Dementia With Lewy Bodies and the Neurobehavioral Decline of Mervyn Peake

Abstract

Mervyn Peake (1911-1968) was an accomplished British artist, poet, novelist, and playwright. He was a prolific and talented illustrator and wrote hundreds of poems, 4 novels, and several plays. His exceptional career was prematurely ended by a neurodegenerative illness variously ascribed to Alzheimer disease, Parkinson disease, or postencephalitic parkinsonism. However, a detailed review of biographical accounts produces substantial evidence in support of a probable diagnosis of dementia with Lewy bodies, a clinical entity remaining undiagnosed outside specialty dementia clinics. Peake developed signs of parkinsonism and insidious cognitive decline during his fifth decade. A breakdown in his writing style has frequently been cited as reflecting his encroaching dementia. Visual hallucinations are portrayed in sketches, and together with paranoid delusions are apparent in poetry composed during his illness. His deterioration was progressive and punctuated by well-described episodes of confusion and psychosis. His occasional preservation of insight is poignantly captured in drawings of figures with dunce caps or pointed heads, often with expressions of fear and apprehension etched with an economy of strokes. Peake spent his final years in various psychiatric institutions but continued to exhibit lucid intervals even late into his illness. His tragic deterioration remained undiagnosed at the time, but in retrospect, his progressive dementia with parkinsonism, visual hallucinations, and marked cognitive fluctuations likely represents one of the earliest recognized historical cases of dementia with Lewy bodies.

What paint can tell us: A fractal analysis of neurological changes in seven artists.

“…It has been suggested that this behavior was “symptomatic of neurological disorder” (Garrels, 1997). Sahlas (2003) goes further and draws parallels between the style expressed by De Kooning and patients with LBD. De Kooning received an official diagnosis of AD in 1989, though reports of observable symptoms were recorded in 1983.…”

What paint can tell us: A fractal analysis of neurological changes in seven artists.

“…It has been suggested that this behavior was “symptomatic of neurological disorder” (Garrels, 1997). Sahlas (2003) goes further and draws parallels between the style expressed by De Kooning and patients with LBD. De Kooning received an official diagnosis of AD in 1989, though reports of observable symptoms were recorded in 1983.…”

Art and the brain: a view from dementia

“…Illustration for 1949 edition of R.L. Stevenson's Treasure Island (Sahlas, ). Courtesy of the Mervyn Peake Estate.…”

“…Compared with pre‐morbid works of Mervyn Peake (Figure ), later works (Figure ) show dramatic loss of detail, caricature‐like representations and simplification. The content of these later works may also be influenced by visual hallucinations (Sahlas, ). Sketch A in Figure shows the characteristic‐pointed hat often reported in the visual hallucinations of eye disease (Santhouse et al ., ) and noted in other patients with DLB, where it has been likened to characters such as ‘Coco the clown’ (Crutch and Rossor, ).…”

“…Case 13: drawings made late into the course of Mervyn Peake's dementia, at a stage when he was having hallucinatory experiences. No Mini mental state exam available (Sahlas, ). Courtesy of the Mervyn Peake Estate.…”

Dementia and Art: Neuronal Intermediate Filament Inclusion Disease and Dissolution of Artistic Creativity

“…preserved her ability to paint and draw for a longer time, stylistic changes in her works appeared early in the disease course and the professional quality of the works rapidly deteriorated. A few characteristic changes of V.V.’s art probably related to NIFID could be noticed in her paintings and drawings created during the course of disease: turn from abstract to symbolic concreteness and ‘return’ to the child’s ‘realistic’ primitivism at the advanced stage of the disease (contrary to the documented cases of the artists with Alzheimer’s disease who mostly turned from realistic to abstract style in the course of disease [15, 18, 19]); shift of color spectrum to predominantly ‘primary‘ colors (the feature also noted in the works of the other artists developing both FTD and Alzheimer’s disease [5, 8, 20, 21, 22]); appearance of aggressiveness and disquietude; drawing perseveration (also noted in the reported cases of FTD [1, 8]); visual expression of inner fear and silent cry for help (one could note a similar expression of cry and fear in the works of the artists with different forms of dementia [1, 18, 23]).…”

What paint can tell us: A fractal analysis of neurological changes in seven artists.

