DEMENZA E PITTURA di DOMENICO SABATINI BOLOGNA - 14 MARZO 2012

1. DEMENZA E PITTURA di DOMENICO SABATINI BOLOGNA - 14 MARZO 2012

2. S P U N T I D I R I F L E S S I O N E • Non tutte le demenze sono uguali e non tutti i pazienti sono uguali. • In nessuna demenza ci sono sintomi prodromici che riguardano la pittura, tranne nelle demenze fronto-temporali. • Alcuni sintomi della demenza sono secondari a deficit visivi e non cognitivi. • La produzione tarda di artisti affermati non si modifica sempre in senso involutivo; in tutti le espressioni del disegno si conservano più a lungo di ogni altra funzione. • Nei disegni ci possono essere dei messaggi da leggere, spesso molto tempo prima della diagnosi e nelle fasi estreme della malattia.

3. S P U N T I D I R I F L E S S I O N E 1) Non tutte le demenze sono uguali e non tutti i pazienti sono uguali.

4. She demonstrates that dementia in not a monolitic entity and that each individual is affected differently. Asymmetric left hemisphere degeneration may release previously untapped cognitive abilities. Our brain wiring appears to be a major factor in determination of the nature of our creativity. Release of creativity and originality represents an unexspected and unexplored feature of dementia.

5. Fingerpainting in acrylic by an individual with A. disease Figurines painted by an individual with frontotemporal dementia. MILLER B.L, Neurology, 1998

6. RANKIN KP, LIU AA A case-controlled study of altered visual art production in Alzheimer’s and FTLD Cogn. Behav. Neurol.2007; 20: 48-61. TORRANCE Test of Creative Thinking To copy

7. To complete To copy

9. DEMENZA FRONTO-TEMPORALE con coinvolgimento prevalente in sede temporale sinistra

10. MENDEZ MF, PERRYMAN KM Disrupted facial empathy in drawings from artists with fronto-temporal dementia. Neurocase 2003; 9 : 44-50 Portrait d’un artiste souffrant de DFT

11. CLASSIFICAZIONE ARTISTICA Malattia di Alzheimer Demenza a corpi di Lewy FTD con coinvolgimento prevalente TS con coinvolgimento prevalente TD varianti FTD Afasia primaria non fluente Demenza semantica Neuronal Intermediate Filament Inclusion D. SABATINI 2010

13. S P U N T I D I R I F L E S S I O N E 2) In nessuna demenza ci sono sintomi prodromici che riguardano la pittura, tranne nelle demenze fronto-temporali.

14. 1970 1980 1983 1990

15. DIANA MATALLANA, PATRICIA MONTANES Demencia y creatividad: emergencia de una actividad pictórica en un paciente con afasia primaria progresiva Rev. Colomb. Psiquiat., vol. 39 / No. 1 / 2010 (…) Presentar el caso de una mujer de 66 años de edad que premórbidamente no tenía interés por el arte, pero comenzó a pintar a los 56 años, cuando aparecieron alteraciones conductuales y de expresión lingüística. El deterioro marcado del lenguaje y del comportamiento fue progresando hasta instaurarse una afasia primaria progresiva (APP), un subtipo de una demencia frontotemporal (DFT), y su inusitado talento se convirtió en el primer síntoma de la APP.

16. “No utilizo referencias como fotos o imágenes” “Yo no pinto lo de afuera, sino lo que está en mi imaginación”

17. Unravelling Boléro: progressive aphasia, transmodal creativity and the right posterior neocortex William W. Seeley, Brandy R. Matthews, Richard K. Crawford, Maria Luisa Gorno-Tempini, Dean Foti, Ian R. Mackenzie and Bruce L. Miller Brain (2008), 131, 39-49

18. 1996 1998 2000

19. Unravelling Boléro, 1996

20. S P U N T I D I R I F L E S S I O N E 3) Alcuni sintomi della demenza sono secondari a deficit visivi e non cognitivi.

