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Handbook of Medical Neuropsychology - Handbook of Medical Neuropsychology: Applications of Cognitive Neuroscience, Carol L. Armstrong and Lisa Morrow (Eds.). 2010. New York: Springer Science+Business Media, LLC. 564 pp., $79.95 (HB).

Published online by Cambridge University Press:  16 November 2012

Nikki H. Stricker*
Affiliation:
VA Boston Healthcare System, Boston University School of Medicine, Boston, Massachusetts, USA
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Abstract

Type
Book Reviews
Copyright
Copyright © The International Neuropsychological Society 2012

Although neuropsychology has a long history of important contributions in primary central nervous system (CNS) disorders such as cerebrovascular accidents, epilepsy, traumatic brain injury, and dementia, the role of neuropsychology in medical conditions with secondary or less well established CNS effects is rapidly evolving and represents an important future direction for the field of neuropsychology. Armstrong and Morrow's edited volume, Handbook of Medical Neuropsychology: Applications of Cognitive Neuroscience, provides an impressive overview of both disorders with obvious CNS involvement and those with more subtle or indirect CNS effects. The editors indicate that the purpose of the book is to “provide a current and cutting edge understanding of the various diseases and disorders covered within and their neuropsychological effects,” and they certainly succeed in fulfilling this goal. Among the most impressive feats of this volume is the dedication to a thorough explanation of disease mechanisms. Clinicians, students, and researchers seeking a detailed level of understanding regarding the medical and neurological underpinnings of disease expression will quickly view this as one of their go-to resources for most of the conditions covered within this book, when looking for a concise yet dense overview. The editors succeeded in providing a uniform structure for chapter authors, many of whom are leaders within the field, which enhances the coherence and flow of the volume. Although there is some overlap between this book and Reference Grant and AdamsGrant and Adam'sNeuropsychological Assessment of Neuropsychiatric and Neuromedical Disorders, there are enough unique chapters in Armstrong & Morrow's book to recommend it as an additional important resource for covering both common and less frequently encountered disorders in medical neuropsychology, particularly given its inclusion of pediatric topics and a lifespan approach.

The book is divided into 8 sections and 29 chapters. A simple glance at the table of contents does not quite capture the book's full coverage as many chapters include discussion of multiple disorders under a general chapter heading, thus several of the highlights are discussed below.

Part I, Primary Nervous System Disease, begins with a discussion of epilepsy and, similar to the majority of chapters within the book, it provides a detailed discussion of disease mechanisms. Highlights of this chapter include discussion of neuroplasticity, the algorithm for surgical intervention in epilepsy and the role of neuropsychology and fMRI in epilepsy. The chapter on neuropsychological problems in neuro-oncology is truly a gem. It is longer than most within the book, with discussion of the biological processes and diagnosis of brain neoplasms, neuropsychological mechanisms, the effects of tumors on cognitive functions with a particularly insightful discussion of whether tumors cause regional cognitive effects, illustration of an individualized approach to neuropsychological evaluation, neuropsychiatric disturbances associated with brain tumors and effects of adjuvant treatments on cognition (e.g., surgery, radiation, chemotherapy). This section also contains a chapter focused on Multiple System Atrophy and autonomic dysfunction, a topic typically only briefly reviewed within discussion of Parkinsonism in other texts.

Part II covers Vascular System Disease and includes an initial overview of cardiovascular disease and neurocognitive function that provides a thorough discussion of a multitude of cardiovascular risk factors and diseases and their relationship to dementia, neurocognitive function, and the brain. The next chapter on Cerebrovascular Disease and Disorders primarily focuses on stroke in children and adults, and reviews common cognitive deficits by domain, as well as outcomes and treatment approaches for those with post-stroke cognitive impairment. Subsequent chapters review transient cognitive deficits during headaches and discussion of a number of respiratory disorders and their effect on cognition, including hypoxia, chronic obstructive pulmonary disease (COPD), acute respiratory distress syndrome (ARDS), carbon monoxide poisoning, and obstructive sleep apnea. One area that is notably missing from Part II is a discussion of Vascular Dementia and Vascular Cognitive Impairment, although these topics are minimally addressed within some chapters.

