Savant syndrome is characterized by outstanding abilities in specific areas co-existing with developmental disabilities. People with savant syndrome exhibit extraordinary skills in areas like math, music, art or memory. These profound abilities far exceed normal levels. There is a paradox between their special skills and disabilities. Savant skills have been documented in lightning-fast calculation, calendar calculation, perfect musical pitch, hyperlexia and artistic or memory abilities. The goal of the article is to review savant syndrome based on neurophenomenology and recent findings.

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ABSTRACT
Savant syndrome is an enigmatic disorder. It is characterized by cluster of outstanding mental ability in otherwise handicapped individuals.
People with savant syndrome exhibit exceptional-extraordinary abilities and demonstrate some specific talents or particular skills along
with developmental disabilities. Their profound and prodigous abilities are far in excess of what are considered normal. There is a paradoxical
presence of special skills and distinguished disabilities. The documented savant skills include “lightning-speed” numerical calculation,
calendrical calculation, musical savants (exceptional musical abilities, especially perfect pitch), artistic skills, hyperlexics (fast reading
and understanding). Other types of talents and artistic skills involving three-dimensional drawing, map memory, poetry, painting, and
sculpturing are also observed. The goal of this scientific article is to review savant syndrome, based on neurophenomenology framework and
recent findings.
Keywords: Savant syndrome, neurophenomenology, neurocognitive models
ABSTRAK
Sindrom savant adalah gangguan yang misterius. Sindrom ini ditandai dengan adanya beberapa kemampuan mental yang menonjol pada
individu dengan kelainan/cacat jasmani. Orang dengan sindrom savant menunjukkan beragam kemampuan luar-biasa serta memiliki
beberapa bakat khusus atau keterampilan yang istimewa di samping gangguan perkembangan. Kemampuan yang dimilikinya melampaui
kondisi normal. Ada paradoks dari kehebatan dan cacat yang dimilikinya. Beberapa keterampilan yang terdokumentasikan, misalnya
perhitungan numerik kilat, kalkulasi kalender, musik (kecuali kemampuan musikal, terutama pitch yang sempurna), keterampilan artistik,
hiperleksia (kemampuan membaca dan memahami kilat). Jenis bakat dan kemampuan artistik lainnya antara lain menggambar tiga
dimensi, ingatan tentang peta, puisi, lukisan, dan seni memahat. Tujuan artikel ilmiah ini adalah untuk meninjau sindrom savant berdasar­
kan pendekatan neurofenomenologi dan kepustakaan serta riset terkini. Dito Anurogo, Taruna Ikrar. Neurofenomenologi dari Sindrom
Savant.
Kata kunci: Sindrom savant, neurofenomenologi, model neurokognitif
Neurophenomenology
of Savant Syndrome
Dito Anurogo,1-3
Taruna Ikrar1,4
1
Health consultant at detik.com
2
Indonesian Young Health Professionals’ Society (IYHPS)
3
Brain Circulation Institute of Indonesia (BCII), Surya University, Indonesia
4
School of Medicine, University of California, Irvine, USA
Alamat korespondensi email: ditoanurogo@gmail.com
Introduction
‘Savant’ is person with obvious mental
retardation who is capable of performing in
sharply circumscribed areas (e.g. arithmetic,
calendar calculating) at a remarkably high
level.1
Savant syndrome is a constellation
of symptoms or behaviors, a collection
of characteristics or conditions that is
superimposed and grafted on to some
underlying disabilities.2-7
It is not a disorder
or disease.8
It is characterized by certain spectacular
skill(s) or prodigious intellectual gifts in a
specific area (i.e.: mathematical, musical,
artistic, mechanical abilities, etc), subnormal
intelligence, massive memory, different
disability/handicap or sometimes with seve­
rely limited emotional range.2-7
Formerly,
savant syndrome is known as idiot savant,
first coined by Down.9
Type
Savant syndrome has been differentiated
into two kinds, i.e.:10
1. ‘Prodigious’ savants, i.e.: individuals
whose talents and abilities are exceptional
and well beyond the range of normal
functioning in relation to both their overall
level of functioning and the general
population.
