title: Verbal creativity in semantic variant primary progressive aphasia.
abstract: Emergence of visual and musical creativity in the setting of neurologic disease has been reported in patients with semantic variant primary progressive aphasia (svPPA), also called semantic dementia (SD). It is hypothesized that loss of left anterior frontotemporal function facilitates activity of the right posterior hemispheric structures, leading to de novo creativity observed in visual artistic representation. We describe creativity in the verbal domain, for the first time, in three patients with svPPA. Clinical presentations are carefully described in three svPPA patients exhibiting verbal creativity, including neuropsychology, neurologic exam, and structural magnetic resonance imaging (MRI). Voxel-based morphometry (VBM) was performed to quantify brain atrophy patterns in these patients against age-matched healthy controls. All three patients displayed new-onset creative writing behavior and produced extensive original work during the course of disease. Patient A developed interest in wordplay and generated a large volume of poetry. Patient B became fascinated with rhyming and punning. Patient C wrote and published a lifestyle guidebook. An overlap of their structural MR scans showed uniform sparing in the lateral portions of the language-dominant temporal lobe (superior and middle gyri) and atrophy in the medial temporal cortex (amygdala, limbic cortex). New-onset creativity in svPPA may represent a paradoxical functional facilitation. A similar drive for production is found in visually artistic and verbally creative patients. Mirroring the imaging findings in visually artistic patients, verbal preoccupation and creativity may be associated with medial atrophy in the language-dominant temporal lobe, but sparing of lateral dominant temporal and non-dominant posterior cortices.
authors: a Department of Neurology , University of California, San Francisco , San Francisco , CA , USA.
authors: Teresa Q
authors: TQ
authors: Wu
authors: Zachary A
authors: ZA
authors: Miller
authors: Babu
authors: B
authors: Adhimoolam
authors: Diana D
authors: DD
authors: Zackey
authors: Baber K
authors: BK
authors: Khan
authors: Robin
authors: R
authors: Ketelle
authors: Katherine P
authors: KP
authors: Rankin
authors: Bruce L
authors: BL
authors: Miller
mesh_terms: D000368:Aged; D018888:Aphasia, Primary Progressive / Q000473:pathology / Q000523:psychology*; D001284:Atrophy; D003405:Creativity; D005260:Female; D057180:Frontotemporal Dementia / Q000473:pathology / Q000523:psychology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014705:Verbal Behavior
keywords: aphasia; creativity; dementia; frontotemporal dementia; semantic dementia; semantic variant primary progressive aphasia; verbal creativity; visual creativity