title: Poor creativity in frontotemporal dementia: a window into the neural bases of the creative mind.
abstract: BACKGROUND
  The prefrontal cortex (PFC) supports functions critical for creative thinking. Damage to the PFC is expected to impair creativity. Yet, previous works suggested the emergence of artistic talent in patients with frontotemporal lobar degeneration (FTLD), which was interpreted as increased creativity.
  
  
  OBJECTIVE
  We designed a study in patients with frontal variant (fv) of FTLD in order to verify whether: (1) creativity is impaired after frontal degeneration, (2) poor creativity is associated with frontal dysfunctions, and (3) poor creativity is related to hypoperfusion in specific PFC regions.
  
  
  METHODS
  Three groups of subjects were enrolled in the study: fvFTLD patients (n=17), non-demented Parkinson's disease (PD) patients (n=12) and healthy controls (n=17). Participants performed a standardized test of creativity, the Torrance Test of Creative Thinking (TTCT) and tests assessing frontal functions. Brain perfusion was correlated to fvFTLD patients' performance in the TTCT.
  
  
  RESULTS
  Patients with fvFTLD were strongly impaired in all dimensions of the TTCT, compared to PD patients and controls. Disinhibited and perseverative responses were observed only in fvFTLD patients, leading to "pseudo-creative" responses. Poor creativity was positively correlated with several frontal tests. Poor creativity was also correlated with prefrontal hypoperfusion, particularly in the frontal pole.
  
  
  CONCLUSIONS
  Poor creativity is associated with fvFTLD. The results also suggest that the integrity of the PFC (in particular frontopolar) is strongly associated with creative thinking. The emergence of artistic talent in patients with fvFTLD is explained by the release of involuntary behaviors, rather than by the development of creative thinking.
authors.affiliation: Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l'Institut du Cerveau et de la Moelle Epinière, UMR-S975, Paris, France.
authors.forename: Leonardo Cruz
authors.initials: LC
authors.lastname: de Souza
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Volle
authors.forename: Maxime
authors.initials: M
authors.lastname: Bertoux
authors.forename: Virginie
authors.initials: V
authors.lastname: Czernecki
authors.forename: Aurélie
authors.initials: A
authors.lastname: Funkiewiez
authors.forename: Gilles
authors.initials: G
authors.lastname: Allali
authors.forename: Baptiste
authors.initials: B
authors.lastname: Leroy
authors.forename: Marie
authors.initials: M
authors.lastname: Sarazin
authors.forename: Marie-Odile
authors.initials: MO
authors.lastname: Habert
authors.forename: Bruno
authors.initials: B
authors.lastname: Dubois
authors.forename: Aurélie
authors.initials: A
authors.lastname: Kas
authors.forename: Richard
authors.initials: R
authors.lastname: Levy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003405:Creativity; D056344:Executive Function; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology*; D057180:Frontotemporal Dementia / Q000503:physiopathology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests