Unravelling Boléro: progressive aphasia, transmodal creativity and the right posterior neocortex.
Most neurological lesion studies emphasize performance deficits that result from focal brain injury. Here, we describe striking gains of function in a patient with primary progressive aphasia, a degenerative disease of the human language network. During the decade before her language deficits arose, Anne Adams (AA), a lifelong scientist, developed an intense drive to produce visual art. Paintings from AA's artistic peak revealed her capacity to create expressive transmodal art, such as renderings of music in paint, which may have reflected an increased subjective relatedness among internal perceptual and conceptual images. AA became fascinated with Maurice Ravel, the French composer who also suffered from a progressive aphasia, and painted his best-known work, 'Boléro', by translating its musical elements into visual form. Later paintings, achieved when AA was nearly mute, moved towards increasing photographic realism, perhaps because visual representations came to dominate AA's mental landscape during this phase of her illness. Neuroimaging analyses revealed that, despite severe degeneration of left inferior frontal-insular, temporal and striatal regions, AA showed increased grey matter volume and hyperperfusion in right posterior neocortical areas implicated in heteromodal and polysensory integration. The findings suggest that structural and functional enhancements in non-dominant posterior neocortex may give rise to specific forms of visual creativity that can be liberated by dominant inferior frontal cortex injury.
Memory and Aging Center, Department of Neurology, UCSF, USA. wseeley@memory.ucsf.edu
William W
WW
Seeley
Brandy R
BR
Matthews
Richard K
RK
Crawford
Maria Luisa
ML
Gorno-Tempini
Dean
D
Foti
Ian R
IR
Mackenzie
Bruce L
BL
Miller
D018888:Aphasia, Primary Progressive / Q000473:pathology / Q000503:physiopathology / Q000523:psychology*; D001921:Brain / Q000473:pathology; D001931:Brain Mapping / Q000379:methods; D003405:Creativity; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009146:Music; D019579:Neocortex / Q000503:physiopathology*; D009483:Neuropsychological Tests; D010151:Paintings