In FTD, Brain Atrophy Lifts Lid on Creative Circuits

People with frontotemporal dementia grapple with behavioral, language, and cognitive problems as their disease worsens. It may be small comfort but for a few, their disease sparks an artistic flair, unveiling previously hidden talents in painting, sculpting, or other visual arts.

In the February 27 JAMA Neurology, William Seeley and Bruce Miller at the University of California, San Francisco, and colleagues pinpoint brain networks that may underlie this strange flourish. The researchers identified a cluster of frontotemporal brain regions that shrank in people with FTD. In healthy controls, these regions collectively squelch activity in the dorsal occipital cortex, an area involved in visual perception. In people with FTD, loss of this suppression may allow artistic tendencies to bloom.

Not everyone with FTD was so impelled, suggesting that other influences are at play. Beyond FTD, the findings illuminate brain networks that enable visual artistry.

Some people with FTD blossom as artists. For a while.

Take the 56-year-old businessman who complained of periods of intense light sensitivity (Miller et al., 1996). He had never dabbled in art but suddenly felt an urge to paint. As his disease worsened, he honed his craft over the following decade, winning awards at local art shows for his brightly colored canvasses.

Like many other new artists with FTD, he suffered from degeneration of the anterior temporal lobes with relative sparing of frontal lobes, and the posterior parts of his brain displayed heightened activity.

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Finally, the researchers found evidence that those who became artists were indeed flexing their creative muscles.

“This structural brain difference may imply that neuroplastic processes may occur in parallel to the disease process,” Friedberg said. “I think that these processes should be further explored and characterized since they may potentially pave the way to novel therapies.”

Sadly, active artistic expression, which can last eight years or more, does not slow the progression of FTD overall. —Jessica Shugart

As reported in Alzforum.org Newsletter March 3 2023