Brain Advance Access originally published online on December 1, 2004
Brain 2005 128(2):250-260; doi:10.1093/brain/awh341
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Brain Vol. 128 No. 2 © Guarantors of Brain 2004; all rights reserved
The effects of very early Alzheimer's disease on the characteristics of writing by a renowned author
1 Institute of Cognitive Neuroscience, London, 2 Defence Services Medical Rehabilitation Unit, Headley Court, Epsom, Surrey and 3 MRC Cognition and Brain Science Unit, Cambridge, UK
Correspondence to: Dr. P. Garrard, Institute of Cognitive Neuroscience, 17 Queen Square, London WC1N 3AR. UK. E-mail: p.garrard{at}ucl.ac.uk and garrard{at}cnbc.cmu.edu
Iris Murdoch (I.M.) was among the most celebrated British writers of the post-war era. Her final novel, however, received a less than enthusiastic critical response on its publication in 1995. Not long afterwards, I.M. began to show signs of insidious cognitive decline, and received a diagnosis of Alzheimer's disease, which was confirmed histologically after her death in 1999. Anecdotal evidence, as well as the natural history of the condition, would suggest that the changes of Alzheimer's disease were already established in I.M. while she was writing her final work. The end product was unlikely, however, to have been influenced by the compensatory use of dictionaries or thesauri, let alone by later editorial interference. These facts present a unique opportunity to examine the effects of the early stages of Alzheimer's disease on spontaneous written output from an individual with exceptional expertise in this area. Techniques of automated textual analysis were used to obtain detailed comparisons among three of her novels: her first published work, a work written during the prime of her creative life and the final novel. Whilst there were few disparities at the levels of overall structure and syntax, measures of lexical diversity and the lexical characteristics of these three texts varied markedly and in a consistent fashion. This unique set of findings is discussed in the context of the debate as to whether syntax and semantics decline separately or in parallel in patients with Alzheimer's disease.
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