{"title":"进行性认知功能障碍患者的功能获得表现为创造性技能及其fMRI相关性：一项描述性研究。","authors":"Safwan Ahmed, Chandra Ratnaswami Sadanandavalli, Ganesan Venkatasubramanian, Subasree Ramakrishnan, Jamuna Rajeswaran, Mariamma Philip, Rajnish Kumar Gupta, Indupriya Babu","doi":"10.4103/aian.aian_727_24","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>Patients with neurodegenerative disorders generally lose their acquired cognitive skills. However, a few of our patients showed creative skills in new areas, and we tried to evaluate a possible neural substrate for this phenomenon.</p><p><strong>Methods: </strong>Patients who attended the memory clinic of National Institute of Mental Health and Neuro Sciences between December 2016 and September 2018 were screened as per the inclusion and exclusion criteria. All mandatory investigations including complete neuropsychology workup were done. The Creativity Styles Questionnaire and Temperament and character inventory-Revised (TCI-R) were used to assess creativity. Magnetic resonance imaging, voxel-based morphometry, and resting-state fMRI were done and the results analyzed.</p><p><strong>Results: </strong>A group of previously non-creative patients showed creative skills in the face of neurodegenerative disorder. Out of 110 patients, 10 patients could be called creative. As the disease worsened, creativity was lost. These persons showed enhanced volume in the non-dominant angular gyrus, and its faciliatory connectivity to dorsolateral prefrontal cortex and inferior parietal lobe was seen. Paradoxically, creativity seems to emerge in some patients with major cognitive disorders and it disappears as the disease progresses. Creative domain varies from person to person, and the longest preserved domain is music. The fMRI findings suggest that the enhanced areas may play a role in sustaining creativity even in patients with degenerative diseases.</p><p><strong>Conclusion: </strong>Although case reports of creative skills in patients with major cognitive disorders exist, a complete workup of the neural basis has not been conducted so far. Higher volume in the non-dominant regions with relatively preserved language domain could be dysfunctional plasticity causing disinhibition of the innate creative skills when frontal lobe functions decline.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":"28 2","pages":"205-212"},"PeriodicalIF":1.8000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049197/pdf/","citationCount":"0","resultStr":"{\"title\":\"Gain of Function Presenting as Creative Skills in Patients with Progressive Cognitive Dysfunction and their fMRI Correlates: A Descriptive Study.\",\"authors\":\"Safwan Ahmed, Chandra Ratnaswami Sadanandavalli, Ganesan Venkatasubramanian, Subasree Ramakrishnan, Jamuna Rajeswaran, Mariamma Philip, Rajnish Kumar Gupta, Indupriya Babu\",\"doi\":\"10.4103/aian.aian_727_24\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and objectives: </strong>Patients with neurodegenerative disorders generally lose their acquired cognitive skills. However, a few of our patients showed creative skills in new areas, and we tried to evaluate a possible neural substrate for this phenomenon.</p><p><strong>Methods: </strong>Patients who attended the memory clinic of National Institute of Mental Health and Neuro Sciences between December 2016 and September 2018 were screened as per the inclusion and exclusion criteria. All mandatory investigations including complete neuropsychology workup were done. The Creativity Styles Questionnaire and Temperament and character inventory-Revised (TCI-R) were used to assess creativity. Magnetic resonance imaging, voxel-based morphometry, and resting-state fMRI were done and the results analyzed.</p><p><strong>Results: </strong>A group of previously non-creative patients showed creative skills in the face of neurodegenerative disorder. Out of 110 patients, 10 patients could be called creative. As the disease worsened, creativity was lost. These persons showed enhanced volume in the non-dominant angular gyrus, and its faciliatory connectivity to dorsolateral prefrontal cortex and inferior parietal lobe was seen. Paradoxically, creativity seems to emerge in some patients with major cognitive disorders and it disappears as the disease progresses. Creative domain varies from person to person, and the longest preserved domain is music. The fMRI findings suggest that the enhanced areas may play a role in sustaining creativity even in patients with degenerative diseases.</p><p><strong>Conclusion: </strong>Although case reports of creative skills in patients with major cognitive disorders exist, a complete workup of the neural basis has not been conducted so far. Higher volume in the non-dominant regions with relatively preserved language domain could be dysfunctional plasticity causing disinhibition of the innate creative skills when frontal lobe functions decline.</p>\",\"PeriodicalId\":8036,\"journal\":{\"name\":\"Annals of Indian Academy of Neurology\",\"volume\":\"28 2\",\"pages\":\"205-212\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049197/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Indian Academy of Neurology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4103/aian.aian_727_24\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/11 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Indian Academy of Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4103/aian.aian_727_24","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/11 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Gain of Function Presenting as Creative Skills in Patients with Progressive Cognitive Dysfunction and their fMRI Correlates: A Descriptive Study.
Background and objectives: Patients with neurodegenerative disorders generally lose their acquired cognitive skills. However, a few of our patients showed creative skills in new areas, and we tried to evaluate a possible neural substrate for this phenomenon.
Methods: Patients who attended the memory clinic of National Institute of Mental Health and Neuro Sciences between December 2016 and September 2018 were screened as per the inclusion and exclusion criteria. All mandatory investigations including complete neuropsychology workup were done. The Creativity Styles Questionnaire and Temperament and character inventory-Revised (TCI-R) were used to assess creativity. Magnetic resonance imaging, voxel-based morphometry, and resting-state fMRI were done and the results analyzed.
Results: A group of previously non-creative patients showed creative skills in the face of neurodegenerative disorder. Out of 110 patients, 10 patients could be called creative. As the disease worsened, creativity was lost. These persons showed enhanced volume in the non-dominant angular gyrus, and its faciliatory connectivity to dorsolateral prefrontal cortex and inferior parietal lobe was seen. Paradoxically, creativity seems to emerge in some patients with major cognitive disorders and it disappears as the disease progresses. Creative domain varies from person to person, and the longest preserved domain is music. The fMRI findings suggest that the enhanced areas may play a role in sustaining creativity even in patients with degenerative diseases.
Conclusion: Although case reports of creative skills in patients with major cognitive disorders exist, a complete workup of the neural basis has not been conducted so far. Higher volume in the non-dominant regions with relatively preserved language domain could be dysfunctional plasticity causing disinhibition of the innate creative skills when frontal lobe functions decline.
期刊介绍：
The journal has a clinical foundation and has been utilized most by clinical neurologists for improving the practice of neurology. While the focus is on neurology in India, the journal publishes manuscripts of high value from all parts of the world. Journal publishes reviews of various types, original articles, short communications, interesting images and case reports. The journal respects the scientific submission of its authors and believes in following an expeditious double-blind peer review process and endeavors to complete the review process within scheduled time frame. A significant effort from the author and the journal perhaps enables to strike an equilibrium to meet the professional expectations of the peers in the world of scientific publication. AIAN believes in safeguarding the privacy rights of human subjects. In order to comply with it, the journal instructs all authors when uploading the manuscript to also add the ethical clearance (human/animals)/ informed consent of subject in the manuscript. This applies to the study/case report that involves animal/human subjects/human specimens e.g. extracted tooth part/soft tissue for biopsy/in vitro analysis.
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