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.
Comparative Vertebrate Neuroanatomy: Evolution and Adaptation
Ann B. Butler and William Hodos
New York, John Wiley & Sons, Inc., 1996. 552 pp.
Comparative Vertebrate Neuroanatomy is a unique book in that it provides very up-to-date neuroanatomy from a comparative perspective and presents it for an uninitiated audience. The book stresses a common theme of anatomy, the relationship between structure and function, and through the comparative window, offers an interesting view of the eyolution of the vertebrate nervous system. The book is intended primarily for graduate students and advanced undergraduate students in the neurosciences, although fans of evolutionary biology will also find it accessible. Knowledge of undergraduate-level biology is assumed, but no prior knowledge of neuroscience or neuroanatomy is required. The authors stress that the prime objective of the book is to present an introductory treatment of neuroanatomy which can be used as preparation for subsequent advanced topics in neuroanatomy and the neurosciences. Thus, this book falls short for the serious neuroanatomists, or those seeking an all-encompassing reference text. The authors succeed in presenting the material in a basic enough fashion to be readable by just about everyone with some biological background, while also providing enough breadth and depth to serve as a springboard to more in-depth treatment of the topics presented in advanced neuroscience courses. Furthermore, a full four chapters are devoted to the comparative evolution, derivation, and organization of the cranial nerves, and therefore may be of value to students interested in neurology,
The book is organized into six major sections, the first being an introduction to the evolution and organization of the central nervous system, and subsequent sections providing more detailed treatment of the various regions of the brain from the spinal chord and hindbrain, to the forebrain. A concluding chapter provides synthesis from an evolutionary standpoint. The text is very easy to read and understand, with the use of bold type highlighting important concepts or anatomy which may be found in the well-organized index. A discussion of relevant embryology is included where deemed appropriate, and this helps to clarify the derivation and evolution of the anatomy. Also, certain techniques are described briefly to show how the anatomy was studied and traced. The text is replete with easy to follow figures and tables, and this allows a visual comparison of the anatomy across species. For those intrigued by the topics and who may want more, at the end of every chapter there are references to textbooks cited for “Further Reading,” as well as references to the original literature cited as “Additional Reading.” The book also provides very useful appendices, such as a list of anatomical, terms with their roots and origins, diagrams describing anatomical directional terms, and a useful but somewhat limited glossary.
In summary, this would make an excellent book for the uninitiated student interested in learning neuroanatomy. The material is clearly presented, and the treatment is thorough enough to serve as a strong foundation for the study of more advanced topics. The evolutionary perspective enhances understanding of the anatomy, and also provides interesting insights.
Elements of Molecular Neurobiology, Second Edition
C.U.M. Smith
New York, John Wiley & Sons, 1996. 640 pp.
Elements of Molecular Neurobiology, Second Edition is one of the most readable and comprehensive introductions to molecular neuroscience available. Recent advances in the neurosciences, particularly in molecular neuroscience, in the six years since the first edition of this book was published, make this edition timely and useful. Large sections of the text have been rewritten to include current approaches, such as “gene-knockout mice,” and recent advances such as ion channel research. New findings indevelopmental neurobiology have been included an entirely new chapter on “Epigenetics of the brain.” Several new illustrations supplement, either schematically or pictorially, the already lucid descriptions found in the text.
Aside from these revisions, the overall structure of the book remains the same as in the first edition. After an introductory chapter on-the nervous system, the next few chapters clearly describe basic concepts in general molecular biology needed throughout the remainder of the book. Appropriate references are made to the application of the molecular biology to the neurosciences, even in these early chapters, to help maintain the focus of the book. In this way the book is a self-contained unit, serving as a very valuable tool to the student wishing to learn neurobiology from the molecular perspective, without being forced to refer to another text on molecular biology. Molecular biological or neurobiological “tidbits” are placed into boxes through the text, allowing the interested student to read further. The book then goes on to discuss receptors, ion channels, the action potential and neurotransmitters in a very conceptual and easy-to-follow manner. The last chapters integrate the material on an organismal level through discussion of memory and basic neuropathology (in which I was impressed to find a section on prion diseases). In fact, throughout the text, neurological correlates are provided which serve to “bring back home” a major purpose of studying molecular neurobiology.
