A right-handed man developed a sudden transient, amnestic syndrome associated with bilateral hemorrhage of the hippocampi, probably due to Urbach-Wiethe disease. In the 3rd month, despite significant hippocampal structural damage on imaging, only a milder degree of retrograde and anterograde amnesia persisted on detailed neuropsychological examination. On systematic testing of recognition of facial and vocal expression of emotion, we found an impairment of the vocal perception of fear, but not that of other emotions, such as joy, sadness and anger. Such selective impairment of fear perception was not present in the recognition of facial expression of emotion. Thus emotional perception varies according to the different aspects of emotions and the different modality of presentation (faces versus voices). This is consistent with the idea that there may be multiple emotion systems. The study of emotional perception in this unique case of bilateral involvement of hippocampus suggests that this structure may play a critical role in the recognition of fear in vocal expression, possibly dissociated from that of other emotions and from that of fear in facial expression. In regard of recent data suggesting that the amygdala is playing a role in the recognition of fear in the auditory as well as in the visual modality this could suggest that the hippocampus may be part of the auditory pathway of fear recognition.
What about artistic creativity following a cerebral lesion? We studied the case of a prominent right-handed Swedish painter and sculptor who suffered a cerebral hemorrhage at the age of 55 years. The patient displayed a lesion of the left capsular lenticular region, which resulted in a right hemiplegia and sensory loss, with aphasia of the subcortical type. The linguistic impairments recovered well but at 1 year postonset, the right hand was still completely paralyzed. After a period of a few weeks, during which the patient refused to use his nondominant hand, he produced his first left-handed drawing, and by 1 year postonset, he had once again resumed an intensive artistic activity using his nondominant hand. The pictorial works were reviewed by several renowned art specialists: changes of style and even of contents were judged without loss of artistic quality. The result was described as a gain in emotional and artistic intensity. We discuss our observation in the context of the literature and focus on the crucial role of cerebral dominance and hand preference. We conclude that pictorial creativity and language are distinct forms of expressions.
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