成就天才的疾病

wopd66

A Disease That Allowed Torrents of Creativity

If Rod Serling were alive and writing episodes for “The Twilight Zone,” odds are he would have leaped on the true story of Anne Adams, a Canadian scientist turned artist who died of a rare brain disease last year.

Trained in mathematics, chemistry and biology, Dr. Adams left her career as a teacher and bench scientist in 1986 to take care of a son who had been seriously injured in a car accident and was not expected to live. But the young man made a miraculous recovery. After seven weeks, he threw away his crutches and went back to school.

According her husband, Robert, Dr. Adams then decided to abandon science and take up art. She had dabbled with drawing when young, he said in a recent telephone interview, but now she had an intense all-or-nothing drive to paint.

“Anne spent every day from 9 to 5 in her art studio,” said Robert Adams, a retired mathematician. Early on, she painted architectural portraits of houses in the West Vancouver, British Columbia, neighborhood where they lived.

In 1994, Dr. Adams became fascinated with the music of the composer Maurice Ravel, her husband recalled. At age 53, she painted “Unravelling Bolero” a work that translated the famous musical score into visual form.

Unbeknown to her, Ravel also suffered from a brain disease whose symptoms were identical to those observed in Dr. Adams, said Dr. Bruce Miller, a neurologist and the director of the Memory and Aging Center at the University of California, San Francisco. Ravel composed “Bolero” in 1928, when he was 53 and began showing signs of his illness with spelling errors in musical scores and letters.

“Bolero” alternates between two main melodic themes, repeating the pair eight times over 340 bars with increasing volume and layers of instruments. At the same time, the score holds methodically to two simple, alternating staccato bass lines.

“ ‘Bolero’ is an exercise in compulsivity, structure and perseveration,” Dr. Miller said. It builds without a key change until the 326th bar. Then it accelerates into a collapsing finale.

Dr. Adams, who was also drawn to themes of repetition, painted one upright rectangular figure for each bar of “Bolero.” The figures are arranged in an orderly manner like the music, countered by a zigzag winding scheme, Dr. Miller said. The transformation of sound to visual form is clear and structured. Height corresponds to volume, shape to note quality and color to pitch. The colors remain unified until the surprise key change in bar 326 that is marked with a run of orange and pink figures that herald the conclusion.

Ravel and Dr. Adams were in the early stages of a rare disease called FTD, or frontotemporal dementia, when they were working, Ravel on “Bolero” and Dr. Adams on her painting of “Bolero,” Dr. Miller said. The disease apparently altered circuits in their brains, changing the connections between the front and back parts and resulting in a torrent of creativity.

“We used to think dementias hit the brain diffusely,” Dr. Miller said. “Nothing was anatomically specific. That is wrong. We now realize that when specific, dominant circuits are injured or disintegrate, they may release or disinhibit activity in other areas. In other words, if one part of the brain is compromised, another part can remodel and become stronger.”

Thus some patients with FTD develop artistic abilities when frontal brain areas decline and posterior regions take over, Dr. Miller said.

An article by Dr. Miller and colleagues describing how FTD can release new artistic talents was published online in December 2007 by the journal Brain. FTD refers to a group of diseases often misdiagnosed as Alzheimer’s disease, in that patients become increasingly demented, Dr. Miller said. But the course and behavioral manifestations of FTD are different.

In the most common variant, patients undergo gradual personality changes. They grow apathetic, become slovenly and typically gain 20 pounds. They behave like 3-year-olds in public, asking embarrassing questions in a loud voice. All along, they deny anything is wrong.

Two other variants of FTD involve loss of language. In one, patients have trouble finding words, Dr. Miller said. When someone says to the patients, “Pass the broccoli,” they might reply, “What is broccoli?”

In another, PPA or primary progressive aphasia, the spoken-language network disintegrates. Patients lose the ability to speak.

All three variants share the same underlying pathology. The disease, which has no cure, can progress quickly or, as in the case of Senator Pete V. Domenici, Republican of New Mexico, who announced his retirement last fall because of an FTD diagnosis, over many years.

Dr. Adams and Ravel had the PPA variant, Dr. Miller said.

From 1997 until her death 10 years later, Dr. Adams underwent periodic brain scans that gave her physicians remarkable insights to the changes in her brain.

“In 2000, she suddenly had a little trouble finding words,” her husband said. “Although she was gifted in mathematics, she could no longer add single digit numbers. She was aware of what was happening to her. She would stamp her foot in frustration.”

By then, the circuits in Dr. Adams’s brain had reorganized. Her left frontal language areas showed atrophy. Meanwhile, areas in the back of her brain on the right side, devoted to visual and spatial processing, appeared to have thickened.

When artists suffer damage to the right posterior brain, they lose the ability to be creative, Dr. Miller said. Dr. Adams’s story is the opposite. Her case and others suggest that artists in general exhibit more right posterior brain dominance. In a healthy brain, these areas help integrate multisensory perception. Colors, sounds, touch and space are intertwined in novel ways. But these posterior regions are usually inhibited by the dominant frontal cortex, he said. When they are released, creativity emerges.

Dr. Miller has witnessed FTD patients become gifted in landscape design, piano playing, painting and other creative arts as their disease progressed.

Dr. Adams continued to paint until 2004, when she could no longer hold a brush. Her art, including “An ABC Book of Invertebrates,” a rendering of the mathematical ratio pi, an image of a migraine aura and other works, is at two Web sites: members.shaw.ca/adms and memory.ucsf.edu/Art/gallery.htm.

