Emergence of visual artistic creativity in frontotemporal dementia

Alzheimer's & dementia : the journal of the Alzheimer's Association

Alzheimers Dement. 2022 Dec;18 Suppl 9:e065202. doi: 10.1002/alz.065202.


BACKGROUND: Emergence of novel visual artistic skills has been described in neurodegenerative disorders, particularly in the frontotemporal dementia - amyotrophic lateral sclerosis (FTD-ALS) spectrum, but associated clinical and genetic features and the underlying neural mechanisms have not been systematically examined. We aimed to address these gaps.

METHOD: We performed comprehensive chart review of all 734 participants in the University of California San Francisco FTD Program Project Grant who had a clinical syndrome within the FTD-ALS spectrum. This review allowed us to ascertain subjects meeting current FTD-ALS clinical research criteria who had: (1) an emergence of novel visual artistic skills or (2) a change in the style of visual art produced or (3) a significant increase in quantity of visual art produced. Clinical data, imaging studies, and genetic information were collected and analyzed.

RESULT: Among the 734 patients screened, 45 were excluded due to lack of available research notes. We identified a change in visual artistic creativity in 17/689 patients (prevalence 2.5%). Mean age of FTD symptom onset was 57.4 (±10.4), and the visual artistic creativity (VAC) change was reported an average of 0.7 years (±10.1) prior to FTD symptom onset. Of the 17 patients with VAC, 8 exhibited no prior interest in art, 2 were professional visual artists who experienced a change in artistic style, and 7 reported some prior interest in art but a substantial change of style or quantity. Artistic output was diverse however bright colors and non-human subjects were prominent. VAC occurred in patients with semantic variant primary progressive aphasia (8), behavioral variant FTD (3), nonfluent variant primary progressive aphasia (2), progressive supranuclear palsy - Richardson's syndrome (2), corticobasal syndrome (1), and ALS (1). None carried a common pathogenic variant in a FTD gene.

CONCLUSION: Change in VAC is an uncommon but early positive symptom that occurs in patients across the FTD-ALS clinical spectrum but appears most common in patients with anterior temporal lobe degeneration. We are pursuing the neural mechanisms of VAC through structural and functional neuroimaging studies.

PMID:36537928 | DOI:10.1002/alz.065202