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September 21, 2004

Artistic Expression Need Not End,
and Can Even Improve After Brain Damage

Penn Researcher Finds Neuropsychological Processes Offer Insights into Artistic Production

(Philadelphia, PA) – What happens to visual artists that experience brain damage? And what can it tell us about how humans represent the world? According to Anjan Chatterjee, MD, an Associate Professor in the Center for Cognitive Neuroscience at the University of Pennsylvania School of Medicine, brain damage does not necessarily end the ability to produce compelling works of art; additionally, artists with brain damage can provide useful information on the nature of artistic expression. In a review article published in Neuropsychologia (Volume 42, Issue 11), Chatterjee draws on nearly 50 research articles and books, and finds that, “Artists with neuropsychological deficits do not necessarily produce art of lesser quality. Rather, their art may change in content or in style, sometimes in surprising and aesthetically pleasing ways.” Not only does this collection illustrate various forms and changes in perception, but it also suggests that continuing research in the field could bring about new therapies that could help patients with brain damage.

In the article, Chatterjee surveys nearly a half-century of findings of medical researchers on neurological syndromes and brain disorders and their consequences for the production of art. The purpose of the survey is to bring these findings, which appear in disparate books and journal articles, together and finally synthesize them into a single site. Although the data are descriptive in nature, the reports are few, and artistic talents and styles can vary greatly, Chatterjee believes this field is a rich seam to mine. “This opens up the possibility of obtaining greater insights into how the brain produces rich, intricate cultural products that move, enlighten, and transform each of us,” explains Chatterjee.

Chatterjee finds that artists are still susceptible to visuo-spatial deficits caused by brain damage as are other individuals but, because of their skill, they are “often quite eloquent in expressing these deficits.” The Italian film director Federico Fellini, also an accomplished cartoonist, recently suffered from a right-hemisphere stroke and left spatial neglect – that is, he cannot orient or respond to stimulation on his left. He was aware of his left-side paralysis and many of his cartoons demonstrated left neglect; however, some also demonstrated his partial awareness of these deficits. For example, one cartoon shows an elephant on the left with man behind a desk on the right – as the animal’s trunk, on the left, appears to be missing (click on thumbnail above to view full-size image).

Those that suffer from aphasia, another selective neuropsychological deficit, have difficulties communicating verbally. However, rather than having a uniform effect, the impact of aphasia on communicating through art can be quite variable. Chatterjee cites a description of a French painter that did not experience any changes in his artistic skills or style; critics did believe that he had found a “more intense and acute expression.” The painter explained: “When I am painting I am outside my life; my way of seeing things is even sharper than before; I find everything again; I am a whole man. … There are two men, the one who is grasped by reality to paint, the other one, the fool, who cannot manage words any more.”

While the ability to communicate verbally may not be required for artistic production, is the ability to generate visual images in the “mind’s eye” necessary? Chatterjee observes that it seems to be a requirement for spontaneous artistic expression rather than for producing a copy of art. One case describes a 38 year-old teacher and psychotherapist who had a congenital visual imagery deficit: he was unable to visually imagine people, places, and objects in his “mind’s eye.” His drawings were competent and included detail when he copied from a model. However, when the model was removed from his view, his drawings were simple and merely schematic. His drawings were also poor when given only names of objects to draw. Such a case demonstrates the types if dissociations between perception and imagery, between the eye that views the outside world and the “mind’s eye.”

Chatterjee asks if artists who suffer from diffuse cognitive impairment, such as from Alzheimer’s and autism, experience a drastic impairment of their artistic production. Surprisingly, this is not the case. As seen with artists who suffer from selective neuropsychological deficits, artistic skills are relatively preserved and sometimes even enhanced.

William DeKooning is the best-known artist who continued to paint after developing Alzheimer’s disease. There is general agreement among experts that his late period constituted a new and coherent style that was particularly sensual and lyrical – these paintings were abstract and successively simpler, utilizing mostly primary colors.

Chatterjee notes, however, that the most striking examples of exceptional artistic skills in the setting of general intellectual deficiencies are seen in some patients with autism. By three-and-a-half years, an autistic child named Nadia was drawing remarkably life-like horses in perspective. Her artistic skills were highly developed at the outset and did not change much over time; she did not go through a process of drawing simple schematic objects before learning how to draw realistically. She would sometimes start at the middle or bottom of the page and, rather than try to squeeze the image onto the page, she would terminate the drawing when she arrived at the end of the page. Her reproductions of other drawings were recognizable as a version of the original but could be changed in size or orientation. It could be said that her drawings, and those of other autistic savants, are more prototypic than realistic in form. Thus, Nadia’s pictures of horses were inspired by images that she saw but became amalgams of horses she had seen previously.

By bringing all of these scattered accounts into one body of literature, Chatterjee raises intriguing themes relevant to the nature of artistic expression and proposes that art is worth considering as a neuropsychological probe. Continuing research that focuses on these themes could bring exciting developments in various therapies for brain damage – including, of course, art therapy – and unlock perceptual mysteries of the mind. “Artists are especially adept at making their internal representations manifest,” explains Chatterjee. “Many more descriptions of the neuropsychology of artists could help determine and confirm the underlying principles of the consequences of brain damage on artistic expression.”

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