuropsychological profile of his neglect syndrome was characterized by left visuo-motor neglect which persisted for two months. At onset, FF also showed indications of neglect dyslexia as well as some evidence of implicit processing of the neglected parts of visual stimuli. However, there was no sign of personal and representational neglect, and FF was well aware of his motor and attentional deficits. FF's neglect was characterised by several dissociations, of which the lack of functional carryover despite intact conceptual and semantic insight is the most relevant.
Body image distortion is a major and often persistent symptom in anorexia nervosa. During a functional imaging investigation we confronted female anorectic patients and healthy controls with their own digitally distorted body images using a computer-based video-technique. Our findings indicate activation of the attention network as well as of structures involved in visuo-spatial processing and self-reflection in both groups. Anorectic patients showed a greater activation in the prefrontal cortex (BA 9) and the inferior parietal lobule (BA 40), including the anterior intraparietal sulcus, than did controls. However, an analysis of the BOLD-response in the IPL area revealed that anorectic patients showed only a specific increase in activation to their own pictures than to others indicating different visuo-spatial processing, while controls did not differentiate.