Galetta, Steven L. MD
University of Pennsylvania Medical Center
A Compendium of Degenerative Brain Diseases Larry G. Baratta, MD, PhD. Charles C. Thomas, Springfield, IL, 2001. ISBN: 0398071543, Price: $26.95
Scope: This is a single-authored, soft-cover bird's eye view monograph addressing neurodegenerative disease.
Contents: This is a concise, focused exposition of the neurophysiology and neuropharmacology of the more common neurodegenerative disorders seen in clinical practice. The text is presented in outline form in three chapters. The opening chapter reviews basic neurophysiology, with an emphasis on the autonomic nervous system and common neurotransmitters. The many excellent diagrams and tables provide a quick and easy reference guide for those preparing for board examinations. The neurotransmitters reviewed in this section include acetylcholine, norepinephrine, dopamine, serotonin, and GABA. Disappointingly, there are no discussions of glutamate, of the NMDA receptor, or of excitotoxicity.
The second chapter reviews in bullet format the common clinical neurodegenerative disorders, including Alzheimer disease, Parkinson disease, Pick disease, Huntington disease, and amyotrophic lateral sclerosis. This section is cogent, well organized, and easy to read. A brief discussion of the pathology, clinical features, etiology, diagnostic criteria, and treatment of each disorder is provided.
The last chapter is lengthy and dedicated to a review of the various medications used to treat degenerative disorders. Medications discussed include the cholinesterase inhibitors, anticholinergics, and dopaminergic agents. This section is in tabular form and includes information about indications, contraindications, dosing, and side effects. The chapter is supplemented by excellent illustrations that depict the mechanisms of action of the described agents.
Strengths: The book provides a concise, easy-to-read discussion of the common neurodegenerative disorders and the standard drugs used to treat them.
Weaknesses: Less common conditions that are relevant to the neuro-ophthalmologist, such as progressive supranuclear palsy, cortical basal ganglionic degeneration, and the spinocerebellar ataxias, are not covered. Given the relatively brief description of each entity, evolving subtle issues are omitted, including the importance of tau protein in Alzheimer disease and the role of genetic testing in some of these disorders.
Recommended audience: The book is intended for a wide audience: medical students, residents, and specialists. The former will benefit from it more than the latter. The restricted scope of this monograph will limit its usefulness for those who are ultimately responsible for making decisions about patients with neurodegenerative disease.
Critical appraisal: I enjoyed reading the book and found the information provided to be useful. The arena of neurodegenerative disease is one of intense investigation, and some of the material is dated. Although the text was created for a wide readership, this book will prove to be most useful for neurology and psychiatry residents preparing for board examinations.
© 2002 Lippincott Williams & Wilkins, Inc.