# Can Semantics Uncover Hidden Relations between Neurodegenerative Diseases and Artistic Behaviors?
## 4 State-of-the-Art
### Neurodegenerative Diseases and Artistic Behavior  
Recent studies explored the relationship between various neurodegenerative disorders and changes in patients' artistic behavior [24; 25; 26; 27; 28; 29; 30]. A number of different approaches were adopted, varying in methods used and participant mix. Many of these studies  
Figure 3: PRISMA for the third category (Ontologies for NDs). highlight changes in painting styles among ND patients [24; 25; 26; 27; 28; 29; 30], whereas others focus on the increased creativity of dementia patients [31; 32]. Several authors compared the artistic behavior of ND patients to that of healthy controls of the same age [24; 28; 29; 33; 34; 35]. In one study [24], the creative potential of dementia patients was evaluated by comparing the artistic products of 15 professional artists and 15 dementia patients with no prior artistic experience. After participating in a custom artistic education program, the results confirmed that dementia patients can exhibit a great deal of creative potential, even despite progressive brain damage. Another study by [PERSON] et al. [4] aimed to examine the link between creativity and pathology by using the Diverse Thinking Test. 17 idiopathic PD patients, 11 frontotemporal dementia (FTD) patients, and 15 healthy subjects participated. The results showed that PD patients and healthy controls performed better than the FTD group, highlighting the connection between creativity and NDs. [PERSON] et al. [35] aimed to gain a deeper understanding of the relationship between NDs and personal artistic styles. They analyzed the artwork produced by four individuals suffering from various forms of dementia and four healthy individuals who participated in an art exercise. The authors concluded that different forms of dementia can be distinguished by the unique artistic styles produced. [PERSON] et al. [29] compared the aesthetic and formal evaluations of paintings created by PD patients and healthy individuals. The sample consisted of 21 PD patients and 23 age and gender-matched controls who evaluated a series of paintings using a modified version of the assessment of formal art attributes (AAA). The authors included demographic data and data related to art interests, and after analyzing the data, they found a significant difference in emotional expressivity between PD patients and healthy controls, which was probably due to dopamine pathways. However, most of these studies have limitations, such as a lack of information on the severity of the disease and a limited sample size as well as not specifying if the patients had prior artistic experience. Few researchers [27; 28; 36; 37; 38] have attempted to compare changes in artistic production among professional and even renowned artists who were diagnosed with a ND to the alterations in artistic behavior among artists who experienced normal aging. [PERSON] et al. [27] utilized fractal analysis to determine the presence of alterations in artistic expression and NDs. Fractal analysis is used as a verification method to establish the authenticity of an artistic work. The fractal dimension measures the extent to which a pattern fills a space. The results indicate that the artistic production of artists who suffer from NDs is significantly different from that of artists who experience normal aging. This distinction is particularly important, as it lays the foundation for creating a system for early detection of the disease. The authors in [28] conducted an analysis of the paintings of famous and unknown artists before and during different stages of progressive neurodegeneration caused by various types of dementia. The analysis included the examination of paintings along with medical information such as the type of ND, design, color, abstraction, simplicity, and overall modification of the art form. The findings show that each type of dementia damages different regions in the brain, leading to modifications in artistic expression.