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      Where art meets neuroscience: a new horizon of art therapy

      Croatian Medical Journal

      Croatian Medical Schools

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          Advances in human brain imaging help us evaluate brain functions from many perspectives. We can define structural brain differences between individuals with various disorders, such as adult schizophrenia (1) and childhood, autistic-spectrum disorders (2). From these studies, we can posit hypotheses regarding structure, and how structure relates to symptoms. However, often we find it difficult to assign causality to such findings. For example, we can ask whether structural anomalies cause the symptoms or whether symptoms drive the abnormal brain structures. Nevertheless, we can confidently say that the brain’s structure changes as a consequence of illness and activity, eg, imaging data show that with proper rehabilitation, the injured brain rewires and recovers its function (3). We label this process “brain plasticity.” Various fields use the concept of brain plasticity. One such very exciting, emerging field involves the study of art and the brain, or art therapy (4). Originally, art therapy used pure art concepts, void of scientific inquiry. Now, slowly, it is embracing scientific thinking by using abundant neuroscientific data and the objective tools of scientific investigation. For years, we recognized that art-making allowed one to reframe experiences, reorganize thoughts, and gain personal insights that often enhanced one’s quality of life. Art therapy has gained popularity because it combines free artistic expression with the potential for significant therapeutic intervention. Although based on subjective data and testimonies, various artistic disciplines have helped patients with diverse disorders that include developmental or acquired, medical, and/or psychiatric conditions (5,6). To utilize nonstandard, medical therapies within the well-established medical model, we must demonstrate the utility and efficacy of novel tools and approaches. The scientific method is one way we can demonstrate that art and art therapy modify the brain’s physiology and structure and lead to a more flexible, adaptable individual. Moreover, if we want to validate non-standard approaches, such as art therapy, we need more studies to assess their effects on brain function. As we might imagine, it is very difficult to define art and its optimal therapeutic uses. Naturally, as a new field, art therapy is trying to define its territory and claim its domain within brain science. To gain acceptance and credibility from the medical establishment, art therapy is, seemingly, hoping to assign unique artistic processes to specific brain structures, but the specific brain effects of the artistic process are difficult to study. Nevertheless, through neuroscience, art therapy is attempting to locate particular brain areas or activity patterns that may be devoted exclusively to art-making (7,8). Yet, this specificity presents a problem – the brain does not distinguish between the processes used to create a scientific invention and a work of art – the brain undergoes identical activity sequences and manipulations (9,10). At the outset, an artist may wish to express an idea and a scientist may hope to develop a new treatment or novel molecule. Next, both artist and scientist choose their tools. Then, both experiment, and, eventually, create a final product. At the system level, the brain is unaware of the anticipated outcome, ie, a new pharmaceutical agent or a sculpture. If we accept that scientific and artistic processes use congruent networks, we can assume that artists and scientists use very similar brain processes to deploy their conceptualizations (11). As such, in terms of therapy, there is no difference between using scientifically validated novel art therapy and other current standard therapeutic interventions. Treating human pathology using art gives us a tremendous alternative unique and novel option for engaging brain networks that enhance the way the brain processes information, incorporates external and internal data, and develops new efficient brain connections. Ultimately, our goal is for humans to become better adapted to their defined environments. It is quite evident that scientists, clinicians, and artists must come together to share and discuss their experiences. Their interaction can lead to novel communication and cooperation. Clearly, at the brain level, any intervention’s goal is the dynamic enhancement of emotion, cognition, and executive flexibility so that one fully participates in life and avails oneself of the experiential and hereditary gifts in his or her environment (12). Ultimately, we hope to integrate all disciplines without prejudice and develop novel therapies that optimize the treatment of mental illness.

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          A functional MRI study of subjects recovered from hemiparetic stroke.

          Stroke recovery mechanisms remain incompletely understood, particularly for subjects with cortical stroke, in whom limited data are available. We used functional magnetic resonance imaging to compare brain activations in normal controls and subjects who recovered from hemiparetic stroke. Functional magnetic resonance imaging was performed in ten stroke subjects with good recovery, five with deep, and five with cortical infarcts. Brain activation was achieved by index finger-tapping. Statistical parametric activation maps were obtained using a t test and a threshold of P < .001. In five bilateral motor regions, the volume of activated brain for each stroke subject was compared with the distribution of activation volumes among nine controls. Control subjects activated several motor regions. During recovered hand finger-tapping, stroke subjects activated the same regions as controls, often in a larger brain volume. In the unaffected hemisphere, sensorimotor cortex activation was increased in six of nine stroke subjects compared with controls. Cerebellar hemisphere contralateral and premotor cortex ipsilateral to this region, as well as supplementary motor areas, also had increased activation. In the stroke hemisphere, activation exceeding controls was uncommon, except that three of five cortical strokes showed peri-infarct activation foci. During unaffected hand finger-tapping, increased activation by stroke subjects compared with controls was uncommon; however, decreased activation was seen in unaffected sensorimotor cortex, suggesting that this region's responsiveness increased to the ipsilateral hand and decreased to contralateral hand movements. Use of a different threshold for defining activation (P < .01) did not change the overall findings (kappa = .75). Recovered finger-tapping by stroke subjects activated the same motor regions as controls but to a larger extent, particularly in the unaffected hemisphere. Increased reliance on these motor areas may represent an important component of motor recovery. Functional magnetic resonance imaging studies of subjects who recovered from stroke provide evidence for several processes that may be related to restoration of neurologic function.
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            Overlapping and non-overlapping brain regions for theory of mind and self reflection in individual subjects.

            When subjects are required to reason about someone's false belief, a consistent pattern of brain regions are recruited including the medial prefrontal cortex, medial precuneus and bilateral temporo-parietal junction. Previous group analyses suggest that the two medial regions, but not the lateral regions, are also recruited when subjects engage in self-reflection. The current study directly compared the results of the 'false belief' and 'self' tasks in individual subjects. Consistent with previous reports, the medial prefrontal and medial precuneus regions recruited by the two tasks significantly overlap in individual subjects, although there was also evidence for non-overlapping voxels in medial regions. The temporo-parietal regions are only recruited for the 'theory of mind' task. Six possible models of the relationship between theory of mind, self-reflection and autobiographical memory, all consistent with both neurobiological and developmental evidence to date, are discussed.
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              A randomized, controlled trial of mindfulness-based art therapy (MBAT) for women with cancer.

              The purpose of this study was to gather data on the efficacy of a newly developed psychosocial group intervention for cancer patients, called mindfulness-based art therapy (MBAT). One hundred and eleven women with a variety of cancer diagnoses were paired by age and randomized to either an eight-week MBAT intervention group or a wait-list control group. Ninety-three participants (84%) completed both the pre- and post-study measurements. As compared to the control group, the MBAT group demonstrated a significant decrease in symptoms of distress (as measured by the Symptoms Checklist-90-Revised) and significant improvements in key aspects of health-related quality of life (as measured by the Medical Outcomes Study Short-Form Health Survey). This investigation of MBAT provides initial encouraging data that support a possible future role for the intervention as a psychosocial treatment option for cancer patients. Copyright 2005 John Wiley & Sons, Ltd.

                Author and article information

                Croat Med J
                Croat. Med. J
                Croatian Medical Journal
                Croatian Medical Schools
                February 2014
                : 55
                : 1
                : 73-74
                Department of Psychiatry, Loyola Medical Center, Maywood, IL, USA and Yellowbrick Consultation and Treatment Center, Evanston, IL, USA
                Author notes
                Copyright © 2014 by the Croatian Medical Journal. All rights reserved.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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