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References1. Burn DJ, Troster AI. Neuropsychiatric complications of medical and surgical therapies for Parkinson's disease.Enhancement of pre-existing artistic talent as well as the emergence of a new artistic tendency has been associated with frontotemporal dementia (FTD) 1,2 but is an unusual finding in Parkinson's disease (PD). 3 Conversely, available case studies and anecdotal reports have shown that PD does not adversely affect the artistic expression of established artists. 4 We present a patient who was diagnosed with PD and started producing a large amount of artistic work several months after an increase in dopamine agonist dose. Although he previously had demonstrated artistic tendencies, his productivity since beginning dopamine agonist therapy presented a striking change. More recently, he also developed sexual disinhibition in both observed behavior in an unstructured setting and on neuropsychological assessment, which was apparently unrelated to medication change.The patient had been diagnosed with PD and started on levodopa/carbidopa with good results 11 years previously. He had always sketched occasionally, but 3 years ago had started continually producing several pastel drawings per week, sometimes two per day. This increase occurred several months after initiation and increase of ropinirole to 8 mg/day and also coincided with a change in social circumstances, including relocation to an assisted living facility where he had more freedom to draw. He carried a sketchbook with him at all times, and approached acquaintances and strangers in public places to show his work. He believed that the medication positively affected his creativity and was unwilling to make dosage changes. Recently, unrelated to any concurrent change in medication, he developed inappropriate social behaviors, including excessive flirting with women on the street and asking residents and staff of his assisted living facility to pose nude for his artwork.Clinical examination was consistent with the diagnosis of idiopathic PD. Neuropsychological evaluation revealed deficits across several cognitive domains, indicative of a mild PD dementia syndrome. He showed subtle but clear behavioral evidence of disinhibition as evidenced on phonemic fluency performance, with initial generation of expletives consistently across three trials.Artistic critiques of the patient's drawings were varied. One artist described his work as showing originality, attitude, and a strong sense of color and kinesthesia. Another believed his artwork was naive and unoriginal but that his output was so voluminous that some pieces were likely to be artistically successful. His work had been shown in several local galleries, and he reported having sold over $2000 worth of work in the past 1.5 years.Another case report has been published of artistic talent developing or emerging in PD. A 55-year-old patient began writing poetry of publishable standard after initiation of treatment. 3 He had never written poetry previously but had family members who were published...

Researchers disagree as to whether Lewy body disease (LBD) constitutes a variant of Alzheimer's (AD) or Parkinson's disease (PD), or alternatively, whether it is an independent disease process. The neuropathological, genetic, and clinical characteristics of LBD are reviewed and compared to those of AD and PD. Data for 150 cases of LBD reported in the literature were compiled and grouped according to neuropathological status. Patients with pure LBD (with limited or no concurrent AD pathology) tend to present at a younger age with extrapyramidal signs followed by dementia, whereas patients with mixed LBD–AD (concurrent LB and AD pathology) are somewhat older and tend to present with dementia. The cognitive profile of LBD patients, and the relationships among LBD, AD, and PD remain unclear due to methodological limitations and the paucity of studies comparing the groups directly. (JINS, 1997, 3, 179–194.)