There is enough depth in the book to satisfy the introductory reader, but in the event that more information is desired, a complete bibliography is provided in the back, which is broken down by chapter and topic. In addition, useful appendices, a glossary, and an organized index allow easy referencing. This book would be ideal for an undergraduate student beginning to study neuroscience, the neuroscience student wanting a treatment of molecular biology as applied to the nervous system or for the student with a firm grounding in molecular biology, but who would like an introduction to molecular neurobiology. The book’s greatest value may be to this latter group. For those readers who are fairly comfortable with molecular biology, but who feel that the field of neuroscience is whirling by and would like a tether to help reel it in, this book provides a thorough yet accessible introduction.
Biological Psychology: An Introduction to Behavioral, Cognitive and Clinical Neuroscience (Book and CD-ROM), Third Edition
Mark R. Rosenzweig, S. Marc Breedlove, and Arnold L. Leiman
Sunderland, Massachusetts: Sinauer Associates, 2001. 651 pp.
Biological Psychology by the trio of Rosenzweig, Breedlove, and Leiman explains the biological foundations of evolution, development of the nervous system, regulation of behavior, emotions and mental disorders on a student-oriented textbook. Throughout the entire book lies a strong emphasis in the biological processes that produce and govern behavior and cognition with respect to the environment. The level of the text is geared to the beginning student in the discipline. With a colorful format, icons, key terms, boxes, and a CD-ROM, which contains quizzes and Sylvius, a module to learn neuroanatomy, a new student should consider purchasing or buying Biological Psychology.
The writing is clear and the illustrations that accompany it are not only attractive but illustrative as well. With CD-ROM links to several key illustrations, the book is undoubtedly tightly integrated and cross-referenced among its various modes of presenting information to the student. Because the text is geared for the beginner that would consider specializing in the discipline, it was general, yet technical enough that as a medical student I found it helpful in relearning some neuroanatomy structures such as the circle of Willis. Therefore, certain parts of the text can also be used by students who wish to become clinicians in addition to those who want to become specialized researchers. All chapters contain up-to-date research that would prove useful to both kinds of students. As an aside, the book actually contains photographs of current researchers such as Nancy Wexler, which connects a face with hot-off-the press research.
Usually, I devote the second or third paragraphs in the review to criticisms of the book. The terseness of this paragraph indicates how I feel this textbook is as close to a paragon for excellence for biological psychology textbooks that I have read.
Biological Psychology was clearly designed with the student in mind. I give it the highest recommendation and it should be welcome addition to your library.
Neuroanatomy: An Atlas of Structures, Sections, and Systems, 5th Edition
Duane E. Haines
Philadelphia: Lippincott, Williams and Wilkins, 2000.256 pp.
To our ancient ancestors, the mass of gelatinous tissue between our two ears was a mystery for the most part; its importance, nevertheless, was underscored by the serious consequences of damage to it. Several thousand years later, the brain still represents one of the frontiers of biomedicine, a mystery which is tenaciously guarded behind layers of neurobiological riddle. Our first understanding of the importance of our brains to everything from the subtleties of memory and cognition to motor function came together as we gradually pieced together the various deficits suffered by individuals who had damaged parts of their brains. Therefore, the intricate anatomy of the brain became the initial road map to understand the function of the brain. This endeavor continues today, and neuroanatomy remains a common dictionary for piecing together the more detailed understanding of the brain afforded us by the advances in cellular neurobiology and neurophysiology. So it is conceivable that neuroanatomy is a fundamental course taken by junior medical students and graduate students of the neurosciences.
