Augmentation of artistic productivity in Parkinson's disease

Abstract

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...

The awakening of artistic creativity and Parkinson's disease.

“…The specific artistic style he adopted emphasized larger amplitude proximal movements that were relatively preserved. Chatteijee et al (Chatterjee et ai., 2006) suggested that a possible mechanism that might influence this discrepancy between spontaneous movements and those involved in painting might be related to differences in proximal versus distal target reaching, an observation previously described in PD (Chatterjee et Bindler et al, 2011Canesi et al, 2012Chatterjee et al, 2006Kulisevsky et al, 2009Pinker, 2002Schräg & Trimble, 2001Schwingenschuh et al, 2010Walker et al, 2006Witt et al, 2006 Age Note. LD = levodopa; DA = dopamine agonist; CBG = cabergoline; LIS = lisuride; PRG = pergolide; PRX = pramipexole; ROP = ropinirole-ROT = Rotigotine; NA = not available.…”

Brain Illness and Creativity: Mechanisms and Treatment Risks

“…Creative motivation, like motivation in general, increases in some patients taking dopaminergic agents. 29,87 Motivation may be strongest with chronic administration of the less sedating agonists, less sedating DA agonists seem preferable, and D3 receptor binding may be important. 88 Unfortunately, DA agonists can also cause impulse control problems, gambling addiction, compulsive spending, hypersexuality, and hallucinations.…”

Changes in artistic style and behaviour in Parkinson’s disease: dopamine and creativity

“…While changes in artistic productivity and style have been related to cortical degeneration in FTD, AD, and CBD, the present case report suggests that changes in creativity and artistic output in PD may be more related to dopaminergic imbalance in the limbic system. Impulse control disorders (ICDs) have been observed previously in PD patients reported to have shown changes in their creative expression [6][7][8]. In one report, a 'strong urgency' and great interest in painting suggestive of the development of punding was also described [8].…”

“…In Alzheimer's disease (AD) [4] and corticobasal degeneration (CBD) [5], increasing abstraction with no deliberate stylistic effort has been associated with global cognitive impairment and visuospatial deficits. In Parkinson's disease (PD), emergence of poetic talent [6] and compulsive augmentation of artistic productivity [7,8] have been reported in association with dopaminergic druginduced hypomania [6], behavioural disinhibition and obsessive-compulsive behaviour [7,8].…”