Creative skills can develop with dementia

Writing in the British Journal of Psychiatry, neurologist Dr. Bruce L. Miller and colleagues describe 12 patients with dementia traced to the brain's left temporal lobe, who developed or maintained musical or artistic ability.

The temporal lobe functions in aspects of memory, learning and expression. It is part of the largest region of the brain, the cerebrum, made up of the two hemispheres of the brain.

According to the results of the study, it seems that people who had demonstrated exceptional visual and musical abilities before the onset of their dementing diseases maintained their creativity even as difficulties with other skills began to manifest themselves.

The researchers describe one woman who had been an inventor, with numerous patents to her credit. Though her disease caused a serious degeneration in language-related skills, her ability to refine her inventions continued virtually undisturbed.

In another case, a patient who had once been linguistically talented began to lose this ability while a new musical ability began to emerge. Yet another patient, who had mastered languages as diverse as Chinese, Italian and Russian, suffered a deterioration in his ability to manipulate words but gained an exceptional ability to compose classical music, though he had little training in the field.

Of the 12 patients, "seven developed new skills (five visual and two musical) in the setting of dementia, while five maintained visual and/or musical abilities...despite progression of dementia."

A key point is that verbal skills played no part in these retained abilities. The authors point out that patients who had been gifted bridge and chess players, for example, "continued playing these games by manipulating visual images of cards or chess pieces learned earlier in life." Similarly, those skilled in music did not require verbal processing to generate music.

Miller and his colleagues explain that "these processes have in common the recall of previously learned information or images" that permit them to continue "without the mediation of language."

Importantly, while creativity continues, the quality of the creativity is different since it lacks an abstracting or symbolic component, the researchers explain. In paintings, this results, for example, in realistic depictions.

Miller's team concludes that these patients "offer an unexpected window into the neurological mediation of visual and musical talents."