2. ‘Talented’ savants, i.e.: individuals
showing outstanding skills in comparison
with their overall levels of functioning.
Both prodigious and talented savants
are most frequently reported as autism
spectrum disorder (ASD).
Epidemiology
Savant syndrome occurs in less than 1%
of the intellectually disabled population.11

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The incidence of savant syndrome is 10%
in autistic disorder (531 savant in 5400
children with autism).12
If the presence of
savant syndrome is not limited to autism, it
is estimated to be 1-2 in 200.6
In population
with mental retardation, the incidence of
savant skills was 1:2000.13
The prevalence
of savant syndrome is 1.4 per 1000.14
Ratio
males: females is 6:1.15
At present, there are
perhaps fewer than 100 known prodigious
savants living worldwide.15
“SAVANT”as Clinical Portraits, Early
Detection and Identification
The clinical portraits of savant syndrome
can be memorized easily by mnemonics
“SAVANT” below (Table 1). It can also be
used as the fastest way in early detection or
identification of savant syndrome.
Specific Savant Skills, Abilities, or
Expertise
Savant skills are often referred to the exis­
tence of extraordinary talent in art, music,
maths, calendar calculation, or memory.16
Actually, savant skills have multispecific areas.
They are certain arithmetic-mathematical
skills, art (visual arts; particularly drawing),
calendar calculations (the ability to give the
correct day of the week for a given date),
coordination skills, computation-calculation,
language, mechanical aptitude/skills, me­
mory (dates, facts, places, routes, etc), music
or musical performance, prime number
derivation, ‘pseudo-verbal’ skills (hyperlexia/
facility with foreign languages), sensory
sensitivity, visuospatial, or multiple skills (more
than one skill simultaneously in one savant).
They might be reported or observed by
parents, friends, medical practitioners,
etc.12,17-22
The savant skills above could be
classified into five major expertises, i.e.: art,
musical abilities, calendar calculation,
mathematics, and spatial skills.15
Calendar
calculation is one of the most prevalent
savant skills.12,23
The specific areas of savant skills above are
mainly categorized into three spectra, i.e.:15
1. Splinter skills (e.g.: memorization of
music and historical facts trivia)
2. Talented savants (e.g.: having special
abilities but cognitively impaired)
3. Prodigious savant [e.g.: having special
skill(s) which is so amazing, astonishing,
outstanding, and spectacular).
Autism
Some of savants have autism.24,25
The autistic
savants have a tendency to have repetitive
behaviour and/or preoccupations with a
restricted area of interest. They also show
interest in one specific topic.26,27
Not
all persons with savant syndrome have
autistic disorder and vice versa.15
Increased
perceptual expertise may be implicated
in the choice of special ability in savant
autistics.28
Therefore, autism is sometimes
superimposed in savant syndrome.
Variations and Anomalies
There are a lot of variation that can be
observed in person with savant syndrome.
Variations are in intelligences and maturity of
emotion (usually severely limited emotional
range). Table 2 summarizes some brain
researches related to savant syndrome.
Table 1. The mnemonics of SAVANT (original idea)
S : Specific savant skills
A : Autism (is sometimes superimposed)
V : Variations (and veridical mapping)
A : Anomaly (in specific brain’s region)
N :
Neurological-neurodevelopmental
disorders-disability
T : Talents (or talented)
Table 2. Summary of some brain researches related to savant syndrome
Explanation of (Brain) Researches Reference(s)
Seventeen autistic subjects (4 savants) were investigated with pneumographic
techniques. Fifteen cases demonstrated enlargement of the left ventricle, in particular,
enlargement of the left temporal horn. These abnormalities represented mild and
variable atrophy in the left cerebral hemisphere.
29
In a blind and retarded savant with exceptional musical abilities, a CAT (Computerized
Axial Tomography) scan demonstrates clear left sided abnormalities.
30
One prodigiously talented savant was observed in CAT (Computerized Axial
Tomography) scan. This scan demonstrated a considerable left sided abnormality,
especially in the left frontal lobe, which was considered a large area of scarring. There
was also damage to the anterior and posterior portions of the left parietal lobes and to
a minor degree damage to the left and right occipital lobes.