Crucial to learning any anatomy is a good atlas from which structures may be appreciated in their proper orientation. Enter Neuroanatomy by Duane E. Haines, a popular choice for neophytes to the field for the better part of the last two decades. This fifth edition represents the latest revisions to the text since 1995. Several changes, all for the better, have been made to this edition, making it Haines’ strongest product to date. Certain old radiograms have been removed, and sixty new labeled images (CT and MRI) have been included. This is one of the best features of the new edition. Labeled MRI images are placed adjacent to the labeled gross specimens, thereby rendering an effective and highly educational juxtaposition. The understanding of in situ neuroradiological anatomy will be of direct clinical utility for many students of neuroanatomy, and helps to place an important clinical context from which case studies are effectively interpreted. Moreover, consistent with emerging clinical technology, the neurovasculature is also represented by new MRA (magnetic resonance angiography) and MRV (magnetic resonance venography) images, which will again be a more common clinical visualization of the brain vasculature. Important clinical ascending and descending systems have also been coherently put together as color coded pathways to help integrate the systems with the anatomy in a very useful educational tool. All together, the revisions of this latest edition of the Haines atlas make the book more clear, concise, and informative. This is a valuable resource for students of neuroanatomy. The clinical emphasis in the atlas actually serves to strengthen its educational utility as a neuroanatomy atlas, whether or not one plans to follow clinical neuroscience training. I would definitely add this book to my shelf.
The Brain Atlas: A Visual Guide to the Human Central Nervous System
Thomas A. Woolsey, Joseph Hanaway, and Mokhtar H. Gado
Fitzgerald Science, 2002. 249 pp
As a student learning neuroanatomy, one of the biggest challenges is often mastering the blood supply to any given region of the central nervous system. The most user-friendly approach to learning such information can now be found within the second edition of The Brain Atlas by Woolsey et al. from the Washington University School of Medicine. Even as one picks up the manual, the brilliant colors and easy to flip notebook style bring the atlas to life as an appealing teaching guide. For every tissue section through the brain and spinal cord, one can easily follow clearly numbered anatomical regions: from a histological photograph to a colorful representation of the vascular supply and lastly to an in situ view through a MR image. The atlas ends with an emphasis on all of the major Central Nervous System (CNS) pathways by superimposing brightly labeled pathways upon actual histological sections from the brain to the lower spinal cord levels. This “one glance reveals all” approach is not only a major time-saver, but also depicts the pathways more clearly than any other reference I have ever encountered.
The logical, multi-disciplinary progression in The Brain Atlas succeeds beautifully in integrating the anatomical, radiological, vascular, and functional aspects of neuroanatomy just as a student would be expected to know in a clinical setting. Furthermore, the clearly delineated sections make this an easy and fast reference on the wards for any student or resident. One possible improvement for future editions might be the inclusion of actual clinical syndromes as they apply to normal anatomy, vascular supply, and pathways. The Brain Atlas is clearly a valuable asset to any student, teacher, or clinician broaching the wonderful world of neuroscience.
Behavioral Neurobiology: The Cellular Organization of Natural Behavior
Thomas J. Carew
Sunderland, Massachusetts: Sinauer Associates, 2000. 435 pp.
The 1990s, dubbed the “Decade of the Brain,” contained a procession of neuroscience advances that showed how far our understanding of the brain has come and how much further it needs to go. So as the decade, which brought NIH budget highs, begins to recede from the rearview mirror, the effects of accelerating pace of neuroscience discoveries can be felt in related areas such as animal behavior. Understanding the molecular and cellular mechanism underpinning the brain’s function has helped produced incisive explanations for behavior that were once limited to description. For an undergraduate, a beginning graduate student, or a dabbling ethologist, Thomas J. Carew’s Behavioral Neurobiology is a succinct and organized textbook that covers a wide array of topics and experiments from classical Pavlovian conditioning to Kandel’s work on memory and alpysia.
A distinguishing feature of Carew’s approach is the case-based mode of explanation. Rather than expostulating some general principle and leaving real examples to a call-out quote or in a margin, Carew takes the opposite approach. To elucidate the mechanisms behind the sensory system, echolocation in bats, prey location in barn owls, and feature analysis in toads are examined. In the “Echolocation in Bats” section, concepts such as Doppler shift compensation and FM sweep are explained in a clear fluid fashion that uses the example of bat echolocation as a logical backdrop. The other two large sections, “Motor Strategies” and “Behavioral Plasticity,” are also explained with a similar approach.
