Wu Teresa Q, Miller Zachary A, Adhimoolam Babu, Zackey Diana D, Khan Baber K, Ketelle Robin, Rankin Katherine P, Miller Bruce L
a Department of Neurology , University of California, San Francisco , San Francisco , CA , USA.
Neurocase. 2015 Feb;21(1):73-8. doi: 10.1080/13554794.2013.860179. Epub 2013 Dec 12.
Emergence of visual and musical creativity in the setting of neurologic disease has been reported in patients with semantic variant primary progressive aphasia (svPPA), also called semantic dementia (SD). It is hypothesized that loss of left anterior frontotemporal function facilitates activity of the right posterior hemispheric structures, leading to de novo creativity observed in visual artistic representation. We describe creativity in the verbal domain, for the first time, in three patients with svPPA. Clinical presentations are carefully described in three svPPA patients exhibiting verbal creativity, including neuropsychology, neurologic exam, and structural magnetic resonance imaging (MRI). Voxel-based morphometry (VBM) was performed to quantify brain atrophy patterns in these patients against age-matched healthy controls. All three patients displayed new-onset creative writing behavior and produced extensive original work during the course of disease. Patient A developed interest in wordplay and generated a large volume of poetry. Patient B became fascinated with rhyming and punning. Patient C wrote and published a lifestyle guidebook. An overlap of their structural MR scans showed uniform sparing in the lateral portions of the language-dominant temporal lobe (superior and middle gyri) and atrophy in the medial temporal cortex (amygdala, limbic cortex). New-onset creativity in svPPA may represent a paradoxical functional facilitation. A similar drive for production is found in visually artistic and verbally creative patients. Mirroring the imaging findings in visually artistic patients, verbal preoccupation and creativity may be associated with medial atrophy in the language-dominant temporal lobe, but sparing of lateral dominant temporal and non-dominant posterior cortices.
在患有语义变异型原发性进行性失语（svPPA）（也称为语义性痴呆，SD）的患者中，已有报道称在神经系统疾病背景下出现了视觉和音乐创造力。据推测，左前颞叶功能丧失促进了右后半球结构的活动，导致在视觉艺术表现中观察到的全新创造力。我们首次描述了三名svPPA患者在语言领域的创造力。仔细描述了三名表现出语言创造力的svPPA患者的临床表现，包括神经心理学、神经系统检查和结构磁共振成像（MRI）。进行了基于体素的形态计量学（VBM），以量化这些患者相对于年龄匹配的健康对照的脑萎缩模式。所有三名患者在疾病过程中均表现出新发的创造性写作行为，并创作了大量原创作品。患者A对文字游戏产生了兴趣，并创作了大量诗歌。患者B对押韵和双关语着迷。患者C撰写并出版了一本生活方式指南。他们的结构磁共振扫描重叠显示语言优势颞叶（颞上回和颞中回）外侧部分均匀保留，内侧颞叶皮质（杏仁核、边缘皮质）萎缩。svPPA中出现的新发创造力可能代表一种矛盾的功能促进。在视觉艺术和语言有创造力的患者中发现了类似的创作驱动力。与视觉艺术患者的影像学发现相似，语言专注和创造力可能与语言优势颞叶的内侧萎缩有关，但外侧优势颞叶和非优势后皮质保留。
