Lazar, Ronald M. PhD

Neurology Today:
Author Information

Dr. Lazar is Professor of Clinical Neuropsychology in Neurology and Neurosurgery, and Director of the Levine Cerebral Localization Laboratory at Columbia University in New York.

Article Outline


Several years ago, an artist came to our Center to consider therapeutic embolization followed by surgery for treatment of a cerebral arteriovenous malformation. He was told about superselective Wada testing as a way to minimize the chances that eloquent brain function would be affected by thrombosis of an artery that was also supplying normal tissue. Could we, he asked, test for possible loss of creativity during the Wada test? I replied that we did not yet know how to approach the matter of creativity in this setting. Having now read Nancy Andreasen's new book, The Creating Brain: The Neuroscience of Genius, I am not sure that there is yet much more to offer.

Dr. Andreasen is an eminent academic psychiatrist and scholar, with a unique background that inspired her to ask questions about creativity and brain function. She began as a professor in the English Department at the University of Iowa, specializing in Renaissance literature – with an interest in the arts, music, and science in that prolific time of Western Civilization. She then attended medical school and trained in psychiatry, in part to allow her to address an essential question: Is there something different about the brains of the great contributors to our civilization (Leonardo da Vinci, Michelangelo, Johann Sebastian Bach, and other “geniuses”)? The passion to delve into the neuroscience of creativity, in general, and genius, specifically, is obvious in her book, and we are swept along in a narrative that is part autobiography, part neuroscience lecture, part journal article, and part editorial.

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Using her Renaissance background as the main frame of reference, Dr. Andreasen first grapples with the complexities of trying to define terms that cross the lines of philosophy, psychology, and aesthetics. It is clear from the outset that there is no way to escape from the moral judgments of the society and the values of the time in which these artists lived. Mihaly Csikszentmihalyi's model of creativity is invoked as a useful concept, stating that beyond originality, there must be some value or “utility” in the creative product. But how does Dr. Andreasen handle the delicate issue of the creative value of art? For her, “Its utility resides primarily in its ability to evoke resonant emotions in others, to inspire, or to create a sense of awe at what the human mind/brain can achieve,” creating an identity problem for the reader. I admire the motivation to ask some larger questions, but is this the voice of a neuroscientist?

Her overview of the historical attempt to differentiate creativity and intelligence, however, places her on firmer ground. The description of research by pioneering psychologist Lewis Terman, for example, goes to the heart of defining the characteristics of creativity. Being smart (having a high IQ) is helpful, but it is not sufficient to being considered creative, as measured by achievement later in life. She lauds this kind of longitudinal-design methodology, and we feel that we are back on some scientific footing. But then she doubles-back on herself by stating that case study and introspective methods “probably illuminate more aspects of the creative process than can be obtained from experimental tests.”

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As literature, the personal descriptions of Mozart, Tchaikovsky, Neil Simon, and others make for great reading but it is unclear how these passages lead us to the scientific study of brain function.

From the aesthetic perspective, we then plunge into some basic principles of neuroscience and brain structure. I think I know why she wanted to discuss the workings of the cerebral cortex, but her chapter called “Reaching Xanadu” reads more as a credential for us to consider her a neuroscientist than as an important intellectual foundation to appreciate work to be described later in the book. This segment came somewhat as a surprise because she is, in fact, a pioneering neuroscientist in her field. Moreover, I found it inconsistently superficial in some sections (“who and what pathways”) and highly technical in others, not defining terms such as “columnar organization,” and what PET actually measures.

Most troublesome is that she invokes the notion of “the unconscious mind” (quotation marks are hers), which frankly has no place in neuroscience. In fact, she has the habit of using quotation marks throughout the book to make points more “relevant” for the reader despite the lack of scientific rigor. I was reminded of a courtroom lawyer asking the witness a question, knowing the opposition will have a sustained objection, but wanting the jury to hear it anyway.

On the other hand, her chapter on genius and mental illness was spectacular. It is not neuroscience, to be sure, but she was among the first investigators to demonstrate parallels between creativity and psychopathology, specifically bipolarity and affective disorders. Her description of the Iowa Writers' Workshop Study was an excellent example of how to design a controlled experiment, exploring the patterning of psychiatric disorders in 30 writers, 30 control subjects and their families. She uses the outcomes of this study to discuss the nature-nurture controversy, and how difficult it is to disentangle the relative contributions of each. Her overview of this dichotomy would have been stronger if she could have cited, for instance, the important work by Gottfried Schlaug who used morphometric MR studies on musicians and found structural brain changes that could be explained by either innate developmental differences or practice-induced plasticity.

A major problem in seeking insights into the neuroscience of creativity is that the author doesn't consider research beyond that relating to psychiatric disorders. There have been well-described case studies of musicians and artists with tumor resection or stroke. The importance of key neurotransmitters such as dopamine is never brought out. In addition, some of the most exciting work implicating the role of the frontal lobe, especially the prefrontal cortex, is not mentioned. Why is there a disproportionate number of non-right handers among gifted individuals? Why is there an apparent increase in the prevalence of autoimmune disorders in these people? And not all exceptionally gifted people are talented in many fields, as is suggested by Dr. Andreasen. More than 20 years ago, Benjamin Bloom found that six of 20 world-class mathematicians had trouble learning to read.

To reassure her readers that all hope is not lost for the rest of us, she finally spends considerable time providing tips for mental exercises for young children and adults. Frankly, the suggestions are no more than common sense and have been proposed by others in the past. Is it novel to propose that children should not watch too much television? The push to early, multimodality stimulation in tots is also apparent.

It is not cautioned that some prodigies, as described by Bloom, have been pushed too hard and lose their motivation to meet the adult potential. The line between encouragement and coercion is a matter of great concern among educators, but ignored here. Also, some points are misleading. The notion that higher education “protects against degenerative diseases” comes out of population studies showing that those with more education can have Alzheimer disease longer before becoming cognitively symptomatic, probably through unwitting compensation in activities of daily living. There is no evidence that the elderly going to the library, as is implied here, will stave off Alzheimer disease. Whether Dr. Andreasen's ideas are relevant or not, the relationship to neuroscience is tenuous at best.

I believe strongly that neuroscience holds promise to increase our understanding of brain mechanisms in individuals who function at all points on the spectrum of intelligence, talent, and creativity. In developmental terms, however, we are only in the toddler stage in our state of knowledge. As much as clinical and basic neuroscientists want to educate the larger community about their work and its implications for all of us, we need to be cautious about how much we know and what people should do about capacity and achievement.

©2006 American Academy of Neurology