“…It has been suggested that this behavior was “symptomatic of neurological disorder” (Garrels, 1997). Sahlas (2003) goes further and draws parallels between the style expressed by De Kooning and patients with LBD. De Kooning received an official diagnosis of AD in 1989, though reports of observable symptoms were recorded in 1983.…”

Art and the brain: a view from dementia

“…Illustration for 1949 edition of R.L. Stevenson's Treasure Island (Sahlas, ). Courtesy of the Mervyn Peake Estate.…”

“…Compared with pre‐morbid works of Mervyn Peake (Figure ), later works (Figure ) show dramatic loss of detail, caricature‐like representations and simplification. The content of these later works may also be influenced by visual hallucinations (Sahlas, ). Sketch A in Figure shows the characteristic‐pointed hat often reported in the visual hallucinations of eye disease (Santhouse et al ., ) and noted in other patients with DLB, where it has been likened to characters such as ‘Coco the clown’ (Crutch and Rossor, ).…”

“…Case 13: drawings made late into the course of Mervyn Peake's dementia, at a stage when he was having hallucinatory experiences. No Mini mental state exam available (Sahlas, ). Courtesy of the Mervyn Peake Estate.…”

Dementia and Art: Neuronal Intermediate Filament Inclusion Disease and Dissolution of Artistic Creativity

“…preserved her ability to paint and draw for a longer time, stylistic changes in her works appeared early in the disease course and the professional quality of the works rapidly deteriorated. A few characteristic changes of V.V.’s art probably related to NIFID could be noticed in her paintings and drawings created during the course of disease: turn from abstract to symbolic concreteness and ‘return’ to the child’s ‘realistic’ primitivism at the advanced stage of the disease (contrary to the documented cases of the artists with Alzheimer’s disease who mostly turned from realistic to abstract style in the course of disease [15, 18, 19]); shift of color spectrum to predominantly ‘primary‘ colors (the feature also noted in the works of the other artists developing both FTD and Alzheimer’s disease [5, 8, 20, 21, 22]); appearance of aggressiveness and disquietude; drawing perseveration (also noted in the reported cases of FTD [1, 8]); visual expression of inner fear and silent cry for help (one could note a similar expression of cry and fear in the works of the artists with different forms of dementia [1, 18, 23]).…”

What paint can tell us: A fractal analysis of neurological changes in seven artists.

“…It has been suggested that this behavior was “symptomatic of neurological disorder” (Garrels, 1997). Sahlas (2003) goes further and draws parallels between the style expressed by De Kooning and patients with LBD. De Kooning received an official diagnosis of AD in 1989, though reports of observable symptoms were recorded in 1983.…”

Art and the brain: a view from dementia

“…Illustration for 1949 edition of R.L. Stevenson's Treasure Island (Sahlas, ). Courtesy of the Mervyn Peake Estate.…”

“…Compared with pre‐morbid works of Mervyn Peake (Figure ), later works (Figure ) show dramatic loss of detail, caricature‐like representations and simplification. The content of these later works may also be influenced by visual hallucinations (Sahlas, ). Sketch A in Figure shows the characteristic‐pointed hat often reported in the visual hallucinations of eye disease (Santhouse et al ., ) and noted in other patients with DLB, where it has been likened to characters such as ‘Coco the clown’ (Crutch and Rossor, ).…”

“…Case 13: drawings made late into the course of Mervyn Peake's dementia, at a stage when he was having hallucinatory experiences. No Mini mental state exam available (Sahlas, ). Courtesy of the Mervyn Peake Estate.…”

Dementia and Art: Neuronal Intermediate Filament Inclusion Disease and Dissolution of Artistic Creativity

“…preserved her ability to paint and draw for a longer time, stylistic changes in her works appeared early in the disease course and the professional quality of the works rapidly deteriorated. A few characteristic changes of V.V.’s art probably related to NIFID could be noticed in her paintings and drawings created during the course of disease: turn from abstract to symbolic concreteness and ‘return’ to the child’s ‘realistic’ primitivism at the advanced stage of the disease (contrary to the documented cases of the artists with Alzheimer’s disease who mostly turned from realistic to abstract style in the course of disease [15, 18, 19]); shift of color spectrum to predominantly ‘primary‘ colors (the feature also noted in the works of the other artists developing both FTD and Alzheimer’s disease [5, 8, 20, 21, 22]); appearance of aggressiveness and disquietude; drawing perseveration (also noted in the reported cases of FTD [1, 8]); visual expression of inner fear and silent cry for help (one could note a similar expression of cry and fear in the works of the artists with different forms of dementia [1, 18, 23]).…”