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The Brain and Behavior: An Introduction to Behavioral Neuroanatomy, Second Edition
Am J Psychiatry 2007;164:1443-1444. doi:10.1176/appi.ajp.2007.07071139
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by David Clark, Nashaat Boutros, and Mario Mendez. New York, Cambridge University Press, 2005, 278 pp., $70.00.

The last two decades have brought an exponential increase in our understanding of the neurobiological processes underlying behavior. This has transformed both the science and practice of neuropsychiatry. Clinicians are confronted almost daily with new information concerning the structural and biochemical abnormalities associated with clinical disorders. To assimilate this information requires at least a basic understanding of the neuroanatomy of brain areas implicated in behavioral pathology. These brain regions often receive only passing mention in standard neuroanatomy texts. It is to fill this gap that The Brain and Behavior is offered.

This is not a new book. Originally published in 1999, it was reissued as a second edition in 2005, although without indications of what has been changed. The book is, at its core, a descriptive neuroanatomy text. It is intended primarily for “behavioral clinicians, trainees, residents, and students,” and only secondarily for “psychiatrists, psychologists, neurologists, and neuroscientists,” who are likely to have stronger backgrounds in neuroanatomy. Three introductory chapters present basic anatomical nomenclature, an overview of gross brain structure, and a summary of the structure and function of the neuron, including a review of different neurotransmitter classes and receptor subtypes. These are followed by chapters focusing on specific brain regions. No effort is made to be comprehensive in the sense of a classic neuroanatomy text. Rather, the emphasis is placed on those brain regions most strongly implicated in behavior and behavioral pathology. So the frontal and temporal lobes each merit an individual chapter, while the occipital and parietal lobes are combined together and the cerebellum is excluded. In contrast, there are three chapters devoted to the limbic system: one providing a general overview and two focusing separately on cingulate and temporal lobe subcomponents. The neuroanatomic detail that can be presented in a book this size is necessarily narrow and superficial. While it could serve well as a selective refresher for someone already familiar with basic neuroanatomy, it is unlikely that a naïve reader could glean much from it.

The book focuses on neuroanatomy, but it does so with a twist. Interspersed among the descriptions of regional boundaries, Brodmann area demarcations and gyral and fiber tract labels are sections describing relevant physiological correlates, behavioral implications, and clinical vignettes. These enrich and enliven what would otherwise be a somewhat dry recounting of anatomical details. One hopes, however, for much more than what is offered by these brief sections highlighting pertinent behavior and physiology. For a book entitled The Brain and Behavior, it is the emphasis on behavior that provides its raison d’etre, setting it apart from standard neuroanatomy texts. Unfortunately, these components have a very “cut and paste” feel to them. They are not organized into any kind of structured or systematic approach to behavior, either as this relates to the behavioral correlates of individual brain regions or to the behavioral correlates of broader anatomical networks. Rather, they are a potpourri of unrelated findings culled from the literature in a relatively arbitrary way. For example, the behavioral implications of the anterior cingulate are covered in five sentences, in which it is noted that 1) electrical stimulation of different parts of the anterior cingulate evoke different emotions, 2) anterior cingulate lesions may produce contralateral neglect, 3) attention tasks and transient sadness both increase blood flow to the anterior cingulate, and 4) patients with obsessive-compulsive disorder have greater anterior cingulate activity, particularly when provoked. What is missing is the systematic conceptual integration that would allow a reader to organize and interpret these diverse findings. Had the focus been on specific behavioral constructs or abnormalities, the anatomical details could have been presented within a behavioral context and with an appropriate emphasis on integrated neural networks.

Initially published as a hardcover volume, it is now available only as a high-quality paperback. Its production quality overall is excellent. Unfortunately, this does not extend to its figures. Structural brain images are reproduced with relatively low resolution, and no arrows have been added to indicate the features discussed in the legends. Color-scaled functional brain images are presented in black and white alongside the text. Although a separate set of color plates is provided, these black and white images are very difficult to interpret. It is unclear if this represents a fall-off in publication quality from the original hardcover version.

The goals of the book are modest. The authors state, “We will have accomplished our mission if we can convince the reader that the brain is an organ worthy of being the seat for the immensely complex function of behavior” (p. IX). This was perhaps a worthy and sufficient goal in 1999 when the book was originally published. It is still a worthy goal, but it is probably unnecessary and certainly not sufficient. Readers motivated enough to immerse themselves in this book are likely to already accept the premise, and they will be looking for more than this book offers.

+Book review accepted for publication July 2007 (doi: 10.1176/appi.ajp.2007.07071139).




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