The clear pictures aid in understanding, and the size of the book lends to easy reading and toting. With a total of 208 illustrations, Behavioral Neurobiology, is not only a clear text tract but also a visually appealing one. The pictures used to describe and explain how bees learn through association is a fascinating read. A suggestion for the next edition would be the use of a CD-ROM or a Flash-enabled program to animate processes such as song recognition in birds. In sum, Carew has written a text that serves as an fine starting point for understanding the neurobiology behind animal behavior.
Neurology in Clinical Practice. Principles of Diagnosis and Management
W Bradley, R B Daroff, G M Fenichel, GD Marsden, eds
1880 pp (2 vols)
ISBN 0-409-90193-8
Guildford: Butterworth-Heinemann, 1990
In the past few years many neurologists have tried their hand at the single volume textbook on clinical neurology. Most have been adequate but usually conventional and unimaginative. Now is the era of the blockbuster text, two volumes, multiple international authorship and expensive. Three have appeared recently including Neurology in Clinical Practice, edited by Bradley, Daroff, Fenichel and Marsden. This is a well-produced book which covers all the major areas of neurology and many more besides. The format has been carefully considered by the editors. For example, the usual categoric description of neurology by disease (found in Volume II) is supplemented by 35 chapters, each discussing the clinical approach to a common neurological problem. This is largely successful and will be particularly helpful to the trainee neurologist.
Several chapters deal specifically with neurological investigations and principles of neurological management. Of particular interest are the chapters on the place of laboratory investigations in diagnosis and management and on decision analysis. As we enter an era when neurologists will be pressed to justify their investigation and treatment of patients in financial terms these chapters offer a useful approach.
My main criticism of this tome is the paucity of references. This was a deliberate policy by the editors who instructed authors to provide only recent ones so the reader can look them up to find references in the older literature. This may save space but makes reading the chapters highly frustrating. A book of this size should be properly referenced even if the reference list is printed in characters a few points smaller than the text.
At £160 this is a pair of volumes for the departmental library rather than one’s personal bookshelf. The income of trainee neurologists is unlikely to stretch to this and Adams and Victor’s ‘Principles of Neurology’ at a fraction of the cost is still the best value for money.
Solomon H. Snyder
New York, Oxford, Oxford University Press, 1980.
Readers interested in psychiatry and the behavioral sciences will be pleasantly surprised by this compact book. Lasker award winner Solomon Snyder, known for his neuroscience achievements at Johns Hopkins, and specifically for his contributions to the understanding of the dopaminergic receptor sites and other neurotransmitters in the brain and their relationship to psychosis, has produced a succint and pluralistic handbook touching upon the major afflictions of the mind. In 23 chapters the focus ranges from schizophrenia to organic brain disorders, from alcoholism to sexual dysfunctions. (The chapter on psychosomatic disorders was contributed by Robert L. Sack.) Apart from neurochemical and genetic references one finds substantive phenomenological and clinical description. Because of the briefness of the presentation, those who long for more may feel that the book may fall within the ranges of a diagnostic manual. In fact, the recently published DSM III by the American Psychiatric Association may have more bulk. The two chapters covering the phenomenology, etiology, and treatment of schizophrenia are attractive, lucid, and informative. When discussing its etiology, one may more prudently refer to pathogenesis because the decoding of this riddle remains unknown. Chapter 6, with the title Chemical messengers in the Brain, covers in 15 pages the neurochemical findings which, although they clarify only a miniscule fraction of the functions of the human mind, have restored psychiatry to science. The references to published literature reflect the author’s preference for the American scene of the past 20 years rather than worldwide contributions. The book, written by a researcher, identifies him as a skilled clinician and it can be effectively used either as an introduction to or an overview of psychiatry.
