Art Reveals the Inner Mind

Alzheimer’s disease and primary progressive aphasia (PPA) are both associated with progressive neurodegeneration of the brain and are different types of dementia with overlapping pathologies. Alzheimer’s disease is generally known for significant impairments in memory and learning while PPA is characterized by deficits in the language areas within the left hemisphere of the brain. Although both neurodegenerative diseases affect the brain in similar ways, PPA patients often demonstrate increased creativity as the disorder progresses while creativity normally declines with Alzheimer’s disease. It was fascinating to see how researchers, like Bruce Miller M.D. (Memory and Aging Center, Department of Neurology, UCSF), examine artistic creations of patients through the course of neurodegenerative diseases to evaluate neurological damage and its effects on art. Although I myself am not an artistic individual and have zero to none experience with evaluating artistic pieces, it becomes clear through various patient studies the extent to how different illnesses influence and change an artist’s artwork. For example, consider the case study done on patient AA by Seeley et al. (2008). Coming from a science heavy background, patient AA pursued a lifelong interest in music and art shortly after leaving academics to care for her son who was injured in a car accident. After her son recovered, AA continued to paint and reached a peak in creativity in 1994 with her painting “Unraveling Bolèro” just 8 years before being diagnosed with PPA in 2002. As the disorder increased in severity, AA began painting realistic impressions of objects containing high levels of symmetry, as seen in her paintings “Arbutus leaves” (2002) and “Amsterdam” (2004). At the beginning of her creative peak, AA painted more abstract concepts (e.g. music illustrated in paint) which shifted to more concrete and symmetrical objects (e.g. buildings) as the illness progressed and language skills diminished. MRI scans revealed enhanced right posterior regions during AA’s creative peak, which may explain the creative peak through the high connectivity of non-dominant brain regions responsible for integrating abstract concepts. This evidence seems to suggest certain neurodegenerative diseases that attack specific locations in the brain may incidentally affect other regions in different and unique ways.

            

In contrast to the previous PPA case study, Maurer and Prvulovic (2003) examined the effects of Alzhiemer’s disease on the paintings of patient CH. Patient CH, in contrast to AA, took an interest in painting and showed advanced skills early in life. Often painting realistic pictures, patient CH’s progression through Alzheimer’s disease becomes increasingly apparent with each passing year as the disease transforms once concrete paintings (pictured above) into childish abstractions (pictured below). In the early stages of the disease, paintings by CH begin to lose concepts such as depth perception and shading giving the paintings a more childish appearance. A measurable difference noted by Maurer and Prvulovic was an increase in red and yellow color choices as the disease progressed, which may have illustrated CH’s deficit in being able to distinguish darker colors. During the later stages, CH’s psychotic and hallucinatory phases could be seen in his paintings of double faces. In the several months leading up to his death, CH entered the “scribbling phase” characterized by a lack of spatial and object organization as seen in previous paintings.

            

Taken together, both patients CH and AA clearly differentiate their respective illnesses through creative peaks and overall artistic decisions. I find using art as a noninvasive method to explore the inner mind of a patient fascinating. After assessing the content, techniques, and artistic decisions behind a series of artworks, the progressive nature of Alzheimer’s disease and PPA becomes more apparent than ever. Simple decisions such as color choices or shading emphasis can lead to great insights into which areas of the brain are being influenced the most. Patient CH’s gradual shift from realistic to abstract paintings to scribbles illustrates the gradual progression and existence of stages within Alzheimer’s disease. Although Alzheimer’s disease affects each individual diagnosed differently, it is clear that patient AA’s progression was completely different and resembled PPA. Patient AA, before showing any symptoms, hit a creative peak in which she was able to intricately paint her rendition of a song. After symptoms became increasingly apparent, her paintings shifted from complicated abstractions to simple symmetrical realism, an almost reverse pattern as seen in CH. Overall, I think using art as a microscope into the inner thoughts and processes of patients is an extremely interesting and ingenious technique that has the potential to bring forth huge advances in medical and research fields.

References:

Maurer, K., & Prvulovic, D. (January 01, 2004). Paintings of an artist with Alzheimer's disease:      visuoconstructural deficits during dementia. Journal of Neural Transmission (vienna,   Austria : 1996), 111, 3, 235-45.

Seeley, W. W., Matthews, B. R., Crawford, R. K., Gorno-Tempini, M. L., Foti, D., Mackenzie, I.            R., & Miller, B. L. (January 01, 2008). Unravelling Boléro: progressive aphasia,   transmodal creativity and the right posterior neocortex. Brain, 131, 1, 39-49.