Fifteen years ago, Derek Amato was fooling around with some old high school buddies when he took a flying leap into a swimming pool to catch a tossed football. He plunged to the bottom of the shallow end, hitting the left side of his forehead hard against the concrete.
Amato, then a corporate sales director who was about to turn 40, was diagnosed at the emergency department with a severe concussion. For the next five days, he mostly slept. When he felt better, he decided to go over to a friend's place. While there, he saw a piano keyboard sitting in the corner and was inexplicably drawn to it.
When he sat down, he didn't just tinker with the keys; he began producing complex and emotional chords and melodies that were unfamiliar to him. He played for about five hours, feeling as though the music were bursting out of his skin. “I was doing things I didn't know I could do,” says Amato, who had never previously played the piano. He had dabbled with guitar and drums as a kid but considered himself an athlete, not a musician.
Perplexed about what was happening, Amato took his mother to a music store the next day and turned on a digital piano. After a couple of minutes of hearing him play, his mother started crying. When the clerk asked how long he had been playing the piano, Amato said, “About the last eight hours of my life.”
Amato believes he is an example of an extremely rare phenomenon called acquired savant syndrome, which refers to someone who suddenly develops an extraordinary and perhaps obsessive ability in music, art, math, or another field after sustaining a head injury, stroke, or other neurologic illness.
Some people are savants from birth—they may have a neurodevelopmental disability like autism, but they also possess an uncanny ability to recall trivia or calculate numbers. In the 1988 movie Rain Man, Dustin Hoffman portrayed an autistic savant who could rattle off telephone book listings and baseball statistics from memory.
Amato, who lives in the Denver area, has shared his story in newspapers and magazines and on radio shows and podcasts and has played for audiences. Since the concussion, which he thinks somehow activated neural connections in his brain, sending them into overdrive, he “sees” the music (instead of reading it, which he never learned) pouring out of him—even from his ears—as black and white squares moving in a circular fashion, a strange phenomenon characteristic of a neurologic condition known as synesthesia. He also has experienced hearing loss, headaches, and memory problems.
Defining a Term
Medical and popular literature is sprinkled with cases of savants, but less is known about acquired savant syndrome. Some scientists who study the brain and cognition are skeptical.
“I am not convinced that this syndrome exists,” says Pamela Heaton, PhD, professor of psychology at Goldsmiths University of London. “I once saw a conference presentation of ‘acquired savantism,’ but the quality of the art produced had not been evaluated by an art expert. If someone sustains brain damage that results in obsessional activity, and this becomes focused on drawing without regard to the quality of the output, is that savantism? The problem is that people use the term in different ways.”
Dr. Heaton thinks it's an oversimplification to think that injury to one side of the brain would lead to musical talent emerging from the other side. “People sometimes talk about music being a right-brain activity, but this is not consistent with what we know from scientific studies of the brain,” she says. “We know that music is a whole-brain activity, and this reflects its complex nature—sensory, perceptual, structured, emotional, and linked with movement.”
“There probably are people who are naturally talented,” says Bernard Bendok, MD, a neurosurgeon at the Mayo Clinic in Phoenix who has an interest in music as it relates to brain function. But few would be called musical geniuses, he says. “Mostly what we perceive as talent is actually hard, deliberate work over many years,” says Dr. Bendok, who remains unconvinced by what he's read in the medical literature claiming that a head injury can result in artistic genius. He says he has seen patients with learning differences who are unusually creative but has never had a patient with brain injury who suddenly became a virtuoso.
Rewiring the Brain
Amato says that after he developed his piano ability, he searched the internet for possible explanations. He eventually connected with Darold Treffert, MD, a well-regarded psychiatrist affiliated with the University of Wisconsin Medical College who did research on autism and savant syndrome. Dr. Treffert, who died in 2020, never evaluated Amato in person, but in phone calls and video visits over 15 years, the doctor told him his case was undoubtedly acquired musical savant syndrome.
