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Experimental approaches to anxiety and depression
230 Yoscmitc, February 1992. The monograph packs an up-to-date wealth of data into a mere 280 pages, and the terse style of all chapters indicates the Editor's b a t o n . There are 5 main sections (molecular biology of the iono- and metatropic N M D A receptors), pharmacology of the excitatory synapses (including chapters on nitric oxide and kynurcnic acid), the role of E A A in signal transduction, the role of E A A in motor function (basal ganglia) and memory and learning (hippocampus) and, finally, a section on clinical applications which provides more hypothetical data and circumstantial evidence. Actual knowledge of the structural chemistry and actions of the NMDA, kainatc (KA) and aminomethylisoxazal (AMPA) receptors, in particular the glutamatergic one, has been expanding fast. The distribution of these receptors and their subtypes within the CNS of the experimental animal rapidly becomes familiar territory, The significance of protein kinases and calmodulin-tied calcium flux, cyclic A M P / G M P messengers is progressively unravelled. The reader (who should be versed in basic ra:her than clinical science) is fully informed on these subjects in just over 30 short chapters, each of which provides a short and ~ell-sclected relerence list. For the clinician who is aware of the relevance of E A A in neuronal death (in CNS ischemia and so-called neurodegenerative disease), 1crag-term potentiation, and epileptic kindling, quite a number of chapters will make rewarding and clarif'sing reading.
PI,:¢)F;. DR. G.W. BRWYN, PROF. EMERITUS Department of Neurology University Hospital Leiden Leiden, The Netherlands
Experimental Approaches to Anxiety and Depression, by J. Martin Elliot, David J. Heal and Charles A. Marsden (eds.), John Wiley and Sons, New York, 1992, 272 pages, $55.00, ISBN 0471930962 This volume contains the edited proceedings of the 41st Symposium organized by the Biologic Council's Coordinating Committee for Symposia on Drug Action held in London in 1991. The focus of this symposium was to review the neurophysiologic rationale for drug treatment of anxiety and depression in the wake of a recent clinical shift acknowledging the frequent overlap of anxiety and depression. The fifteen chapters were written by separate sets of authors representing France, Switzerland, the United Kingdom, and the United States. The authors' backgrounds are from academia and pharmaceutical companies, and the symposium was sponsored in part by fourteen pharmaceutical companies. The editors are to be credited with the book's evenness of writing style throughout the chapters. There is minimal overlap between chapters and, in general, each chapter builds on the ones preceding. Most chapters have a generous bibliography for those desiring to read more deeply. Ample tables, figures, and micrographs are helpfully arranged throughout the text. The first two chapters provide the historical and clinical background for the current understanding of anxiety and depressive disorders and their treatment. The remaining chapters describe animal models of depression and anxiety, the anatomical substrate of these disorders with a focus on the amygdala, and the neurochemical correlates of these disorders in man and animal models. The chapters on animal models are surprisingly readable, but the coverage of neurochemical and molecular aspects is predictably encyclopedic. Adrenergic, serotonergic, and GABAergic systems are discussed. The chapter "'Amine mechanisms in anxiety and depression" is a thoughtful attempt to explain the origins of anxiety within an organism's adaptive framework. As a whole, the book's content is more
concerned with pre-clinical than clinical aspects of anxiety and depression. This book may not hold the interest of the general psychiatric clinician, but will give a current perspective on how treatment designs are sensitive to shifts in clinical thinking. It is particularly recommended to graduate students in pharmacology and the behavioral sciences who desire to have an m'crwiew of this topic. W. VAU
Neuropsychological Disorders Associated With Subcortical Lesions, G. Vallar, S.F. Cappa and C-W. Wallesch, Oxford Scientific Publications, New York, 1992, 506 pp., $55.00, ISBN 0 19 854677 7 Vallar, Cappa, and Wallesch have captured the excitement of modern cognitive neuroscientists engaged in deciphering one of the most important aspects of modern neuropsychology: the role of the striaturn, thalamus, and other subcortical structures in higher brain function. The work is authoritative and boasts an impressive list of contributors (e.g., von Cramon, Graff-Radford, Alexander, Naeser, and Kertesz). Anyone serious about understanding higher brain function should be interested in the "'state-of-the-art" ideas and data presented in this interesting volume, which is based on papers presented at a conference held in Como, Italy in September, 1989. The book emphasizes the importance of integrating animal and h u m a n research into an overall view of the many potential roles of subcortical brain structures in neuropsychological function. The book is divided into four sections: general introduction; subcortical lesions, memory., and amnesia; cognitive function in extrapyramidal disease; and aphasia, apraxia, and neglect, after subcortical lesions. The editors introduce the work with a superb consideration of of what? that sets the standard of excellence followed throughout the book. Section 1 introduces evidence that specific subcortical structures such as the thalamus and striatum contribute to cognitive function. Divac and Oberg briefly review the phylogenic evidence for such a role, noting that striatum size has increased in parallel with neocortical expansion. The segregated circuits hypothesis is discussed and critiqued in light of neurophysiological and anatomical data from primates engaged in cognitive and motor tasks. Section 2 addresses the possible contributions of subcortical white matter, thalamus, and other structures such as the hypothalamus, to h u m a n memory. Both the "'disconnection" model, in which subcortical lesions disrupt white matter connections among cortical zones, and the alternative perspective, in which the deep nuclei have important processing roles in memory, are presented. A strength of this section is the contrasting views examined in light of experimental human data (e.g., PET studies of patients with Korsakoff's amnesia). Section 3 is an outstanding collection of papers on the neuropsychology of extrapyramidal diseases and "'subcortical dementias." Once again, the authors directly address several areas of controversy: the nature of "frontal lobe" dysfunction in Huntington's disease, Parkinson's disease, and focal frontal-subcortical lesions; the meaning of impaired/retained ability to use adwmce information (primes and cues) in extrapyramidal disorders; the complex roles of the caudate in motor programming networks for procedural memory; and the (lack of) specificity of subcortical hypometabolism seen on PET studies of patients with subcortical dementias. Section 4 introduces compelling evidence that many "cortical" functions such as aphasia and neglect can be produced by subcortical
