August 2012  << Back  

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Understanding Neuropsychiatric Disorders: Insights from Neuroimaging

James Allen Wilcox, DO, PhD

University of Arizona, Tucson, AZ, USA

Edited by Martha E. Shenton and Bruce I. Turetsky. New York, NY: Cambridge University Press; 2011; ISBN: 978-0-521-899420, pp 575; $199 (hardcover).

This book has an interesting premise; that mental illness is related to the brain. As technology has advanced, we have found many studies that link mental illness to specific neuroimaging findings. Static computerized tomography and magnetic resonance imaging (MRI) have detected interesting correlations in grey matter density, white matter aberrations, and ventricular size in psychosis for quite some time. In recent years, fMRI, single photon emission tomography, and positron emission tomography have yielded vast amounts of data regarding the metabolic activity of the brain in various states of illness and health. This text attempts to assemble this information in 1 volume of <600 pages.

The first chapter begins with the topic of structural imaging in schizophrenia. It starts out with an interesting review of historical commentary going all the way back to Dr. Emil Kraepelin. This rapidly moves along with comparisons of various studies and, as one would guess, many illustrations. The next chapter goes on to functional imaging and spectroscopic studies in psychosis. The final concentration on schizophrenia is a wonderful commentary by Nancy Andreasen, a noted researcher in the field. The entire piece on imaging in schizophrenia is informative, and makes a good reference.

The second section of the book concentrates on affective disorders. It is highly detailed and very interesting. Again, the pattern of moving from structural imaging to functional imaging and then on to spectroscopic work is continued. This allows for a logical flow of information that generally parallels the history of neuroimaging in this area of psychiatry. This segment on affective disorders is approximately 100 pages and covers topics and anatomic locations not often seen in common writings. This is an excellent condensation of data. The section on mood disorders is followed by sections on anxiety disorders and cognitive disorders. The fact that obsessive-compulsive disorder is covered is refreshing and interesting. The area on cognitive disorders is completely appropriate to this text and well done, but much more predictable in a book on neuroimaging. All of this is well covered and referenced by many key studies and illustrations.

The next portion is divided between substance abuse and eating disorders. These are topics that often are underrepresented in the neuroimaging literature and it is good to see them included. I found the section on stimulant abuse and relapse to be interesting. The section on cannabis abuse and functional imaging also was very good. The final chapters are devoted to developmental disorders. Although not as long as would be desired, this is an important addition to the text.

This is a fine book on the neuroimaging of psychiatric illness. Each part is well organized and contains references for further reading. The text is enhanced by a number of excellent photos and illustrations. The busy clinician will find the handy summary box format at the end of every chapter to be a quick way to review items. The portions on the insular region and prefrontal cortex are well written and could be useful for teaching residents and students. The authors have integrated many concepts such as genetic variation age and chemical exposure into the consideration of imaging results. The result is a book that is informative, while being balanced and avoids unreasonable conclusions. The reader can rest assured that due diligence was put into the quality of each clinical conclusion described in the text. I enjoyed this book and highly recommend it.