Part III covers Developmental, Genetic, and Structural Disorders and each chapter makes an important contribution to the book by including helpful clinical recommendations for both assessment and treatment in addition to discussion of disease mechanisms. Topics covered include cerebral palsy, autism and Asperger's syndrome, genetic syndromes associated with intellectual disabilities including Down syndrome, fragile X syndrome and Williams syndrome, congenital and late-life onset hydrocephalus, learning disabilities, Attention Deficit Hyperactivity Disorder, and Tourette disorder.

There are numerous books that cover the contents within Part IV on Aging in an elaborate way, and these chapters reference many of these previous works. Covering this entire area with only three chapters is difficult and so necessarily these chapters cover the breadth but not the depth that can be found elsewhere. Because of their brevity, each chapter is a nice introductory overview for students or a quick reference for those without frequent exposure to these populations. Within the chapter on dementia, there is discussion of Alzheimer's disease, posterior cortical atrophy, dementia with Lewy bodies, Parkinson's disease dementia, Binswanger's dementia, Prion diseases (covering multiple types), and mild cognitive impairment. This is followed by a discussion of the cognitive and neurobiological changes that occur with normal aging that is grounded in theoretical discussion with an additional focus on inter-individual variability. The chapter on movement disorders and motor neuron disease is essentially 5 mini-chapters folded into one and provides an excellent, concise overview of Parkinson's disease, progressive supranuclear palsy, essential tremor (which is not frequently included in similar chapters and is a nice addition), Huntington's disease, and amyotrophic lateral sclerosis.

Part V, Immune-Mediated Disease, includes excellent overviews of conditions frequently discussed in many texts, such as multiple sclerosis and HIV-AIDS, and also covers diseases with lesser-known neurocognitive effects including Guillain-Barré Syndrome, systemic lupus erythematosus, rheumatoid arthritis, Sjögren's syndrome, fibromyalgia, and chronic fatigue syndrome. Part VI, Endocrine Disease, includes a detailed discussion of neuropsychological sequelae of type I and type 2 diabetes in children and adults; an excellent review of neuropsychological assessment of Posttraumatic Stress Disorder, included in this section due to chronic dysregulation of stress-related neurotransmitters and neuropeptides; and neuropsychological functioning of endocrine disorders that includes discussion of estrogen, testosterone, corticosteroids, Alzheimer's disease and hormone replacement therapy in women, Turner syndrome, Klinefelter syndrome, Cushing syndrome, and Addison's disease.

Part VII, Metabolic Disease, provides a helpful overview of hepatic encephalopathy and toxic disorders (organic solvents, lead and carbon monoxide). Particularly noteworthy is the fantastic chapter on neurocognition in mitochondrial disorders that includes discussion of a variety of heterogeneous disorders, yet considers commonalities that may help with clinical identification. Part VIII, Rehabilitation, closes the book and includes a succinct and practical overview of current approaches to cognitive rehabilitation while emphasizing the need for treatments with demonstrable generalization.

Future editions of this book may benefit from additional content. Although, at first glance, the book provides good coverage of conditions of interest in medical neuropsychology, there were several topics that may deserve future consideration, including delirium, symptom validity testing in medical populations, polypharmacy and cognitive effects of certain medication classes, laboratory results relevant for the neuropsychological exam, and neuropsychological assessment in pre-transplant evaluations. Given the complexity of the information presented, future revisions would benefit from the addition of more figures and tables, as a sizable number of chapters (>40%) included neither visual aid. Finally, although several chapters cite studies that demonstrate the utility of neuropsychology, routine inclusion of outcome research or a specific chapter on this topic would be a welcome addition.

The chapters within this book are truly dense with information and the primary audience will likely be researchers and clinicians. Researchers will appreciate a text that is grounded in cognitive neuroscience and that provides a critical review of topics covered, with identification of areas lacking clarity and avenues for future research. Clinicians will value the inclusion of practical clinical recommendations by disorder and the frequent mention of specific measures with demonstrated utility for the population in question. This book is unlikely to be used as a graduate course text, but it is a useful reference for postdoctoral fellows or early career neuropsychologists preparing for the American Board of Clinical Neuropsychology written exam as it provides the level of depth necessary for an advanced understanding of the disorders covered. In summary, this is an excellent resource for neuropsychologists and cognitive neuroscientists.

References

REFERENCE

Grant, I., Adams, K. (Eds.). (2009). Neuropsychological Assessment of Neuropsychiatric and Neuromedical disorders, Third Edition. New York: Oxford University Press.Google Scholar