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Creativity in the arts increase in Parkinson's patients taking certain therapies

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A new TAU study, "Enhanced creative thinking under dopaminergic therapy in Parkinson disease," published online in the June 2014 issue of the Annals of Neurology confirms creative energy in Parkinson's sufferers is greater than in healthy individuals. But how many art galleries or museums and exhibits are actually showing the creative works of those who have become more creative after developing Parkinson's disease?

And how many publishers are publishing the works of literature, music, or other arts of those with the disease? There may be a difference between artistic inclination, for example, as a hobby, and producing art for exhibits or sales. What you actually see in thrift shops are the paintings and crocheted crafts, sculpture, ceramics, or knitted objects and various arts and crafts made by older people, some with Parkinson's disease, where the creative work ends up not in galleries, but in thrift shops and various second hand stores.

Linking Parkinson's disease and artistic inclination

Do Parkinson's disease patients taking specific types of medicine to increase the dopamine in their brain suddenly take an interest in creating artistic projects? Tel Aviv University has conducted the first empirical study to verify a link between Parkinson's disease and artistic inclination. The study demonstrates that Parkinson's patients are more creative than their healthy peers, and that those patients taking higher doses of medication are more artistic than their less-medicated counterparts.

Professor Rivka Inzelberg of Tel Aviv University's Sackler Faculty of Medicine and the Sagol Neuroscience Center at Sheba Medical Center, Tel Hashomer, documented the exceptional creativity of Parkinson's patients two years ago in a review for the journal Behavioral Neuroscience. Since then, she has conducted the first empirical study to verify a link between Parkinson's disease and artistic inclination.

That empirical study, now published online in the Annals of Neurology, definitively demonstrates that Parkinson's patients are more creative than their healthy peers, and that those patients taking higher doses of medication are more artistic than their less-medicated counterparts

"It began with my observation that Parkinson's patients have a special interest in art and have creative hobbies incompatible with their physical limitations," said Professor Inzelberg, according to the July 14, 2014 news release, Proof: Parkinson's enhances creativity. "In my last paper, I reviewed case studies from around the world and found them to be consistent. In my present research, we conducted the first comprehensive study to measure the creative thinking of Parkinson's patients. This was not a simple task, because how does one measure, or quantify, creativity? We had to think creatively ourselves."

Measuring artistic creativity

Prof. Inzelberg and a team of researchers from TAU, the Sheba Medical Center, and Bar-Ilan University conducted a full battery of tests on 27 Parkinson's patients treated with anti-Parkinson's drugs and 27 age- and education-matched healthy controls. Some of the tests were well-known and others newly adapted for the purpose of the study. The tests included the Verbal Fluency exam, in which a person is asked to mention as many different words beginning with a certain letter and in a certain category (fruit, for example) as possible.

The participants were then asked to undergo a more challenging Remote Association Test, in which they had to name a fourth word (following three given words) within a fixed context. The groups also took the Tel Aviv University Creativity Test, which tested their interpretation of abstract images and assessed the imagination inherent in answers to questions like "What can you do with sandals?" The final exam was a version of the Test for a Novel Metaphor, adapted specifically for the study.

Throughout the testing, Parkinson's patients offered more original answers and more thoughtful interpretations than their healthy counterparts

In order to rule out the possibility that the creative process evident in the hobbies of patients was linked to obsessive compulsions like gambling and hoarding, to which many Parkinson's patients fall prey, participants were also asked to fill out an extensive questionnaire. An analysis indicated no correlation between compulsive behavior and elevated creativity.

Express yourself

The conclusions from the second round of testing — in which the Parkinson's participants were split into higher- and lower-medicated groups — also demonstrated a clear link between medication and creativity. Parkinson's patients suffer from a lack of dopamine, which is associated with tremors and poor coordination. As such, they are usually treated with either synthetic precursors of dopamine or dopamine receptor agonists.

According to Professor Inzelberg, the results are hardly surprising, because dopamine and artistry have long been connected. "We know that Van Gogh had psychotic spells, in which high levels of dopamine are secreted in the brain, and he was able to paint masterpieces during these spells — so we know there is a strong relationship between creativity and dopamine," said Prof. Inzelberg, according to the news release.

Professor Inzelberg hopes her research will be instrumental in spreading awareness.

Parkinson's patients often feel isolated by their physical limitations, so artistic work could provide a welcome outlet of expression. "After my first paper, I helped organize exhibits of patients' paintings in Herzliya and Raanana and received feedback about similar exhibits in Canada and France," said Prof. Inzelberg. "These exhibits were useful in raising funds for Parkinson's research, providing occupational therapy for patients — and, most importantly, offering an opportunity for patients to fully express themselves."

Creative thinking requires a combination of originality, flexibility, and usefulness. Several reports described enhanced artistic creativity in Parkinson disease (PD) patients treated with dopaminergic agents.

The researchers, according to the study's abstract, aimed to examine Parkinson's disease patients' ability to perform creativity tasks compared to healthy controls and to verify whether creativity is related to an impulse control disorder (ICD) as a complication of dopaminergic therapy

Parkinson's disease patients treated with dopaminergic drugs demonstrated enhanced verbal and visual creativity as compared to neurologically healthy controls, says the abstract's study. This feature was unrelated to impulse control disorder (ICD). Dopaminergic agents might act through the reduction of latent inhibition, resulting in widening of the associative network and enriched divergent thinking.

Professor Inzelberg is currently researching additional forms of creativity in Parkinson's patients. You also may wish to check out the website, American Friends of Tel Aviv University.

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