Principles of neurology (5th edition)

Principles of neurology (5th edition)

150 BOOK REVIEWS basis of behavior. It is dew)ted to the study of neurocircuitry "whereby biologically relevant environmental stimuli are translated...

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basis of behavior. It is dew)ted to the study of neurocircuitry "whereby biologically relevant environmental stimuli are translated into appropriate behavioral responses. Since many neuropsycbiatric disorders are characterized by inappropriate behavioral responses, characterization of the neural circuitry involved would yield significant information regarding the pathology and therapeutics of psychiatric disease." After reading the whole thing from cover to cover I am convinced that this is not the best way to utilize this material. Individual chapters should be selected according to the reader's interest. Topics and highlights are outlined as follows. Chapter 1 deals with neuroanatomy and presents the concept of the extended amygdala. This is a scholarly, comprehensive work reminding me of lectures delivered by Dr. Elizabeth Crosby at the University of Michigan during the 1950s. I was gratified to find her name in the list of 236 references. Chapter 2 provides very interesting data on effects of typical and atypical neuroleptics on nucleus accumbens. Unfortunately this chapter is among the most difficult to follow because of the overuse of letter abbreviations, as many as nine in a single sentence. Three brief chapters follow dealing with mesencephalic dopamine regulation, electrophysiology of nucleus accumbens and pallidal functions. Chapter 6 on mesolimbic interactions and modulation of locomotion provides interesting hypotheses about clinical entities such as narcolepsy, autism and schizophrenia. Chapter 7, by Mogenson and colleagues, reviews the connections of nucleus accumbens and limbic motor circuits ending with a discussion of how deranged motor behavior is often a feature of neuropsychiatric disorders. Chapter 8 deals with linkages between motivational stimuli and adaptive motor responses. I appreciated the section on barriers to understanding extrapolations from basic science data to the interpretation of complex behavior. Several chapters refer to Stevens' early work in efforts to bridge the gap between basic science and clinical psychiatry. Chapter 9 considers drug dependence, reward and the functional role of the extended amygdala with data from animal self-stimulation experiments with cocaine and amphetamine. Chapter 10 deals with animal models of psychiatric disorders. Studies of sensorimotor gating are summarized with accounts of the effects of drugs on these p h e n o m e n a in animals. Defective gating is proposed as an underlying p h e n o m e n o n in a variety of psychiatric and neurological conditions. In chapter 11 workers from N I M H stress that cortical defects can produce subcortical dysregulation, particularly in the presence of stress. Moreover there may be a time-lag between lesions occurring early in development and their dysregulatory effects which appear after maturation. The volume concludes with two brief clinical chapters on magnetic resonance imaging of the basal ganglia in depression and on movement disorders in psychiatric and neurological conditions. The bottom line is that there are sections of this volume that provide superb descriptions of basic work in areas of relevance to psychiatry and neurology. It belongs as a reference on the shelves of departmental libraries.

Joyce G. Small

Department of Psychiatn,, Larue D. CarterMemorial Hospital, Indianapolis, IN (USA)

Principles of neurology (5th edition). - R.D. Adams and M. Victor (McGraw Hill, New York, 1993, 1394 p., Price: US $72.00)

This work represents the 5th edition of the classic textbook edited by Drs. A d a m s and Victor entitled "Principles of Neurology." This monograph has educated a generation of neurologists since the appearance of the first edition in 1977. The book is based on the

clinical experience and teachings ot two superb and outstanding investigators. Once again the textbook is well written, well illustrated, and full of clinical vignettes. The format for the monograph is very similar to the previous editions. The book is divided into several parts which are well organized and well referenced. The reader can easily negotiate with the index to identify a topic of interest. The initial chapters are quite basic and provide an introduction to neurology. The subsequent chapters deal with the pathophysiology of neurlogical diseases. Each of the major neurological illnesses are covered with the emphasis on important neurodiagnostic techniques and common-sense therapy. As with previous editions, the book should not be used as ~t tool to learn about ongoing investigative work that expands the frontiers of science. Rather, this is a reference textbook that provides the reader with information that can be used in confronting common clinical problems in neurology. The textbook will not intimidate the non-neurologists and may be quite useful for the general physician to maintain in close proximity to the examining office. The contents of the 5th edition are divided into 6 parts. The first 3 parts are introductory and probably are most helpful for the physician least familiar with neurologic disease. Parts 4 and 5 present the individual neurologic disorders. Finally, part 6 is devoted to psychiatric disease. Significant editions to the 5th edition include descriptions of newer diagnostic techniques, e.g., SPECT and transcranial motor cortex stimulation. Recent findings in neuroimmunology and identification of abnormal genes associated with neurologic disease are discussed. Several previous chapters have been rewritten using contemporary information. Tables, figures, and references have also been updated. It is my recommendation that the physician serious about neurologic disease considers acquiring this textbook. This certainly should be available in all medical libraries 1o be used as a general reference on neurology. This textbook would also be helpful in the clinical EEG laboratory for appropriate electroclinical correlations.

Gregory D. Cascino

Department of Neurology, The Mayo Clinic, Rochester, MN (USA)

The neuropsychology of consciousness. - A.D. Milner and M.D. Rugg (Eds.) (Academic Press, London, 1992, 292 p., Price: £48.50)

This book is based upon a symposium held in September 1990 at the University of St. Andrews by a panel of major researchers in the forefront of the field. Investigators from England and Scotland dominate the panel of investigators. Electrophysiology apparently takes a backseat in the presented work even though the role of the recently discovered neuronal 4 0 / s e c oscillations (Llimls et al. 1991) and concepts derived from these data (Crick and Koch 1990: "Towards a neurobiological theory of consciousness," Sem. Neurosci., 2: 263-275) are not left undone in the discussion. The 12 chapters of the book focus on visual recognition, blindsight, face recognition and awareness (after trauma), disorders of perceptual awareness, language function and aphasia, memory and amnesia, unconscious influences of memory, automatic memory processes in amnesia and conscious/unconscious processes in language and memory. Scientific work of high quality is found everywhere in this volume. This reviewer was most impressed with the chapters 5-7: attentional mechanisms and conscious experience (Posner and Rothbart), understanding consciousness (Bisiaeh) and disorders of perceptual awareness (Milner). W h a t is consciousness? This simplistic question is not being posed. Speculation is avoided and a spirit of noble restraint exudes