31
There are alterations in brain cytoarchitecture. In the future, it may help to explain
exceptional abilities in both autistic savants and the intellectually gifted.
32
Dominance in hemisphere is important for the acquisition of savant abilities/skills. In
people who acquire savant-like abilities, an injury to the frontal lobe, particularly in the
left hemisphere, preceded the emergence of the abilities/skills. Frontotemporal lobe
is associated with several skills possessed by savants (i.e.: memory). Degeneration of
the lobe leads to varying effects depending on the hemisphere it targets in individual
cases.
33
The effects of repetitive transcranial magnetic stimulation (rTMS) of the left anterior
temporal lobe (LATL) lend credence to Treffert’s damage-compensation theory and
open the possibility for scientists to uncover talents in ordinary people. Improvements
may only be possible for some, not all, individuals, just like savant abilities are not
present in all autistic patients. rTMS is a noninvasive method that works by depolarizing
or hyperpolarizing neurons in the brain, allowing a researcher to safely shut off the left
frontotemporal lobe to observe the right hemisphere compensate for this reduction
in function.
34,35
Prodigious artistic skills in a 63-year-old male with autistic savant were observed in
a high-resolution magnetic resonance (MR) imaging, J-resolved MR spectroscopy,
and diffusion tensor imaging; they revealed no gross anatomical differences, a larger
cerebral volume (1362 mL) than normal adults males’ brain. The corpus callosum
was intact. The right cerebral hemisphere was 1.9% larger than the left hemisphere.
The right amygdala and right caudate nuclei were 24% and 9.9% larger, respectively,
compared to the left side. The putamen was 8.3% larger on the left side. Fractional
anisotropy was increased on the right side as compared to the left side for 4 of the 5
bilateral regions studied (the amygdala, caudate, frontal lobe, and hippocampus). Fiber
tract bundle volumes were larger on the right side for the amygdala, hippocampus,
frontal lobe, and occipital lobe. Both the left and the right hippocampi had substantially
increased axial and mean diffusivities as compared to those of a comparison sample
of nonsavant adult males. The corpus callosum and left amygdala also exhibited high
axial, radial, and mean diffusivities. MR spectroscopy revealed markedly decreased
gamma-aminobutyric acid and glutamate in the parietal lobe.
36

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It is concluded that there are a lot of
variations and anomalies in specific regions
in the brain of person with savant syndrome.
Veridical Mapping Mechanism
Savant abilities share the same structure-
developmental course. They represent related
ways by which the perceptual brain deals
with objective structures under different
conditions. These different phenomena
develop through a veridical mapping (VM)
mechanism whereby perceptual information
is coupled with homological data drawn
from isomorphic structures.37
VM is a peculiar mechanism that can
expound the higher incidence of savant
abilities especially in autism. It has also been
hypothesized in an effort to account for the
role of perception in the high prevalence of
savant syndrome, particularly in autism.17,38
The prevalence of savant abilities among
persons with autism range from 1/20039
to
1/3 or higher.17,38
The mechanisms involved in savant abilities
initially entail VM between perceptually
presented isomorphic patterns. It is veridical
in the sense that the mapping emerges
when there is a sufficient level of similarity
between at least two structures. The mapping
involves the coupling of homologue
elements of recurrent isomorphic patterns,
and is the basic mechanism for structure
detection.40
The seven basic components in savant
abilities based on VM are:37
1. Savant abilities involve materials with a
high density of isomorphisms.
2. Savant abilities are based on the early
implicit within- and between-code mapping
among large isomorphic structures.
3. Material and operations involved in a
domain-specific ability depend on episodic
exposure to this material.
4. Superior performance of savants
on domain-relevant tasks results from a
combination of enhanced perception and
expertise.
5. Savant performance involves non-
strategic recall or redintegration.
6. Understanding of linguistic codes is
achieved in perceptual, non-linguistic ways.
7. During development period, savant
abilities become gradually more explicit, and
merge with typical reasoning/algorithmic
processes, resulting in a unique combination
of perceptual and abstract structure.
