Mapping Neuroimaging Findings of Creativity and Brain Disease Onto a Common Brain Circuit.

Importance: Creativity is important for problem solving, adaptation to a changing environment, and innovation. Neuroimaging studies seeking to map creativity have yielded conflicting results, and studies of patients with brain disease have reported both decreases and paradoxical increases in creativity, leaving the neural basis of creativity unclear. Objective: To investigate the brain circuit underlying creativity and assess its association with brain injury and neurodegenerative disease. Design, Setting, and Participants: This study examined neuroimaging coordinates from a meta-analysis of 36 studies published between 2004 and 2019 associated with increased activity during creative tasks in healthy participants. A validated method termed coordinate network mapping and a database of resting-state functional connectivity from 1000 healthy individuals were used to test whether these coordinates mapped to a common brain circuit. Specificity was assessed through comparison to random coordinates and coordinates from working memory tasks in healthy participants. Reproducibility was assessed using an independent dataset of coordinates from additional studies of creativity in healthy participants. Finally, alignment with effects of focal brain damage on creativity was tested using data from patients with brain lesions and coordinates of brain atrophy from 7 different neurodegenerative disorders. Main Outcomes and Measures: The primary outcomes were creativity or no creativity and alignment with a creativity circuit or no alignment. Results: Creativity tasks activated heterogenous locations, with coordinates scattered across many different brain regions (415 coordinates derived from 857 healthy participants; pooled mean [SD] age, 24.1 [6.91] years; 461 [54%] female). However, these activation coordinates were part of a common brain circuit, defined by negative connectivity to the right frontal pole. This result was consistent across creative domains, reproducible in an independent dataset (383 coordinates derived from 691 participants) and specific to creativity when compared with random gray matter coordinates (n = 415) or coordinates activated by working memory tasks (3072 coordinates derived from 2900 healthy participants). Damage to this creativity circuit by lesions (n = 56 patients) or neurodegenerative disease (2262 coordinates derived from 4804 patients) aligned with both decreases and increases in creativity observed in these disorders. Conclusions and Relevance: Findings from this study suggest that brain regions activated by creativity tasks map to a brain circuit defined by negative functional connectivity to the right frontal pole. Damage to this circuit aligned with changes in creativity observed in individuals with certain brain diseases, including paradoxical creativity increases.