21. JEFFREY L. CUMMINGS, JUDY ZARIT Probable Alzheimer’s disease in an artist JAMA 1987; 258: 2731-2734

23. Maurer K., Prvulovic D. Carolus Horn – When the Images in the Brain DecayBogousslavsky J, Boller F(eds): Neurological Disorders in Famous Artists. Front Neurol Neurosci. Basel, Karger, 2005, vol 19, pp 101-111  Abstract Here we analyze the artwork of Carolus Horn, a famous German artist. Despite developing Alzheimer’s dementia (AD), he continued to produce drawings and paintings until he died. There are impressive changes in spatial relations, in the preference of colors, in the size of objects and other aspects of his paintings. The most prominent change is the loss of 3-dimensionality, followed by a continuous simplification and finally a decay of all objects and structures. We point to the relation between these changes in his artwork and the course of neuropsychological and neuropathological processes in AD.

24. 1978 1986 1988

25. 1975 1986 1988

28. S P U N T I D I R I F L E S S I O N E 4) La produzione tarda di artisti affermati non si modifica sempre in senso involutivo. In ogni caso la capacità di disegnare si conserva più a lungo di altre funzioni e rimane (o compare) il più spesso come unica forma di espressione.

29. LEO SCHNUG

30. LEO SCHNUG

32. Self-portrait, 1931 Self-portrait, 1933

33. Treasure Island, 1949

34. Figure with dunce cap, a repetitive theme Animal-like floating creatures surround a tormented individual, drawn while Peake was suffering from visual hallucinations.

35. De Kooning’s late colours and forms: dementia, creativity, and the healing power of art CARLOS HUGO ESPINEL Lancet, 347, 1096-98, april 20, 1996

36. In the 1980s works, the essential procedures and techniques were not changed but simplified, and the vocabulary of forms was retained but clarified. Particularly in the works from 1984, the results are paintings of an openness and freedom not seen before, paintings that are extraordinarily lyrical, immediately sensual, and exhilarating. GARRELS G. (1995) Three toads in the garden: Line, color, and form. In Willem de Kooning. The late paintings, the 1980s (pp. 9–37). San Francisco Museum of Modern Art and Walker Arts Center.

38. JOSHUA CHANG MELL, SARA M. HOWARD, BRUCE L. MILLER The influence of Frontotemporal Dementia on an accomplished artist Neurology 2003;60:1707-1710 A talented artist developed a progressive aphasia syndrome associated with frontotemporal dementia (FTD). As her disease progressed, language and executive skills declined, but her paintings became freer and more original. She demonstrates that artistic development can occur in the setting of language-dominant types of FTD. The study of artistic development in the setting of FTD suggests that language is not required for, and may even inhibit, certain types of visual creativity.

39. CASE HISTORY (….) By 1986, she was having difficulty with grading and lesson planning and slowly transferred these responsibilities to her teenage son. Language deficits increased, and early 1995, she retired when she could non longer control the classroom or remember her students’ names. (.…)

40. In 1997, she … produced 12 large male nude figurative paintings, rich in color and slightly sewual in theme, (…)

41. Male Figure in Cave Male Figure Outside Town Male Figure on Back It is tempting to attribute the imaginative, freer, and visually complex paintings between 1996-1997, when our patient had aphasia and behavioral disinhibition, to FDT.

42. Four maskes, 1999 Only two more color pieces were completed: the Four Masks painting from 1999 and a small watercolor made in 2001. While no longer producing new art, she continues to have excellent memories regarding her pictures and the strategies that she used to create her lifetime of work.

43. Tableau réalisé à l’âge de 64 ans par une patiente présentant une forme évoluée de DFT: lorsqu’elle réalise cette oeuvre, elle est boulimique, obèse, désinhibée sur le plan verbal, avec un discours stéréotypé, et incontinente.

44. 1968 UnitledUnitled

45. S P U N T I D I R I F L E S S I O N E 5) Nei disegni ci possono essere dei messaggi da leggere, spesso molto tempo prima della diagnosi e si conservano nelle fasi estreme della malattia.

46. CRUTCH S.J., ISAACS R., ROSSOR M.N. Some workmen can blame their tool: artistic changes in an individual with Alzheimer disease Lancet, 2001, 357:2129 William Utermohlen

47. DENISE GRADY The face decline New York Times, Oct 24, 2006 SEBASTIAN DIEGUEZ William Utermohlen: autoportrait du neant Cerveau&Psycho N°26, mars - avril 2008

48. MASKS, 1996; water-colour, mixed with gouache

49. WILFRED OWEN: Ten Poems William Utermohlen: Lithographie, 1994

50. Conversation, 1991