A blinded pilot study of artwork in a comprehensive epilepsy center population
Introduction
The production of artwork requires complex brain processes not often assessed during routine neurological testing. Unique insights into disordered cognitive processes might be gained through the study of the artwork of neurological patients. Although previous literature has addressed the topic of art and epilepsy [1], [2], [3], artwork has never been studied in a population whose events have been characterized by video-EEG monitoring. Prior to the initiation of the present study, empiric observations by the present authors had suggested the possibility that some patients with epilepsy produce drawings with unique qualities. In particular, we observed use of high color contrast, a preference for a large number of lines with curves, rather than angles, and high use of available workspace. In order to investigate the hypothesis that these characteristics of artwork differed in people with epilepsy from those without epilepsy, we designed three tasks for subjects to complete. The first involved drawing a person picking an apple from a tree (PPAT) which was scored with a previously standardized method called the Formal Elements Art Therapy Scale (FEATS). The second involved a less restrictive “free drawing” that utilized some of the FEATS rating scales. The final task involved using a body outline as a starting point for the art task.
Section snippets
Patient population
Over an 18-month period, all adult patients who entered the Stanford University Epilepsy Monitoring Unit were offered an opportunity to participate in the study, except that those with mental dysfunction so severe that they could not understand the study tasks were excluded. A total of 58 subjects were enrolled from this group. In addition, over a period of approximately two months, epilepsy clinic outpatients were invited to participate. Two subjects were recruited from this population. For
PPAT
Results of the full logistic regression for each of the four groups are shown in Table 1. A statistically significant, negative correlation exists for “Line Quality” for the seizure (*P = 0.041; odds ratio = 0.209) and partial seizure (*P = 0.032; odds ratio = 0.218) groups. The same relationship is nearly significant for the CPS-TF group (P = 0.053; odds ratio = 0.210). In all three cases, the regression coefficients indicate that every reduction of one point in a subject’s Line Quality score (keeping
Discussion
The results of the present study have provided the first step toward the possible development of a new tool, using patient-generated art, for the evaluation of epileptic-appearing behavioral events. This pilot study investigated the artistic traits of patients cared for at a comprehensive epilepsy center, and only can be applied to the types of patients referred to such centers, who may not be representative of all people with epilepsy. The control group was comprised of patients with NEE, and
Acknowledgments
The following people served as blinded raters: Teresa Reyna, Raymond Henley, Patricia McDonald, and Vinnie Cheung. Funding and resources were provided by the Office of Community and Patient Relations at Stanford University Medical Center through the generous and kind assistance of Ms. Jeanne Kennedy. Armin Schwartzman was supported by a William R. and Sara Hart Kimball Stanford Graduate Fellowship. Dr. Fisher was supported by the Maslah Saul MD Chair and the James and Carrie Anderson Fund for
References (7)
- et al.
Seizure drawings: insight into the self-image of children with epilepsy
Epilepsy Behav
(2003) - et al.
Early signs of organicity in art work
Art Psychother
(1979) Epilepsy and art
Med J Aust
(1996)
Cited by (19)
Psychological and social aspects of people with epilepsy expressed through drawing: Pilot study
2023, Epilepsy and BehaviorExploring epilepsy comorbidities in children using artwork
2022, Epilepsy and BehaviorUsing artwork to understand and address the psychosocial challenges facing children and adolescents with epilepsy
2019, Epilepsy and BehaviorCitation Excerpt :For instance, differences may exist between the visual phenomena experienced by children with migraines and those with seizures; migraineurs most often depict their visual auras by zig zag lines and fortification designs [31,37], while those with occipital lobe seizures tend to draw circular colored blobs [38]. To support the contention that artwork can help to understand pathophysiology, a creative study used art to explore epilepsy in inpatients on an epilepsy monitoring unit (EMU) [39]. In a free-drawing task, the EMU patients were asked to draw “anything of their choosing.”
Development and use of the art therapy seizure assessment sculpture on an inpatient epilepsy monitoring unit
2018, Epilepsy and Behavior Case ReportsEpilepsy in children and adolescents: Disease concepts, practical knowledge, and coping
2016, Epilepsy and BehaviorCitation Excerpt :Besides, they were able to distinguish typical drawings for specific epilepsy syndromes or seizure types. Anschel et al. also found that drawings of patients with epilepsy might help in diagnostic evaluation of their disease [18]. Pictures should therefore be seen as an additional means of communication and self-expression of children with epilepsy.
Epilepsy treatment and creativity
2016, Epilepsy and BehaviorCitation Excerpt :Before considering the effects of epilepsy treatment on the creative process, it is worthwhile to note that epilepsy itself may affect creativity in multiple domains. For example, one study found that patients with epilepsy demonstrated poor control over drawing, making disorganized lines [4]. In addition, patients with temporal lobe epilepsy (TLE) and complex partial seizures produced drawings with highly detailed individual components that were not well related to one another.