The Dementias: Crossroads between Neurology and Psychiatry

The Dementias: Crossroads between Neurology and Psychiatry

M. Girgis and K. Harris

St. Louis, Warren H. Green, Inc., 1992, 187 pp.

“The average human life expectancy has increased markedly since the turn of this century … unmasking a new epidemic: dementia.” This epidemic, dementia, is the focus of the book The Dementias: Crossroads between Neurology and Psychiatry, by Girgis and Harris, both of the University of Sydney, Australia. This book provides a fairly technical look at the role of neurotransmitters in degenerative neurologic disease. Glutamate is one major focus. The authors discuss extensively its chemical structure, synthesis, metabolism, and its many known and theorized pathways in the brain, arguing for a role of glutamate in dementia. The authors include data from their own current research, and extensively reference the work of others in the field. In addition they continually suggest new directions for research.

Additional chapters are devoted to such topics as “Neurotoxic Amino Acids in Human Degenerative Disorders” and there is a chapter providing an excellent overview of research in “Neurotransmitter Imbalance in Psychiatric Disorders”. This chapter relates the neurotransmitters discussed previously in reference to dementia to their theorized roles in depression, and in the action of antidepressant medications. The final chapter moves away from discussion of glutamate and deals with another neurotransmitter, acetylcholine, and studies of its role in Alzheimer’s disease.

The middle section of the book contains three chapters which deal with neurotransmitters in limbic epilepsy. As the authors explain in the preface, their own research focus is mediation of excitation in brain tissue in relation to limbic epilepsy. It was neurotransmitters in limbic epilepsy they were studying when data suggested to them a connection between these neurotransmitters and dementia. This specific research interest seems to be the only link between the information presented in the three chapters on limbic epilepsy and the rest of the book. These chapters do, however, present at thorough and up to date discussion of kindling in limbic epilepsy.

In summary, The Dementias: Crossroads between Neurology and Psychiatry presents a good technical discussion of research on the role of neurotransmitters, and especially glutamate, in human degenerative disorders. Although some background information is given, some prior knowledge of biochemistry and neurophysiology is helpful in understanding this text.