Transcranial Direct Current Stimulation in de novo Artistic Ability After Stroke

Abstract

The emergence of de novo artistic ability after brain injury has been well documented in cases following neurological disorders such as stroke ( 1. Annoni JM Devuyst G Carota A Bruggimann L Bogousslavsky J. Changes in artistic style after minor posterior stroke. J Neurol Neurosurg Psychiatry. 2005; 76: 797-803 Crossref PubMed Scopus (36) Google Scholar , 2. Thomas-Anterion C Creac’h C Dionet E et al. De novo artistic activity following insular-SII ischemia. Pain. 2010; 150: 121-127 Abstract Full Text Full Text PDF PubMed Scopus (27) Google Scholar ), frontotemporal dementia ( 3. Mell JC Howard SM Miller BL. Art and the brain: the influence of frontotemporal dementia on an accomplished artist. Neurology. 2003; 60: 1707-1710 Crossref PubMed Scopus (92) Google Scholar , 4. Miller BL Hou CE. Portraits of artists: emergence of visual creativity in dementia. Arch Neurol. 2004; 61: 842-844 Crossref PubMed Scopus (124) Google Scholar , 5. Miller BL Boone K Cummings JL Read SL Mishkin F. Functional correlates of musical and visual ability in frontotemporal dementia. Br J Psychiatry. 2000; 176: 458-463 Crossref PubMed Scopus (193) Google Scholar ), subarachnoid hemorrhage ( 6. Lythgoe MF Pollak TA Kalmus M de Haan M Chong WK. Obsessive, prolific artistic output following subarachnoid hemorrhage. Neurology. 2005; 64: 397-398 Crossref PubMed Scopus (41) Google Scholar ), and Parkinson’s disease ( 7. Canesi M Rusconi ML Isaias IU Pezzoli G. Artistic productivity and creative thinking in Parkinson’s disease. Eur J Neurol. 2012; 19: 468-472 Crossref PubMed Scopus (46) Google Scholar ). Although the mechanisms behind this remarkable phenomenon remain unknown, several theories have attempted to explain the artistic drive in patients with previous nonexistent artistic output. One theory behind the development of such skills propose that savant-like skills are innate in everyone, but are not readily accessible due to top-down inhibition of the conscious awareness ( 8. Snyder AW Mulcahy E Taylor JL Mitchell DJ Sachdev P Gandevia SC. Savant-like skills exposed in normal people by suppressing the left fronto-temporal lobe. J Integr Neurosci. 2003; 2: 149-158 Crossref PubMed Scopus (99) Google Scholar , 9. Snyder A. Explaining and inducing savant skills: privileged access to lower level, less-processed information. Philos Trans R Soc Lond B Biol Sci. 2009; 364: 1399-1405 Crossref PubMed Scopus (95) Google Scholar ). Brain lesions provide an ideal scenario to study the atypical hemispheric imbalance necessary to access this “lower” level information. In stroke, reorganization of neural networks amplifies input signals to compensate for the loss of sensory afferents and may expose previously existing, but functionally inactive pathways ( 10. Lee RG van Donkelaar P. Mechanisms underlying functional recovery following stroke. Can J Neurol Sci. 1995; 22: 257-263 Crossref PubMed Scopus (145) Google Scholar ). Although noninvasive brain stimulation techniques such as repetitive transcranial magnetic stimulation can facilitate savant-like skills in healthy subjects ( 8. Snyder AW Mulcahy E Taylor JL Mitchell DJ Sachdev P Gandevia SC. Savant-like skills exposed in normal people by suppressing the left fronto-temporal lobe. J Integr Neurosci. 2003; 2: 149-158 Crossref PubMed Scopus (99) Google Scholar ), there is limited information on the effects of brain stimulation, namely transcranial direct current stimulation (tDCS), on enhanced skills of individuals with neuroanatomical changes due to brain injury.