Neurological-neurodevelopmental
Disorders-disability
Neurological and/or neurodevelopmental
disorders and any disability are a possibility
and susceptibility in person with savant
syndrome. It is estimated 50% of persons
with savant syndrome have developmental
disability, mental retardation, or other CNS
injury/disease. Another 50% have autistic
disorder.15
There is at least one specific disability in
person with savant syndrome, i.e.: autism,
brain injury, cerebral palsy, congenital syphillis,
delayed language, depression, echolalia,
encephalitis, epilepsy, high fever at age one,
language delay, language disorder, language
impairment, left hemispherectomy, left side
convulsions, Marfan syndrome, mentally
handicapped, premature, meningitis, per­
vasive development disorder, rubella “autistic”,
schizophrenia, slow speech, socially obtuse,
“limited” speech, Tourette syndrome, very
distracted, visual impairment, unspecified.41-
46
Talents or Talented
A person with savant syndrome can have
one or some talents in specific area, i.e.: art,
music, calendrical and numerical calculation,
linguistic and language-related.47
Savants
aren’t gifted. Someone can be gifted without
necessarily being talented (as with the case
of underachievers), but not vice versa.48
The documented savant skills include
“lightning-speed” numerical calculation,
calendrical calculation, musical savants
(exceptional musical abilities, especially
perfect pitch), artistic skills, and hyperlexics
(fast reading and understanding). Other
types of talents and artistic skills involving
three-dimensional drawing, map memory,
poetry, painting, and sculpturing are also
observed. Savant talent has traditionally
involved exceptional memory, and some­
times for peculiar material (e.g. bus routes,
telephone directories, etc). People with
savant syndrome exhibit exceptional-
extraordinary abilities and demonstrate
some specific talents or particular skills with
developmental disabilities. Their profound
and prodigous abilities are far in excess
of what are considered normal. There is a
paradoxical presence of special skills and
distinguished disabilities.
Cognitive Models
There are three current cognitive models of
savant syndrome:55
1. A hypermnesic model.55
This model suggests that savant skills
develop from existing or dormant cognitive
functions (i.e.: memory). Recent researches
based on neuropsychological examinations
imply that savant individuals use problem-
solving strategy fairly different from a non-
autistic one.
2. A paradoxical functional facilitation
model.55
This model offers possible explanations on
how pathological states in the brain lead
to development of prodigious skills. This
model emphasizes the role of reciprocal
inhibitory interaction among adjacent or
distant cortical regions, especially that of
the prefrontal cortex and the posterior
regions of the brain. This model is adjacent
and related to the paradoxical cognitive
phenomena.
Five forms of the paradoxical cognitive
phenomena:56
(a) Enhanced cognitive performance of
neurological patients vis-à-vis neurologi­
cally intact individuals (‘lesion facilitation’).
(b) Alleviation or restoration to normal of
a particular cognitive deficit following
the occurrence of a second brain lesion
(‘double-hit recovery’).
(c) ‘Hinder–help effects’, a variable that
produces facilitation or detriment of
performance in healthy participant’s
results in opposite effects.
(d) Anomalies in the usual relationship
between the presence/size of a brain
lesion and the degree of cognitive deficit
(‘lesion–load paradox’).
(e) There may appear to be direct or indirect
benefits for long-term neurological out­
come as the result of specific cognitive
deficits being present (‘paradoxical
positive outcome’).
3. Autistic models based on weak central
coherence theory.

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(computing-memory),62
Williams syndrome
(music-memory).63,64
SUMMARY
Savant syndrome is an enigma among the
great mysteries of cognitive neuroscience.
It has great challenges for new discoveries
that could reveal greater depths of the
concept of genius from human mind.
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Differential Diagnosis
Clinicians, general practitioners, and prac­
titioners should be careful in establishing
savant syndrome as a certain diagnosis.
Patients are recommended to undergo
specific genetic examination. Specific skills
are also reported in genetic disorders, such as:
Prader–Willi syndrome (memory-visuospatial
skills),59-61
Smith–Magenis syndrome
This model focuses on how savant skills
emerge from an autistic brain.55
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coherence theory refers to the common
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beings to make sense and understand
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