Creativity is a fundamental human trait that has played a pivotal role in the development of human culture, enabling transformative problem-solving, technological progress, and artistic expression. Visual artistic creativity (VAC), in particular, is a unique and ubiquitous process that heavily relies on visual and mental imagery. In recent years, the emergence of novel visual artistic skills has been observed in patients with frontotemporal dementia (FTD) and in individuals with focal brain lesions caused by stroke and traumatic brain injury.
These patients provide a rare window into the neural network building blocks of VAC, shedding light on the underlying neural mechanisms for this phenomenon. In this study, the clinical, neuropsychological, neuropathological, and genetic features of 17 patients with FTD who reported the emergence of VAC were examined, and the neural substrates of this phenomenon were probed using advanced analytical techniques.
A recent study published in the JAMA Neurology has highlighted the importance of visual artistic creativity (VAC) and its potential to illuminate the neural underpinnings of creativity. The ability to generate work that is both novel and valuable is crucial to the development of human culture, enabling transformative problem-solving, technological progress, and artistic expression.
Frontotemporal dementia (FTD), a group of neurodegenerative disorders characterized by progressive deterioration of behavior and/or language, has been linked to the emergence of novel visual artistic skills, particularly in the primary progressive aphasia (PPA) variants.
Patients with anterior brain lesions caused by stroke and traumatic brain injury have also been reported to develop new visual artistic skills, providing a rare window into the neural network building blocks of VAC. In a new study, 17 patients with FTD who reported emergence of VAC were assessed over a period of 17 years.
The study looked at the clinical, neuropsychological, neuropathological, and genetic features of these patients, as well as the neural substrates of this phenomenon using atrophy network mapping and structural covariance analyses. The results of the study shed light on the neural mechanisms for VAC in the setting of brain injury and provide important insights into the broader understanding of creativity.
The study used magnetic resonance imaging (MRI) and voxel-based morphometry to investigate differences in the patterns of brain atrophy between two types of frontotemporal dementia (VAC-FTD and NVA-FTD) and healthy controls. The study used individual atrophy (W-Score) maps to compare atrophy patterns between the groups and thresholded individual W-Score maps to capture each patient’s most atrophied voxels. Atrophy network mapping was also used to investigate how the brain areas atrophied in patients are functionally connected to other brain regions.
Structural covariance analysis was also employed to investigate differences in interregional structural correlations between VAC-FTD and NVA-FTD. Th study included data from 397 healthy controls and a cohort of 175 cognitively healthy individuals, matched to the VAC-FTD group by age, sex, handedness, and years of education. The findings suggest that VAC-FTD and NVA-FTD have different patterns of atrophy and are associated with different functional and structural network disruptions.
Researchers have discovered that visual artistic creativity (VAC) can emerge in a small percentage (2.5%) of patients with frontotemporal dementia (FTD), particularly those with semantic variant primary progressive aphasia (svPPA) (6.7%). This artistic expression is distinct and emerges early in the disease course, around the time of FTD symptom onset.
The study utilized atrophy network mapping, a method that uncovers the network basis for aberrant gains of function, to pinpoint network nodes commonly connected in the healthy brain to lesions from a neurodegenerative disease group of interest. The varied regions of peak frontotemporal atrophy across patients were united by a functional activity pattern that inversely correlated with dorsomedial occipital cortex.
The dorsal visual stream projects to the posterior parietal cortex, and its activity is associated with reaching and grasping behaviors guided by representations of the position, shape, and orientation of objects.
The inverse functional correlation between FTD atrophy and the dorsal occipital cortex suggests that FTD induces disinhibition of dorsal stream regions, which may predispose some patients to engage in visual art early in the illness. The researchers hypothesize that this network rebalancing may manifest as VAC only when certain conditions, such as a latent visual artistic talent or a conducive environment, are met.
Structural covariance analysis, a between-patients network mapping technique, was used to reveal regions that subserve particular behavioral or cognitive functions. Patients with VAC-FTD demonstrated greater structural covariance between dorsomedial occipital cortex and the left primary motor cortex around the representation of the right hand compared to those with non-visual artistic FTD (NVA-FTD).
The higher structural correlation between the dorsomedial occipital cortex and other brain areas may reflect a lifelong trait that predisposes some patients with FTD to develop VAC. A PET-based single case with increasing occipital glucose metabolism in parallel to the emergence of VAC may imply that hyperactivation of the dorsal stream predisposes to visual artistic engagement, although further investigations are warranted to address the specificity of this finding.
