Barkhof F, Fox NC, Bastos-Leite AJ, et al. Neuroimaging in Dementia. Springer 2011, 278 pages, 185 illustrations, $179.00.
In this 8-chapter, 278-page hardcover book, the authors (Drs. Barkhof, Fox, Bastos-Leite, and Scheltens) present high-quality imaging and advanced MR techniques along with clinical information in various types of dementia. After the first, and probably unnecessary, chapter which describes how the disease in this book are classified and which contains a flow diagram which breaks these diseases into four categories (structural lesions, brain swelling, abnormal T2 signal, atrophy), there are 7 chapters which, in order, deal with clinical dementia (7 pages), techniques (or what is termed as tool box, where standard and advanced MR techniques along with nuclear studies are shown), normal aging (an important chapter to set the background for the chapters which follow), dementia with primary grey matter loss, vascular dementia, dementia in which there is primarily white matter abnormalities, and dementia associated with what the authors term “brain swelling”. Because there are so many abbreviations use in all chapters, the authors were wise to include a 4½ page listing of all abbreviations used in the book.
In addition to the high quality imaging and abundant use of color for nuclear studies and perfusion MR as well as the inclusion of gross and pathologic specimens where appropriate, the book serves to highlight many important issues and relatively common diseases, only a few of which are mentioned in this review. The authors nicely distinguish successful aging versus unusual aging in the chapter on normal aging; both quantitative assessments are shown in tabular and imaging formats. Considerable knowledge of neuroanatomy as shown on MR is needed to appreciate the changes described in this chapter and throughout the book because there is no chapter on basic anatomy—for instance, of the temporal lobe—and that is proper since the authors probably assume the readers of their book came in with substantial basic knowledge of anatomy and MR physics. It is interesting that the authors distinguish between successful aging and usual aging, terms which are not frequently used in place of the more commonly used “normal aging.” Separations of type of white matter abnormalities, non accumulation, changes on MRS and MT with age, are clearly explained.
From here, specific diseases in all the above mentioned categories are discussed: Alzheimer’s disease, fronto temporal dementia, parkinsonism/dementia, Huntington’s, prior diseases and drug induced changes (described in the gray matter chapter). What is particularly appealing in this chapter and throughout is the integration of clinical, pathologic, pathophysiologic or imaging data. The writing style from section to section and chapter to chapter shows the advantage of having just 4 major authors as opposed to the more commonplace situation where multiple authors are involved. Nicely demonstrated are the volumetric changes in the hippocampus from a pre-clinical AD to the time of its clinical manifestations. Likewise, variations on the typical AD are shown such as parietal atrophy in the absence of hippocopal atrophy in non elderly patients. This is the type of information that abounds throughout the book in all disease descriptions and what is welcoming is the insertion of nuclear scanning in many of these diseases. Parallel and overlapping features of diseases such as between AD and frontotemporal lobar degeneration make for a broader understanding of these and other diseases.
The authors take readers through the complexities of dementia in Parkinsonism and explain relationships—for example, with Lewy Body Dementia. As with these descriptions and with all other areas the authors give a brief historical background on the disease and those who originally published the clinical and pathologic findings. In the material on Parkinson’s disease, the variations of this disease (atypical parkinsonism) are reviewed with useful tables describing MR findings and highlighted areas which define the synonyms of disease (MSA/shy Drager/ SND/OPCA as just one example). Huntington’s, Wilson’s, prion diseases (in all forms), and drug induced dementia follow.
Vascular dementia in all its forms occupies 40 pages, and it serves to clarify the terminology used, particularly in small vessel disease. Disorders of white matter as causes of dementia are many, and the authors attempt to make sense out of this (which they do) by dividing these into infectious, non-infectious inflammatory, metabolic errors, toxic disorders, and cancer-therapy-induced dementia/cognitive dysfunction. Different patterns and signal characteristics form a useful review. The interesting last chapter is termed Dementia with Associated “Brain Swelling,” and the authors deliberately put the last part of the title in quotations marks. Here a large, ranging set of diseases (some of which really don’t cause brain swelling in the traditional sense) are covered. Examples include grant VR spaces (striking!), HSV, PML Lymphoma, Gliomatosis Cerebri, radiation changes, intravascular lymphomatosis (it is amazing how many synonyms there are for this disease), limbic encephalitis, VGKC (voltage gated potassium chemolopathies), NPH, and PRES.
This is an excellent book, recommended highly to all neuroradiologists and neurologists. It will be useful in day-to-day analysis of MR images and also serves as a platform for what undoubtedly will be newer observations in MR as advanced techniques are used on a more frequent basis.
