A case report of acquired synesthesia and heightened creativity in a musician after traumatic brain injury.

INTRODUCTION: We report on a musician who acquired synesthesia, enhanced sensory experience, and improved creativity following traumatic brain injury (TBI). BACKGROUND: Creativity and synesthesia can be acquired from an injury, though both simultaneously has not been frequently documented. NARRATIVE: This case report details heightened creativity and developing synesthesia in a 66-year-old right-handed man following TBI. He developed a "compulsion" to write music. Synesthesia included "seeing" the notation and being able to name chord structures of music he heard, both of which were novel experiences. The Synesthesia Battery revealed a vision-sound synesthesia with higher than average level of Vividness of Visual Imagery (VVIQ-2), and "Absolute Pitch/Perfect Pitch." PATIENT EXPERIENCE: The patient experienced an approximate four-month history of these changes, including musical compositions, developing perfect pitch, and enhanced sensory experience of typical phenomena. DISCUSSION: Both creativity and synesthesia depend on novel connections in the brain, and both have been reported following insults to the brain, including in degenerative conditions. However, the development of both simultaneously is not frequently reported. Evidence for the etiology of one prompting the other has not been described. Brain injury may result in increased creativity and synesthesia. Our fields would benefit from increased awareness of this possible relationship.

Toward a quantitative basis for assessment and diagnosis of apraxia of speech.

PURPOSE: We explored the reliability and validity of 2 quantitative approaches to document presence and severity of speech properties associated with apraxia of speech (AOS). METHOD: A motor speech evaluation was administered to 39 individuals with aphasia. Audio-recordings of the evaluation were presented to 3 experienced clinicians to determine AOS diagnosis and to rate severity of 11 speech dimensions. Additionally, research assistants coded 11 operationalized metrics of articulation, fluency, and prosody in the same speech samples and in recordings from 20 neurologically healthy participants. RESULTS: Agreement among the 3 clinicians was limited for both AOS diagnosis and perceptual scaling, but inter-observer reliability for the operationalized metrics was strong. The relationships between most operationalized metrics and mean severity ratings for corresponding perceptual dimensions were moderately strong and statistically significant. Both perceptual scaling and operationalized quantification approaches were sensitive to the presence or absence of AOS. CONCLUSIONS: Perceptual scaling and operationalized metrics are promising quantification techniques that can help establish diagnostic transparency for AOS. However, because satisfactory reliability cannot be assumed for scaling techniques, effective training and calibration procedures should be implemented. Operationalized metrics show strong potential for enhancing diagnostic objectivity and sensitivity.