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Not Just Another Pretty Picture

Published online by Cambridge University Press:  04 May 2005

Glenn T. Stebbins
Affiliation:
Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois.
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Extract

Neurology of Cognitive and Behavioral Disorders. Orrin Devinsky and Mark D'Esposito. 2004. New York: Oxford University Press. 451 pp., $99.95 (HB).

A problem with many behavioral neurology texts is the tendency to minimize the connection between behavior and integrated neuroscience theory. Often the illustrative neurological principles are not grounded in behavioral neuroscience, but, instead, present unusual conditions in a type of “Gee whiz” display. The relationship of these conditions to neuroscience is often lost. In Neurology of Cognitive and Behavioral Disorders, the relationship of neurologic condition to neuroscientific principles is clearly explicated. This is perhaps the greatest strength of this addition to the Oxford University Press Contemporary Neurology Series.

Type
BOOK REVIEW
Copyright
© 2005 The International Neuropsychological Society

A problem with many behavioral neurology texts is the tendency to minimize the connection between behavior and integrated neuroscience theory. Often the illustrative neurological principles are not grounded in behavioral neuroscience, but, instead, present unusual conditions in a type of “Gee whiz” display. The relationship of these conditions to neuroscience is often lost. In Neurology of Cognitive and Behavioral Disorders, the relationship of neurologic condition to neuroscientific principles is clearly explicated. This is perhaps the greatest strength of this addition to the Oxford University Press Contemporary Neurology Series.

In the preface to this excellent text, the authors describe one of its distinguishing features as a strong reliance “… on images to convey our story …” (p. vii). This is not an overstatement. With more than 80 illustrations, the text is replete with relevant drawings and photographs that greatly augment the text. The illustrations are not just pretty pictures, but provide roadmaps for the often complex ideas presented in the text. Ranging from depictions of basic neuroanatomy, to displays of pathways, to examples of advanced neuroimaging techniques, these illustrations are valuable for clinicians and researchers alike.

The successful reliance on illustrations is nowhere more evident than in the first chapter: Neuroanatomy and assessment of cognitive-behavioral function. This chapter sets the tone for the remainder of the book with detailed presentations of basic neuroscience, neuroanatomy, clinical neurosciences, clinical neurology, and clinical neuropsychology. By coherently integrating information from these allied fields of study, the authors demonstrate their commitment to providing a comprehensive view of human behavior. This commitment is met throughout the remaining chapters.

An additional highlight is Chapter 2: Functional neuroimaging of cognition. Although limited to functional magnetic resonance imaging (fMRI) techniques, the overall presentation will be helpful to readers with a passing knowledge of functional imaging methods. Despite the relatively narrow presentation on this one functional neuroimaging modality, the authors correctly state that fMRI has become almost commonplace in research, with nascent clinical applications. Because of this expansion in the use of fMRI, there is a great need to educate clinical and research consumers in current theories and techniques. This chapter goes a long way towards providing that education, presenting fMRI theory, methodology, analytic techniques, and potential clinical applications.

Chapters 3–10 cover traditional behavioral neurology topics, including The right hemisphere, interhemispheric communication, and consciousness; Attention and attentional disorders; Perception and perceptual disorders; Language, aphasia, and other speech disorders; Motor system and behavior; Memory and memory disorders; Executive function and the frontal lobes; and Emotion and the limbic system. Each provides relevant information on neural substrates, cognitive neuroscience theory, and clinical manifestations for the respective topic. The overall theme of clinical/neuroscience integration is maintained in each chapter with impressive results.

Two of these chapters integrate clinical and neuroscience perspectives exceptionally well. The authors' expertise in epilepsy and cognitive neuroscience is clearly apparent in Chapter 3: The right hemisphere, interhemispheric communication, and consciousness. The treatment of consciousness is particularly cogent, presenting scientifically grounded theories ranging from parallel distributed processing to modular integration. Chapter 9: Executive function and the frontal lobes reviews current knowledge and does an excellent job of integrating behavioral presentation, neuroanatomy, and cognitive neuroscience. Examples of aberrant behavior associated with frontal lobe damage are fully explicated in relation to the underlying neuroanatomic and neurophysiologic substrates.

The final Chapter 11: Therapy for cognitive and neurobehavioral disorders is also impressive. New pharmacologic and behavioral treatments emerge daily. Yet, the authors present a comprehensive overview of behavioral disorders associated with neurologic disorders, behavioral interventions, pharmacological interventions, and homeopathic approaches. This chapter will assist physicians, nurse practitioners, and psychologists in understanding the mechanisms of, and options for, treatment.

This text provides the reader with an in-depth integration of behavioral neurology and cognitive neuroscience. Graduate, postgraduate students, and practitioners in neurology, neuroscience, and neuropsychology will particularly benefit from this book. Through the judicial use of clinical vignettes, neuroscientific principles, and relevant illustrations, the authors have created an excellent volume that will be appreciated by all who hold an interest in the field of neuroscience.