Divergent Thinking Abilities in Frontotemporal Dementia: A Mini-Review

Abstract

A large number of studies, including single case and case series studies, have shown that patients with different types of frontotemporal dementia (FTD) are characterized by the emergence of artistic abilities. This led to the hypothesis of enhanced creative thinking skills as a function of these pathological conditions. However, in the last years, it has been argued that these brain pathologies lead only to an augmented “drive to produce” rather than to the emergence of creativity. Moreover, only a few studies analyzed specific creative skills, such as divergent thinking (DT), by standardized tests. This Mini-Review aimed to examine the extent to which DT abilities are preserved in patients affected by FTD. Results showed that DT abilities (both verbal and figural) are altered in different ways according to the specific anatomical and functional changes associated with the diverse forms of FTD. On the one hand, patients affected by the behavioral form of FTD can produce many ideas because of unimpaired access to memory stores (i.e., episodic and semantic), but are not able to recombine flexibly the information to produce original ideas because of damages in the pre-frontal cortex. On the other hand, patients affected by the semantic variant are impaired also in terms of fluency because of the degradation of their semantic memory store. Potential implications, limitations, and future research directions are discussed.

Executive functioning and divergent thinking predict creative problem-solving in young adults and elderlies

“…The authors of the review also underlined the role of WM and processing speed, which explained the discrepancies between younger and older adults. Overall, creative performances of the elderlies, particularly in the verbal domain, are comparable to those of younger individuals when no time constraints are set during the task and the workload is not too high (Fusi, Crepaldi, et al, 2021 ; Fusi, Lavolpe, et al, 2021 ). In our study, CRA problems imposed a time constraint to complete each problem (i.e., 15 s).…”

“…In regards to age-related cognitive decline, a recent systematic review by Fusi et al ( Fusi, Crepaldi, et al, 2021 ; Fusi, Lavolpe, et al, 2021 ) highlighted the nonlinear and multidimensional nature of the relationship between aging processes and divergent thinking performances. Mixed results can be found in the literature depending on figural vs. verbal divergent thinking tasks, and when specific indexes are considered (i.e., originality, fluency, and flexibility).…”

“…According to the authors, these findings showed that inhibition is required to suppress dominant but irrelevant response tendencies during a creative task. Clinical evidence on dementia (Fusi, Crepaldi, et al, 2021 ; Fusi, Lavolpe, et al, 2021 ) showed that although patients with frontotemporal dementia could produce a great number of ideas, they were not able to flexibly combine the information to produce original ideas, due to damages in the prefrontal cortex. In addition, other findings highlighted that metacognitive control during the performance of a creative task, in the form of predictions/retrospections tasks, facilitates the broadening of the mental field (Antonietti et al, 2021 ), thus suggesting a combined contribution of convergent and divergent processes.…”

The ambulatory battery of creativity: Additional evidence for reliability and validity

“…This supports the assumption that creative abilities can serve as an index of brain health and cognitive reserve (e.g., Fusi et al, 2020;, which is further strengthened by the findings that creative abilities are (multidimensionally) associated with effects of aging (Fusi et al, 2020), wellbeing, positive affect (Rominger et al, 2020a), mindfulness (Baas et al, 2014), as well as physical activity (Rominger et al, 2020a. Similar to these variables of health, the ecologically valid measure of creative abilities might also provide relevant information about clinical samples such as patients suffering from schizophrenia (Acar et al, 2018) and (frontotemporal) dementia (Fusi et al, 2021).…”

Premorbid de novo artistic creativity in frontotemporal dementia (FTD) syndromes

“…Moreover, SD patients often have well-preserved or even enhanced visuospatial skills and an increased concentration during solving jigsaw puzzles (Green and Patterson 2009). Nevertheless, bvFTD and SD patients also showed impairments in divergent thinking (a measure of creativity) (Fusi et al 2021). Further, bvFTD patients had deficits in both processing musical rules and reward valuation, whereas SD patients demonstrated impairment in reward valuation only (Clark et al 2018).…”