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The Human Hypothalamus: Basic and Clinical Aspects (volumes I and II)
Am J Psychiatry 2006;163:754-755.
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by D. F. Swaab. Amsterdam, Elsevier, 2003. Volume 1: 476 pp, $259.00; volume 2: 597 pp, $285.00.

This is the first two-volume, 33-chapter monograph that deals with the human hypothalamus.

Volume I contains 16 chapters on the cytoarchitecture, chemoarchitecture, functional neuroanatomy, and topographical neuropathology of a great many hypothalamic areas: the nucleus basalis of Meynert and diagonal band of Broca, the Calleja islands, insulae terminalis, suprachiasmatic nucleus and pineal gland, sexually dimorphic nucleus, bed nucleus of the stria terminalis and septum, supraoptic and paraventricular nucleus, ventromedial nucleus, dorsomedial nucleus, infundibulum, lateral tuberal nucleus, tuberomamillary complex, lateral area, subthalamic nuclei, and the corpora mamillaria.

Volume II describes, in 17 chapters, the neuropathology and clinical aspects of psychiatric and other disorders: trauma and iatrogenic disorders, schizophrenia and autism, depression and panic disorders, fatigue, aggression, vascular disorders, growth and development, tumors, infections, neuroimmunological disorders, drinking disorders, eating disorders, reproduction and sexuality, periodic disorders, neurodegenerative disorders, autonomic nervous system, pain and addiction, brain death and “dead” brain cells.

Both volumes are part of the renowned series “Handbook of Clinical Neurology,” which in 1968 was an initiative of Pierre Vinken and George Bruyn. It will be continued under the series editorship of M.J. Aminoff, F. Boller, and D.F. Swaab, and will also deal with major aspects from the field of biological psychiatry.

In their foreword the editors announce their intention to pay more attention to current developments in the field of neuroscience in order to gain a better understanding of a variety of disorders and their therapies. Special attention is also paid to epidemiology, imaging techniques, genetics, and therapeutic approaches. In addition, the two volumes provide an overview of the classic neuropathology of the hypothalamus, which means that a large number of often very old publications, which cannot be found on the internet (Pubmed), remain accessible.

One of the great advantages of a monograph such as this one is the consistency of style and structure. This particular book is also sprinkled with apt quotes from old masters and jokes by the author as well as with plenty of figures and photographs, some directly relating to the neuropathology but others of pieces of art that are relevant to the subject. This alone invites further reading and makes the book a joy to leaf through. On page 306, for instance, we see photos of a laughter-induced cataplectic attack in a man with narcolepsy, with underneath similar pictures of a Doberman pinscher with a mutation in the hypocretin (orexin)-receptor-2 gene. Curious about the substrate we learn that the hypothalamic hypocretin-producing cells near the fornix are no longer detectable in narcolepsy patients. Another chapter that fires the imagination is the last one, which deals with postmortem research and “life after death.” The observation that human brain cells can be kept alive in culture for several weeks after death raises the question for a psychiatrist why these cells “decide” to die after all.

An 1,100-page overview comprising fundamental as well as clinical aspects of the human hypothalamus is not something that can be written during a sabbatical. This is a life’s work. Let us hope that the publishers will keep their promise to keep this work up-to-date via publication on the internet, as happened for the book Psychopharmacology. This particular work can always be accessed—through a password system—and is linked to current references in PubMed. The author will hopefully want to continue updating his work for a number of years to come.

Who should read this book? Every psychiatrist, neurologist, endocrinologist, gynecologist, and every neuroscientist with an interest in hypothalamus-related mechanisms and disorders.

The book will also serve as a reference work for countless generations of students.

Concluding it may be said that The Human Hypothalamus contains a wealth of information that is not available anywhere else in such a structured form and so comprehensively.

The enthusiasm of the author for psychiatry and the abundance of illustrations make this book a joy to read.

+Reprints are not available; however, Book Forum reviews can be downloaded at http://ajp.psychiatryonline.org.




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