Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Can J Psychiatry. 2011 Mar;56(3):132-43. doi: 10.1177/070674371105600303.
Brain diseases and their treatment may help or hurt creativity in ways that shape quality of life. Increased creative drive is associated with bipolar disorder, depression, psychosis, temporal lobe epilepsy, frontotemporal dementia, Parkinson disease treatments, and autism. Creativity depends on goal-driven approach motivation from midbrain dopaminergic systems. Fear-driven avoidance motivation is of less aid to creativity. When serotonin and norepinephrine lower motivation and flexible behaviour, they can inhibit creativity. Hemispheric lateralization and frontotemporal connections must interact to create new ideas and conceptual schemes. The right brain and temporal lobe contribute skill in novelty detection, while the left brain and frontal lobe foster approach motivation and more easily generate new patterns of action from the novel perceptions. Genes and phenotypes that increase plasticity and creativity in tolerant environments with relaxed selection pressure may confer risk in rigorous environments. Few papers substantively address this important but fraught topic. Antidepressants (ADs) that inhibit fear-driven motivation, such as selective serotonin reuptake inhibitors, sometimes inhibit goal-oriented motivation as well. ADs that boost goal-directed motivation, such as bupropion, may remediate this effect. Benzodiazepines and alcohol may be counterproductive. Although dopaminergic agonists sometimes stimulate creativity, their doing so may inappropriately disinhibit behaviour. Dopamine antagonists may suppress creative motivation; lithium and anticonvulsant mood stabilizers may do so less. Physical exercise and REM sleep may help creativity. Art therapy and psychotherapy are not well studied. Preserving creative motivation can help creativity and other aspects of well-being in all patients, not just artists or researchers.
脑部疾病及其治疗方法可能以影响生活质量的方式对创造力产生帮助或损害。创造力的增强与双相情感障碍、抑郁症、精神病、颞叶癫痫、额颞叶痴呆、帕金森病治疗和自闭症有关。创造力取决于中脑多巴胺能系统驱动的目标导向动机。恐惧驱动的回避动机对创造力的帮助较小。当血清素和去甲肾上腺素降低动机和灵活性时，它们可能会抑制创造力。大脑半球的偏侧化和额颞叶连接必须相互作用，才能产生新的想法和概念框架。右脑和颞叶有助于新颖性检测方面的技能，而左脑和额叶则促进目标导向动机，并更容易从新颖的感知中产生新的行动模式。在选择压力放松的宽容环境中增加可塑性和创造力的基因和表型，可能会在严格的环境中带来风险。很少有论文实质性地解决这个重要但棘手的话题。抑制恐惧驱动动机的抗抑郁药（ADs），如选择性 5-羟色胺再摄取抑制剂，有时也会抑制目标导向的动机。促进目标导向动机的 ADs，如安非他酮，可能会改善这种效果。苯二氮䓬类药物和酒精可能适得其反。虽然多巴胺能激动剂有时会刺激创造力，但它们这样做可能会不恰当地抑制行为。多巴胺拮抗剂可能会抑制创造性动机；锂和抗惊厥情绪稳定剂可能会抑制作用较小。体育锻炼和 REM 睡眠可能有助于创造力。艺术治疗和心理治疗的研究还不够充分。保持创造性动机可以帮助所有患者（不仅是艺术家或研究人员）的创造力和其他方面的幸福感。