PI,:¢)F;. DR. G.W. BRWYN, PROF. EMERITUS Department of Neurology University Hospital Leiden Leiden, The Netherlands
Experimental Approaches to Anxiety and Depression, by J. Martin Elliot, David J. Heal and Charles A. Marsden (eds.), John Wiley and Sons, New York, 1992, 272 pages, $55.00, ISBN 0471930962 This volume contains the edited proceedings of the 41st Symposium organized by the Biologic Council's Coordinating Committee for Symposia on Drug Action held in London in 1991. The focus of this symposium was to review the neurophysiologic rationale for drug treatment of anxiety and depression in the wake of a recent clinical shift acknowledging the frequent overlap of anxiety and depression. The fifteen chapters were written by separate sets of authors representing France, Switzerland, the United Kingdom, and the United States. The authors' backgrounds are from academia and pharmaceutical companies, and the symposium was sponsored in part by fourteen pharmaceutical companies. The editors are to be credited with the book's evenness of writing style throughout the chapters. There is minimal overlap between chapters and, in general, each chapter builds on the ones preceding. Most chapters have a generous bibliography for those desiring to read more deeply. Ample tables, figures, and micrographs are helpfully arranged throughout the text. The first two chapters provide the historical and clinical background for the current understanding of anxiety and depressive disorders and their treatment. The remaining chapters describe animal models of depression and anxiety, the anatomical substrate of these disorders with a focus on the amygdala, and the neurochemical correlates of these disorders in man and animal models. The chapters on animal models are surprisingly readable, but the coverage of neurochemical and molecular aspects is predictably encyclopedic. Adrenergic, serotonergic, and GABAergic systems are discussed. The chapter "'Amine mechanisms in anxiety and depression" is a thoughtful attempt to explain the origins of anxiety within an organism's adaptive framework. As a whole, the book's content is more
concerned with pre-clinical than clinical aspects of anxiety and depression. This book may not hold the interest of the general psychiatric clinician, but will give a current perspective on how treatment designs are sensitive to shifts in clinical thinking. It is particularly recommended to graduate students in pharmacology and the behavioral sciences who desire to have an m'crwiew of this topic. W. VAU
Neuropsychological Disorders Associated With Subcortical Lesions, G. Vallar, S.F. Cappa and C-W. Wallesch, Oxford Scientific Publications, New York, 1992, 506 pp., $55.00, ISBN 0 19 854677 7 Vallar, Cappa, and Wallesch have captured the excitement of modern cognitive neuroscientists engaged in deciphering one of the most important aspects of modern neuropsychology: the role of the striaturn, thalamus, and other subcortical structures in higher brain function. The work is authoritative and boasts an impressive list of contributors (e.g., von Cramon, Graff-Radford, Alexander, Naeser, and Kertesz). Anyone serious about understanding higher brain function should be interested in the "'state-of-the-art" ideas and data presented in this interesting volume, which is based on papers presented at a conference held in Como, Italy in September, 1989. The book emphasizes the importance of integrating animal and h u m a n research into an overall view of the many potential roles of subcortical brain structures in neuropsychological function. The book is divided into four sections: general introduction; subcortical lesions, memory., and amnesia; cognitive function in extrapyramidal disease; and aphasia, apraxia, and neglect, after subcortical lesions. The editors introduce the work with a superb consideration of of what? that sets the standard of excellence followed throughout the book. Section 1 introduces evidence that specific subcortical structures such as the thalamus and striatum contribute to cognitive function. Divac and Oberg briefly review the phylogenic evidence for such a role, noting that striatum size has increased in parallel with neocortical expansion. The segregated circuits hypothesis is discussed and critiqued in light of neurophysiological and anatomical data from primates engaged in cognitive and motor tasks. Section 2 addresses the possible contributions of subcortical white matter, thalamus, and other structures such as the hypothalamus, to h u m a n memory. Both the "'disconnection" model, in which subcortical lesions disrupt white matter connections among cortical zones, and the alternative perspective, in which the deep nuclei have important processing roles in memory, are presented. A strength of this section is the contrasting views examined in light of experimental human data (e.g., PET studies of patients with Korsakoff's amnesia). Section 3 is an outstanding collection of papers on the neuropsychology of extrapyramidal diseases and "'subcortical dementias." Once again, the authors directly address several areas of controversy: the nature of "frontal lobe" dysfunction in Huntington's disease, Parkinson's disease, and focal frontal-subcortical lesions; the meaning of impaired/retained ability to use adwmce information (primes and cues) in extrapyramidal disorders; the complex roles of the caudate in motor programming networks for procedural memory; and the (lack of) specificity of subcortical hypometabolism seen on PET studies of patients with subcortical dementias. Section 4 introduces compelling evidence that many "cortical" functions such as aphasia and neglect can be produced by subcortical