Book Review

Parkinson's Disease

N Engl J Med 2005; 353:1304-1305September 22, 2005

Article

Parkinson's Disease
Edited by Manuchair Ebadi and Ronald F. Pfeiffer. 1050 pp., illustrated. Boca Raton, Fla., CRC Press, 2005. $199.95. ISBN: 0-8493-1590-5

Two hundred fifty years after the birth of James Parkinson and 188 years since he wrote his seminal treatise on the “shaking palsy,” the field of Parkinson's disease is expanding in exponential fashion. Recent insights into the genetic causes of familial Parkinson's disease, genetic risk factors in the general population, environmental influences, and the pathology, evolution, and management of this disorder continue to dominate the field of neurodegeneration. Given this rapid rate of progression, the reader might well ask where a major textbook on Parkinson's disease would fit. The answer in this case is that the book belongs on the shelves of clinicians and scientists who have a special interest in this disorder and wish to have an up-to-date, comprehensive, and scholarly review of this complex topic.

An impressive set of experts contributed to this book, in 78 chapters, across a spectrum from cause to pathogenesis to clinical management. Inevitably, chapters on environmental and genetic factors will have a short shelf life, but this is not to detract from several very useful contributions that summarize our current state of knowledge. The sections on the physiology and, in particular, the clinical aspects of Parkinson's disease will be more enduring. The section on treatment is comprehensive, covering both medical and surgical aspects. The challenges to future therapy for Parkinson's disease are encompassed within sections on nonmotor features and the design of clinical trials.

The editors are to be commended for the structure and presentation of this book, which incorporates “bite-sized,” easily digestible chapters. The referencing is comprehensive, and this will be an important resource for readers writing articles in this field. Certain exceptional contributions stand out: a comprehensive overview of the nondopaminergic systems in Parkinson's disease, by Yoshikuni Mizuno; of heredofamilial parkinsonism, by Pramod Kumar Pal and Zbigniew K. Wszolek; and of the neuroleptic-induced movement disorders, by Manuchair Ebadi. Other sections are of more questionable value, such as some of the chapters on specific mouse models and some of the more recherché aspects of free-radical metabolism, including large tables of chemical structures or the theory behind predictive testing.

I believe that physicians will find the clinically oriented sections of great value. These include several sections on the dopamine deficiency in Parkinson's disease and its correction, with some expert and practical sections dealing with motor complications. The problems of autonomic and behavioral dysfunction, in addition to the important nonmotor symptoms, are also covered. These sections are of value not only for cataloguing the respective clinical features and complications, but also for addressing the underlying pathologic basis for their emergence and the limited means by which we can manage them.

At more than 1000 pages, this is a comprehensive book. It is well written, well formatted, and up to date. It has its strengths and weaknesses, but the former considerably outweigh the latter. I would recommend it highly to those with a specialist's interest in Parkinson's disease and to more general neurologists who want an accessible, readable guide to diagnosing and treating this disease. The book will also be of value to nonclinicians who seek a broad review of the science of Parkinson's disease and a guide to clinical features and management.

Anthony H.V. Schapira, M.D., D.Sc.
University College London, London WC1N 38G, United Kingdom