"This case suggests that our brain wiring may be a major factor in determining the nature of our creativity," said neurologist Bruce L. Miller, MD, of the University of California, San Francisco, who was the lead author of the report.
The woman was a high school art teacher who had immigrated to the United States from China as a teenager and studied painting in college. She had completed a master's degree in fine arts, combining training in Western representational art and Chinese brush painting.
By 1986 she was having difficulty with grading and lesson planning, and she retired in 1995 at the age of 52 as the disease progressed and she could no longer control the classroom or remember students' names.
She was diagnosed with frontotemporal dementia, a rare type of dementia that is often genetic and usually develops in people in their 50s. The disease typically causes cell loss in both the frontal lobes of the brain and the temporal lobes, but in this case the cell loss was predominantly in the left frontal lobe, Miller said. The frontal lobe plays a role in language, planning and organization and regulating social behavior.
Prior to her illness, the artist painted mainly landscapes and representational paintings, either in Western-style watercolors or classical Eastern brush paintings. As the disease progressed, she started merging the Eastern and Western styles of painting.
"Her painting became wilder and freer and more original as her language declined," Miller said. "From 1990-93 she created an exquisite series of highly patterned paintings based on the Chinese horoscope, and in 1997 she began a new series of 12 male nude figurative paintings. It was clear that she was released from the formal restraints of her training. Her later pieces were no longer realistic, but had an intense emotional and impressionistic style."
The artist stopped producing new works after 2001, but continues to recall the paintings and the strategies she used to create them, even at a time when she had limited speech ability. "When she talks about her paintings, her language comes more freely and is more spontaneous than when any other topic is discussed," Miller said.
Miller has reported on other frontotemporal dementia patients with no previous artistic ability who developed an interest in and talent for art as the disease progressed.
"The ability to transcend ordinary social, physical and cognitive constraints is a feature of great artists," Miller said. "The release of the language-dominant patterns of thinking appears to be a key factor in the emergence of artistic skills in frontotemporal dementia patients. The release of frontal lobe functions involved with social restraints may have played a role in the later paintings of this artist."
Miller noted that these cases have changed his approach to dementia patients. "We typically don't think that something could be getting better, we only think about what's getting worse," he said. "Now I always ask if there's anything patients are doing very well, or better than before. It's a remarkable response to a dementing illness."
The research was supported by grants from the National Institute on Aging and the Alzheimer's Disease Research Center of California.
The American Academy of Neurology, an association of more than 18,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer's disease, epilepsy, Parkinson's disease, autism and multiple sclerosis.
For more information about the American Academy of Neurology, visit its web site at www.aan.com.