{http://www.nytimes.com/2008/04/0 ... gin&oref=slogin}
创造力暴发

假如洛德瑟林（Rod Serling）还活着，正在构思《阴阳魔界:The Twilight Zone》场景，他会非常激动听到Anne Adams, 一个加拿大科学家转变成艺术家的真实故事，他去年死于一种罕见的脑部疾病。
Adams博士精通数学，化学，生物学，1986年，她离开了她的教师和科学家职位，照顾她的车祸中严重受伤，生存希望渺茫的儿子。但是这年轻人奇迹般的恢复了过来。7周后，他可以不用拐杖，继续去上学。
据 Adams博士的先生Robert回忆，从那以后，她随即放弃了科学，而转向艺术。在最近的电话采访中，Robert说，当她年轻时也曾经是绘画高手，但是现在，作出转向绘画，她或者经过了深思熟虑，或者什么都没想。
她先生Robert Adams,是一个退休的数学家说：“Anne每天从9点到5点在画室，早期，她画一些建筑肖像，西温哥华，卑诗省（ British Columbia，Canada），和他们居住地邻居的房子。
她先生回忆，1994，Adams博士开始迷上拉威尔Maurice Ravel的音乐。在53岁时，她画了“Unravelling Bolero”，把著名的乐谱转化成了视觉旋律。
Adams博士不知道的是，作曲家Ravel也同样受一种脑部疾病的折磨。她的经治医生，旧金山的神经学家，加州大学记忆和年龄中心主任，Bruce Miller医生说, 在1928年，Rave作曲 “Bolero”，当时他是53岁，开始出现疾病的症状，如在曲谱和写信中出现拼写错误。
“Bolero” 在两种主要的交响乐之间转换，重复这对交响乐8次，超过340bars(小节号？), 增加了音量和乐器的层次感。同时，乐谱系统性把握住了两条简单的不连续的低音线。
是一种强制性，有结构感，持续性的演奏曲，前面平和，直到第326bar出现关键性转变。然而加速直到最后的结束。
Adams博士，也画出了这种重复旋律的主题，在“Bolero”中每个bar相对应画了一个倒置的矩形。图形象音乐一样有序排列，并以环绕曲线为衬托。Miller医生说。把音符转化为视觉图形非常清楚而有形。高度表示音量，形状对应音质，颜色对应音调。颜色保持非常一致和谐，直到关键的第326bar,出现了黄色和粉红色的图形以示到达高潮。
当他们正在创作，Ravel 作曲 “Bolero” ，Adams 作画“Bolero,” 时 Ravel 和Adams博士均处于FTD病的早期阶段，FTD又名额颞叶痴呆症（Frontotemporal Dementia）。这种疾病能明显改变大脑中的回路联系，改变了前面部分和后面部分大脑之间的联系，导致创造力的暴发。
Miller医生说，“我们过去通常认为痴呆是全脑性，没有的例外。这是错的。我们现在知道当特殊的，主要回路受伤害或中断，他们可能释放或激活了大脑中的其他区域。换言之，脑中的一个部分受到伤害时，其他部分的大脑可重构，并且功能加强。
因此有些FTD病人当他们额叶区脑功能下降，脑后段的区域占主导地位的时候。发展出了艺术才能。
Miller医生和同事发表了一篇关于FTD如何释放艺术才能的文章在2007年脑杂志(journal Brain)。FTD是一组通常误诊为阿尔茨海默氏病（AD）疾病，阿尔茨海默氏病（AD）疾病患者是进行性痴呆的过程。但两种疾病的过程的行为症状是不一样的。
FTD在最见的症状中，患者会出现渐进性的个性改变。她们对事物变得缺乏兴趣的，懶散的，典型的增加体重20磅。行为象3岁小孩，在公共场所大声问一些尴尬的问题，而且他们否认任何错误。
另两个FTD的变化，包括失语。在一种情况是，患者不能正确理解的单词的意义。当某人对患者说，“给我椰菜”，可能回答，“椰菜是什么。”
另一种情况，PPA，原发性进行性失语，口头语言表达系统伤失，患者失去了说话的能力。
所有的三种变异症状都有共同的病理基础。这种疾病还没有治愈方法，可以进展很快，但也可能象新墨西哥州共和党议员Pete V. Domenici，他在诊为FTD后宣布退休，疾病延续多年。

Adams 和Ravel都有PPA症状。
从1997到死亡的10年间，Adams定期脑部扫描，为她的医生提供了很清楚的脑部变化的信息。
“在2000年，她突然有一点问题想不起单词，”她先生说。“虽然她是一个数学家，但她不能做简单的加法运算，她也意识到在她身生发生了什么，她感到非常沮丧。
然后，她的脑结构出现了重组， 她的左侧额叶的语言区萎缩，同时，右脑后侧的视觉区和空间区增厚。
当艺术家右后脑受到损伤后，他们也失去了创造性。Miller医生说。Adams的例子是刚好相反。她和其他人的例子表明艺术通常是受右后脑区域控制的。在正常健康人中，这些区域整合多个感觉信号。颜色，声音，触觉，空间各种感觉在这里可形成新的联系通路。但是脑后部区域通常受到前部大脑额叶区域的抑制。他说，当抑制消失，这些区域恢复自由，创造性就出现了。
Miller见证了FTD在疾病过程中的各种天赋，图形设计，钢琴，绘画，及其他创造性的艺术。
Adams持续作画直到2004年，那时她已经不能拿起画笔了。她的作品，包括：“An ABC Book of Invertebrates,” 是数学比率pi 的反映，偏头痛的气味（migraine aura），和其他一些作品，在网站：members.shaw.ca/adms and memory.ucsf.edu/Art/gallery.htm.