Neuroanatomical Basis of Art Therapy and Dementia: A Correlative Review and Implications

Dementia involves two or more of the six key domains of cognitive function that interfere with activities of daily living. It affects not only memory, but also speech, perception, and visuospatial orientation. The severity of amnesia varies with the type of dementia. Certain clinical presentations of dementia, such as auditory or visual hallucinations and disinhibition and impulsivity, arise from pathology in particular regions of the brain that include the cingulum, prefrontal cortex and parietal lobe. It is also known that objective and nonobjective drawing tasks (drawing faces, tracing, or creating abstract geometric figures) evoke distinct neuronal networks that activate the frontal, temporal, occipital and parietal lobes. The Expressive Therapies Continuum (ETC) serves as a theoretical framework for assessing and structuring art therapy interventions by identifying the cognitive and emotional processes engaged during creative activities with the use of certain artistic media. The hierarchical structure of the ETC allows therapists to analyze how individuals process information, link artistic expression to specific areas of brain function, and adapt interventions accordingly. Art therapy offers promising ways to enhance the cognitive, emotional, and social well-being of adults with dementia by stimulating multiple neural pathways associated with memory and cognitive function, perception, motor coordination, and symbolic processing, potentially reducing the rate of clinical decline due to dementia. Knowledge of neuroanatomy can thus help provide a means of localizing targeted interventions to those with Alzheimer’s disease, Lewy body dementia, Frontotemporal dementia and Benson’s syndrome, as each of these neurodegenerative diseases initially disturbs unique regions of the brain. By integrating neuroanatomical insights with the framework of the ETC, this review seeks to establish a correlative model that informs evidence-based art therapy interventions for individuals with dementia.