December 16, 2014

Parkinson's Disease and Enhanced Creativity

A recent story from the Parkinson’s Disease Foundation has this headline: "Dopaminergic Therapy Spurs Creativity in People with Parkinson's Disease." The standard treatment for Parkinson's is levodopa, which boosts brain levels of the neurotransmitter dopamine, the depletion of which causes the symptoms of the disease.

The news comes from Tel Aviv University in Israel, where researchers conducted creativity analyses on 27 people with Parkinson’s taking dopamine, and a control group of 27 healthy individuals not taking dopamine therapy – matched with the first group by age and education.

"It began with my observation that Parkinson's patients have a special interest in art and have creative hobbies incompatible with their physical limitations," said Rivka Inzelberg, Tel Aviv University professor and study leader.

Not a New Connection
Inzelberg’s observations weren’t new. Through the years, anecdotal evidence has accumulated about Parkinsonians on dopamine therapy suddenly developing sudden bursts of creativity, like writing poetry.

But a key question has lingered about the dopamine-creativity connection. Is the new inventiveness a direct result of higher dopamine levels in the brain? Or is it an offshoot of the impulse control disorders (ICDs) frequently linked to PD medication, especially dopamine agonists? Those aberrant ICDs among Parkinsonians manifest most often as hypersexuality and gambling compulsions.

To remove that issue from this consideration of dopamine and creativity, the research team simply screened study participants for ICDs. That way, conclusions wouldn’t be muddied by possible connections with compulsive behaviors. 

How the Study Worked
Researchers administered a series of tests on all 54 subjects. One test asked them to list as many words as they could within a certain category that began with the same letter (flowers that begin with the letter “B,” for example).

Subjects also took a “remote association test,” which asked them to choose a fourth word after receiving three words within a fixed context. They took a “creativity test” which assessed their interpretations of abstract images and novel metaphors.

On balance, the Parkinsonians on dopamine therapy produced brighter, more original answers and made more thoughtful, original interpretations than did their healthy counterparts.

 The researchers drew these conclusions:
  • The Parkinsonians on dopaminergic drugs showed enhanced verbal and visual creativity than the control group.
  • In an interesting twist, higher verbal creativity scores correlated with higher doses of dopaminergic meds, but also with decreased verbal fluency.
  • Enhanced creativity and impulse control disorders did not correlate.

And So, Why?
It’s a challenge to explain these results. Perhaps dopaminergic meds lower inhibitions, thus enhancing creativity (we’ve already seen the evidence of compulsive behaviors in some PWPs taking dopamine therapy). Perhaps there is something about the disease itself that brings enhanced creativity; evidence already suggests greater creativity in people with other neurodegenerative diseases, like frontotemporal dementia.

Like nearly every study we’ve reviewed on this blog, this one has its “issues.”  This time, it’s the test sample size, only 27 Parkinsonians. Much larger studies would be needed to validate the results here. In the future, “neuro-imaging” will likely enable scientists to more accurately establish any real connections that exist among Parkinsonians, dopaminergics drugs, and creativity.

Did This “PD and creativity” news surprise me?

Not exactly.

No, I didn’t set up an easel on my back porch to paint pictures of my koi pond after I began taking levadopa for PD. I didn’t start writing poetry.

Enter 5-HTP
But SOMETHING happened. And it seems – like this study – to have involved neurotransmitters. That “something” was 5-HTP

Like dopamine, serotonin is a neurotransmitter that plays a key role in health and wellness. Unlike levodopa (a dopamine booster), 5-HTP is a serotonin booster. In a nutshell – greatly simplified – dopamine is associated with the brain’s pleasure centers, and serotonin helps regulate mood.

After my PD diagnosis over five years ago, I started taking 5-HTP regularly, mainly as therapy for PD’s most common non-motor symptoms – insomnia, depression, and constipation. But it had another effect on me, too.

I began to have spurts of pretty amazing exhilaration and creativity, especially in the morning. Without effort, I’d suddenly be filled with novel ideas to implement, and clever solutions to problems that had been bugging me.

I began this blog to tout 5-HTP’s positive effects, and at first even included “5-HTP” in the blog’s title. Soon enough, I discovered that others did not experience the positive effects I had with the supplement. I was disappointed my miracle wouldn’t become everyone’s miracle.

I also learned something important – that people react very differently to supplements and medications… a fact that would become clearer and clearer to me on my journey with Parkinson’s. I soon recognized that I didn’t just have Parkinson’s, I had John Schappi’s Parkinson’s disease.

In time, I found that 5-HTP was creating problems for me, too – mainly by elevating my blood pressure, often into dangerously high territory. To make an incredibly long story short, I stopped taking it several weeks ago… and those bursts of creative ideas have greatly ebbed.

Still, the Issue of Creativity and Parkinson’s Continues
In fact, there’s a Creativity and Parkinson’s Project that explores, supports, and encourages the therapeutic value of creativity in Parkinson’s disease.

The Parkinson’s Disease Foundation offers an online gallery where Parkinsonians like me can submit their own creations -- like paintings, photographs, and poetry.

Just don’t look for anything there from John Schappi anytime soon.

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