Some people with dementia, like this patient, experience enhanced visual creativity or experience it despite their brain degeneration. However, the underlying mechanisms were unclear until recently. study Led by Friedberg et al., they identified brain structures that may be involved and the connections between them.
The sudden development of new strengths, such as artistic creativity, as well as defects, may be a key signal of neurodegeneration, allowing early monitoring and even treatment, neurologists said. Bruce MillerDirector of the UCSF Memory Aging Center and co-author of the study published in JAMA Neurology.
“This research also helps us understand the different forms of creativity,” Friedberg said, adding that “overlapping brain mechanisms are responsible for creating inspiring works of art and inventing innovative technologies.” This is because it is unclear whether they are involved in doing so.
Other examples of artistic development
The couple’s visit in 2018 piqued the interest of Friedberg, who had just completed a residency at the Tel Aviv-Suraski Medical Center. She began surveying the scientific literature, looking for evidence of a link between neurodegeneration and artistic creativity.
she learned that Anne Adamsthe focus of a 2008 study by neurologists Bill SealyMiller and colleagues at the University of California, San Francisco.
Adams was a scientist, but quit college in his 40s to care for his son who was in a serious car accident. She began painting and did not return to her laboratory after her son recovered. Fully immersed in her art, Adams became more obsessed with FTD, especially as signs of primary progressive aphasia appeared.
FTD are a group of neurodegenerative disorders caused by the death of neurons in the frontal and temporal lobes of the brain, regions that control social behavior and language, respectively.
After reading about a surprising surge in visual creativity in the face of neurological deterioration, Friedberg said she was struck by the “hidden potential that can be aroused in the setting of illness.” .
Friedberg, a researcher at the UCSF Center for Memory Aging, who led the recent study with Miller, Seeley and others, now knows why it happens.
Creativity explodes amid nervous system decline
Increased visual artistic creativity is relatively unique in neurodegenerative diseases.
“Often it’s the other way around,” he said. Raquel Gutierrez Zuniga, a neurologist at the Sanitas La Moraleja University Hospital in Madrid, was not involved in the study. Even though she is an artist, when she develops neurodegenerative diseases such as Alzheimer’s disease, “their style becomes more simplistic,” she says.
mirror published the first case report In 1996, we investigated the visual artistic creativity of FTD patients. The patient, a man from Santa Barbara who had never been an artist, suddenly “had fallen in love with painting,” Miller said.
Miller was fascinated by the idea that something as terrifying as neurodegeneration could produce something positive.
“In neurology, we are very good at explaining defects,” he said. “For me, and for most people, it was a contradiction. It wasn’t what we were trained to think.”
As his curiosity grew, Miller met more FTD patients with visual and artistic creativity. “People started coming to my office carving ducks out of wood, welding beautiful insect-like creatures, and painting,” he said.
Over the decades, case studies have been published, as well as hypotheses about how creativity can be enhanced in patients with debilitating brains. The prevailing theory, Miller said, is that when areas in the front of the brain malfunction, activity in deeper areas of the brain, including those involved in vision, increases to compensate. .
Due to paucity of data, and only a small fraction of FTD patients experiencing visual artistic creativity (Friedberg and Miller found 2.5 percent in their study), it is difficult to elucidate the mechanism. It was possible. “We needed a group study,” Friedberg said. Group studies help identify inter-patient and patient-specific patterns.
Why do only some FTD patients display artistic creativity?
In the first group study of FTD patients with visual artistic creativity, Dr. Friedberg began by evaluating hundreds of patient records collected between 2002 and 2019. She identified 17 FTD patients with visual artistic creativity and was able to match them to both healthy control subjects and FTD patients. People who didn’t show their creativity. This allowed the research team to investigate which brain changes were associated with FTD and which brain changes were unique to patients with FTD and visual artistic creativity.
The researchers performed atrophy network mapping using patient structural magnetic resonance imaging (MRI) data showing the structure and size of brain tissue. This compares the patient’s brain with that of an undiseased human brain to see what the patient’s damaged areas are connected to and how those connected areas increase or decrease their activity as a result. It is a technique for determining whether
“The simplest way to think about it is, ‘How would the damage to this location affect the connectivity elsewhere?'” Michael D. FoxDirector of the Center for Brain Circuit Therapy, Harvard University.
Other (non-degraded) brain regions that are affected may not behave significantly differently than normal, but their activity is more pronounced because they no longer receive the same feedback from the degraded brain regions. may become (increase or decrease). .
Atrophy network mapping revealed connections between frontotemporal brain regions and dorsomedial occipital regions in the posterior part of the brain that are essential for visual processing. The researchers’ findings suggest that for FTD patients with visual artistic creativity, frontotemporal atrophy may lead to increased visual area activity.
However, increased visual processing alone could not explain the surge in visual creativity in these 17 patients, as nearly 90% of FTD patients without visual artistic creativity also exhibited similar symptoms.
The relationship between vision and movement may explain the difference
To understand other possible reasons why visual artistic creativity appears only in some FTD patients, Friedberg decided to look at changes in brain tissue.
She found that in patients with visual artistic creativity, the volume of the left hemisphere primary motor cortex (the area that controls movement of the right hand) is associated with increased volume of the dorsomedial occipital region. discovered. “The only area in the left hemisphere that hasn’t lost volume is the motor strip, which is responsible for the paint itself,” Miller said, despite the surrounding tissue dying off.
The connection between the visual area and the right hand can be interpreted in several ways. For some, it is innate and may only become apparent in the face of FTD, while the connection is strengthened as a result of spending hours each day creating artwork as the symptoms of FTD develop. There is also the case that.
Friedberg thought the finding was interesting, but not surprising. “Art is an athletic act,” she said. “There must be a visual-motor link to make this change manifest in the perceptual realm.”
The link between right-hand movements and visual regions of the brain would have been more pronounced if that link had also been shown through atrophy network mapping, Fox said. But “their genius lies in taking a new technique and applying it to a very interesting problem of new creativity in the context of brain disease,” he says.
Could this change the way neurodegeneration is diagnosed?
Although this was the largest study of FTD patients with visual artistic creativity, it was still small. The researchers hope that future studies will reveal the importance of additional brain regions in larger groups, which could explain why more FTD patients don’t become visual artists. But it’s still interesting to Mr. Miller. “There are probably a lot of factors, including how it was wired in the first place,” he says.
The environment can also play an important role. “Some people come across art in an accidental way,” says Miller. Other patients may have never been exposed to art, or may have been exposed to art but lack the materials and tools to express their creativity, he said.
“We would like to see if these results can be replicated in other cohorts, other countries and other cultures,” said Gutierrez Zuniga. “And let’s see if this can become a cross-cultural phenomenon.”
The study also showed that neurons in some areas of the brain can face death while activity in other areas increases and changes, a process called plasticity.
Friedberg said plasticity is intriguing, and that learning more about areas of the brain that grow in the face of disease could open up new therapeutic possibilities.