Kenneth Dewhurst
Oxford, Sanford Publications, 1982. pp. xi + 169
The clinical researches in neurology of John Hughlings Jackson (1834 – 1911) are well known, but his contributions to the field of psychiatry are not; nevertheless, they are considerable, as Kenneth Dewhurst notes in this fine small book. Jackson’s education at the medical school at York provided him with more experience in the field of psychiatry than most of his contemporary medical students. This was made possible by two exceptional professors on the faculty, Daniel Hack Tuke and Thomas Laycock, both of whom became leaders of British psychiatry during their era. Tuke probably had a greater impact on the clinical side while Laycock’s studies on brain reflexology and on the mind-brain problem had an enduring influence on neurophysiology.
Jackson also attended the St. Bartholomew Hospital Medical School in London for a year. He settled in London finally in 1859, where he spent the rest of his life in private practice and was associated with the London Hospital and the National Hospital for the Paralyzed and Epileptic. During his career, he wrote well over 300 articles using a careful observational and philosophical approach, but never put his findings and thoughts together in a coordinated whole in spite of the urgings of his professional friends. Nevertheless, he was “acclaimed as the greatest British scientific clinician of the 19th century.”
Jackson’s greatest contribution to the understanding of psychiatric issues arose from his careful studies of epilepsy and its phenomena. As he slowly collected material from 1866 on, he became interested in selected patients who experienced odors undetectable to others present (a form of olfactory hallucination). These subjects also revealed episodes of losses of consciousness, automatic movements and thoughts, and the appearance of certain dream-like states. Jackson also explored the amnesia that was associated with these states and finally named them “uncinate fits.” Over the years the terminology changed to epileptic equivalents, psychomotor epilepsy, and currently to temporal lobe epilepsy. Dewhurst also discusses a famous case of Jackson’s known as “Quaerens or Dr. Z.”, who has recently been identified by the studies of D. C. Taylor and S. M. Marsh as Dr. Arthur Thomas Myers, a distinguished sportsman and physician whose major contribution to medical history was his careful reportage of his own case, albeit anonymously. He became a patient of Jackson’s who published Myers’ case and included Myers’ autobiographical study. Both in his own right and through the efforts of his brother, Frederick W. H. Myers, Arthur contributed to the movement for the study of parapsychological phenomena and those of the subconscious. Arthur wrote articles on both hypnotism and telepathy. It was his brother Frederick, however, who helped to found the Society for Psychical Research and wrote extensively on subliminal matters. Both went to LeHavre, France, in 1886 to watch a then unknown professor of philosophy named Pierre Janet do experiments on hypnosis at a distance.
Arthur died in January 1894 from an overdose of chloral hydrate. His illness plus his medical focus thereup had made possible a greater clinical understanding of temporal lobe epilepsy. Exploration of the connections of the temporal lobes to psychiatry has experienced a resurgence during the past two decades. That religious and parapsychological behavior could be connected to this area of the brain was pointed out in a 1970 article by Drs. Dewhurst and Beard. They reported six cases of epilepsy with investigative evidence suggesting a temporal lobe focus. All of these patients reported experiences of religious conversion. Approaching the question from the other side, the authors also found support for their thesis from the history of conversions in a number of saints and religious figures who also had a history of convulsive-like episodes. A more recent study brought further confirmation to this view as well as demonstrating a high incident of dissociation and multiple personality in these patients.
Other topics explored by Dewhurst in Jackson’s writings are: the mind-body problem, consciousness, delirium, coma, psychosis, hysteria, dreams, Gilles de la Tourette Syndrome, obsessions, jokes, etc. Dewhurst concludes his book with a two-chapter review of Jackson’s impact on continental psychiatry as well as on British and North American psychiatry. Among the familiar names that emerge are: Freud, Pick, Charcot, Ribot, Henri Ey, S. Weir Mitchell, J. J. Putnam, Adolf Meyer, and Bernard Sachs.
We are highly indebted to Dr. Dewhurst for surveying John Hughlings Jackson’s voluminous writings and culling those comments of psychiatric import and placing them in their historical context. An excellent index makes the various topics easily accessible. Dewhurst has continued to make valuable contributions to the history of medicine. His range is impressive. He is famous for his 17th century book-length studies on Sydenham, Willis, and Locke. He recently wrote a book on Fredrich Schiller (19th century), and he now has an excellent book on Jackson.