In a TEDx talk he gave in 2017, “Accidental Genius,” Dr. Treffert described Amato and several others who suddenly acquired a talent after having a head injury, including a shopkeeper who suffered traumatic brain injury when he was mugged and awoke showing signs of mathematical genius.
“There are emerging data that when the left anterior lobe of the brain [involved in language, emotional regulation, and social skills] becomes less responsive due to damage, the parts of the brain involved in visual processes become more responsive,” says Bruce L. Miller, MD, FAAN, director of the Memory and Aging Center at the University of California San Francisco. Dr. Miller sometimes gets emails from people who say they have experienced a “burst of creativity they didn't have before” after sustaining a head injury.
He doesn't discount their stories, in part because he has observed a similar phenomenon in some patients with Alzheimer's disease or frontotemporal dementia, which affect the prefrontal cortex of the brain. In one case, a patient who developed aphasia—an inability to understand or express oneself with language—became a remarkable and prolific artist. Dr. Miller also has seen dementia patients without prior artistic talent blossom into excellent painters, sculptors, and gardeners.
The obsessiveness that can develop with Alzheimer's disease and frontotemporal dementia may account for some of the newly acquired skills—practice makes perfect—but rewiring of brain connections is also a factor, says Dr. Miller. Functional MRIs (fMRIs) can reveal the activity that goes on when the brain has creative spurts. “You can watch in real time a brain turning on and off,” he says.
Scientists “started thinking we are born with certain wiring, and this wiring has a predictive value for what strengths and weaknesses we have,” Dr. Miller explains. But new understanding of brain plasticity shows that it can occur both early and late in life and “is not fixed in stone,” he says.
Tapping into Creativity
Amato ended up being evaluated by Berit Brogaard, PhD, professor of philosophy, Cooper Fellow, and director of the Brogaard Lab for Multisensory Research at the University of Miami, who studies acquired savant syndrome. She says there are fewer than 50 confirmed cases of acquired savant syndrome in the world. (Far more people have developmental savant syndrome from birth.)
The exact mechanisms of how a brain injury could lead to virtuoso skills is not fully understood, but the “prefrontal cortex normally suppresses activity in lower brain regions in the parietal cortex and elsewhere involved in creativity,” explains Dr. Brogaard. “This means that the prefrontal cortex keeps our creative abilities in check to ensure that we can be creative when necessary but that not all our energy is devoted to those activities.”
Damage to the prefrontal cortex can sometimes prevent it from suppressing activity in the brain areas involved in creativity or from keeping the lower brain regions in check, she says. “Without the prefrontal cortex suppressing the activity in the lower brain areas, you sometimes see hyperactivity in those areas.”
Dr. Brogaard, co-author of a 2015 book titled The Superhuman Mind: Free the Genius in Your Brain, has evaluated about 10 people with cases like Amato's and says five of them, including Amato, align with what she would consider acquired savant syndrome. She evaluated Amato's fMRIs and saw white spots in his prefrontal cortex indicative of scarring from a concussion. But, she says, without brain scans from before, immediately after the accident, and over time, it's impossible to know definitively that Amato's accident precipitated changes in his brain chemistry and wiring that led to his piano ability. He'd had several concussions when he was younger.
“There is no doubt that he didn't play the piano prior to his brain injury, and following the brain injury he did. We don't know to what extent he suddenly became obsessed with something and had the time to cultivate that obsession,” says Dr. Brogaard, who talked about Amato's case for a BBC special.
Dr. Brogaard and some other neuroscientists believe that one day it may be possible to turn on dormant creative abilities using electronic brain stimulation or pharmaceuticals that activate relevant areas of the brain.
Amato says he will never be able to fully explain his transformation, but he has come to accept that the musical ability was probably hidden inside his brain all along. He likes the thought that everyone has talents waiting to be discovered. In another turn of events, Amato is recovering from multiple injuries from a head-on car crash and planning to pursue a career as an entertainer.
“We feel like we have to define everything about the brain,” he says. “Maybe part of the magic is not defining it at all.”
