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Book Forum: Neuropsychiatry and NeurologyFull Access

Clinical Neuropsychology: Behavioral and Brain Science

What could be more fascinating than the attempt to link brain to mind? This book introduces the reader to this attempt and pulls off a rare feat in that it neither baffles nor bores. Bradshaw and Mattingley do not presume that the reader has previous neurological knowledge; they succinctly and methodically provide the medical information a psychologist would need for reading case notes on brain injury. They also introduce the medical reader to core concepts in the psychological literature, such as modularity and the relative merits of single and group studies.

In their very readable style, the authors take us on a tour of disorders of speech, reading and writing, object recognition, spatial cognition, memory, and movement and thought; along the way they mention right-hemisphere contributions to language, the effects of callosal damage, the dementias, and “neuropsychiatric disorders.” These last include Tourette’s disorder and autism, which, with schizophrenia, are described rather charmingly as the bridesmaids at the (re)unification of neurology and psychiatry.

What is notable about the discussion of each topic is that the reader is given a sense of the current controversies and debates. The chapter on neglect is a good example, presenting five alternative theories with evidence and counter-evidence. This book will be of enormous value to students at all levels, not just for its content, but also for the model it presents of how to appraise alternative theories.

Perhaps the main focus of the book is functional localization—finding what part of the brain does what. Readers may ask, however, whether localization is explication; when we have located all functions and connections, will we understand the mind? The book is described as “more biological than cognitive in emphasis,” and in this respect may leave wanting those readers in search of a science of the mind. The subtleties of localization are not obscured, however. Information from subjects with brain damage and animal models is supplemented with functional imaging results. However, the authors also warn the reader that this body of exciting data is built on an assumption that increased blood flow marks increased neuronal activity, without any clear indication of whether this activity is excitatory or inhibitory.

The accessible writing style, clear and useful illustrations, helpful chapter summaries, and suggested reading all make this book ideal for students or for experts in other areas. The authors also use case histories very effectively to bring to life many of the disorders discussed.

The book finishes with a look to the future and mention of the impact of both imaging and genetics. Here it would have been nice to see consideration of the complementary roles of functional imaging and lesion studies (the former demonstrating sufficient brain substrates and the latter, necessary substrates). Similarly, some indication of how insights from genetics will converge with findings from neuropsychology would have been an exciting, if demanding, addition. Perhaps these will appear in a second edition—a volume I would certainly like to read.

By John L. Bradshaw and Jason Mattingley. Orlando, Fla., Academic Press, 1995, 458 pp., $54.95 (paper).