Abstract
When asked to reproduce abstract figures from memory, people with brain damage may draw meaningful figures or add extra features unrelated to the original stimulus. Such a phenomenon has been classified as an uncommon type of confabulation. However, this interpretation is unsatisfactory. The aim of this study was to revisit this phenomenon to provide a more robust interpretation. The records of 496 people presenting with cognitive complaints have been reviewed. Their copy and their reproduction by memory of the Rey-Osterrieth Complex Figure were analysed. Sixteen people presented with clear instances of the phenomenon. Although differences in cognitive profiles, including memory and executive functions, were detected in this group compared to the rest of the sample who did not present with the phenomenon, considering this phenomenon as a confabulation is misleading. We suggest that the compulsion to semantically process the meaningless figure as a meaningful object leads to the production of Graphic Transmutation. The meaningful object overrides the original due to a failure of monitoring functions associated to a defective visuo-spatial memory. Identifying Graphic Transmutation in neuropsychological evaluations may provide valuable insight into the cognitive profile of people with brain damage. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1038/s41598-025-33833-7.