Book Review

Neurobiology of Disease

N Engl J Med 2007; 356:2335-2336May 31, 2007

Article

Neurobiology of Disease
Edited by Sid Gilman. 1085 pp., illustrated. San Diego, CA, Elsevier Academic Press, 2007. $199.95. ISBN: 978-0-12-088592-3

The goals of Neurobiology of Disease are outlined by the editor's preface: “The book is aimed at nonclinician neuroscientists, who may possess the conceptual and technical expertise required for productive investigations and translational research but lack frequent contact with scientifically oriented clinicians who can inform them about current concepts and recent developments.” Is there a need for a book with these goals? This question applies to all comprehensive books in biomedicine, and it must be interpreted within the framework of rapidly changing forms of communication — a book such as this one is often 1 to 2 years out of date by the time it is published. The most up-to-date appraisal of a particular problem often comes from an online survey with which no book can compete. For example, one of the recent advances in the study of Alzheimer's disease resulted from the attempt to develop imaging compounds that would demonstrate the accumulation of amyloid or amyloid products in the brain of a living patient. There is virtually no discussion of such research in books like this one, in part because such advances have occurred only in the past 2 or 3 years.

What is the role of a book of this type? This book provides a series of background essays, giving the reader a concise background in a disease process, some context around which a particular disease process is being considered, recent observations, and possible new directions of research. The editor, Sid Gilman, has achieved these goals by selecting a series of associate editors; each was responsible for a particular section and was asked to choose authors for 4 to 10 topics that they considered good examples of basic concepts within their areas. I believe this strategy was highly successful, even though it does lead to rather selective presentations, as the editor acknowledges.

A book of this scope is difficult to review. One does not read it from cover to cover; I must admit that I did not. Rather, I did three things: First, I looked at areas in which I have a certain expertise or have been actively contributing. Second, I looked at areas in which I have had an interest in recent years and about which I consider myself more or less up-to-date. Finally, I looked at areas in which I am like the intended reader of this book — that is, not very well informed about the particular topic. In the first category, there were two topics: the immune neuropathies, and the interrelationship between vascular diseases of the heart and the brain, including the issue of vascular cognitive change, or vascular dementia. The first topic was excellently covered in two different chapters, but I was disappointed with the lack of coverage of the second topic. Section 11 of the book, for example, which covers neurologic manifestations of medical diseases, did not include a chapter on the neurologic manifestations of heart disease. Although much of the information that would be included in such a chapter is covered elsewhere, it would have been more helpful to gather it in a single chapter.

In the second category of my inquiry, I was particularly interested in how the various neurodegenerative diseases were covered. In general, these chapters are excellent, although a reader has to skip around a bit to go, for example, from the discussion of Alzheimer's disease to the discussion of protein aggregation disorders, to get the full range of recent developments in the area of Alzheimer's disease.

Falling into the third category of my investigation were the sections on malformations and developmental disorders and the section on substance abuse and basic toxicology. In both instances, I found the chapters well organized and informative.

So what are my conclusions about this book? I think it is very valuable, and it has benefited from careful editing and good organization. Many chapters start with a brief historical introduction and then go on to epidemiology and aspects of pathogenesis and pathophysiology. The illustrations are excellent — color has been used judiciously and effectively. Unfortunately, it is unclear what the guidelines were for the use of references. Some chapters have a small number of references, most of which refer to review articles; in other chapters, the authors seem to have tried to be more inclusive, providing 100 or more references. Thus, it would be a futile exercise for a reader to try to use the number of references to determine the importance of a subject.

Who should have this book? As it is a reference book, it should be available to the nonclinician audience Gilman has targeted. The number of undergraduate neuroscience majors is growing, and a book of this type could be of great value to them. Neurology residents would find it a very quick way to get the background on which to superimpose new findings. Clinical neurologists, however, would be better served by a more clinically oriented book. I recommend that Gilman and his colleagues consider putting the book online, which would allow many people access to many excellent chapters and would also simplify the task of updating the material. Overall, I think the book does achieve the goals that Gilman proposed — he and his colleagues are to be congratulated.

Guy McKhann, M.D.
Johns Hopkins University, Baltimore, MD 21218