Neurovascular Neuropsychology. J.R. Festa and R.M. Lazar, eds. Springer; 2009, 315 pages, 46 illustrations, $149.00.
What determines human cognition and behavior has been a topic of intense speculation and investigation for centuries. In the days of Broca and Alzheimer, the relationship between brain structure and cognitive function could only be inferred from postmortem studies. Today, new noninvasive functional imaging techniques that allow us to assess cerebral perfusion and activation in real-time have significantly advanced our understanding of how the brain works. One fact that has become exceedingly clear is that cerebral function is the result of complex and often malleable interactions occurring both intra-and extracranially. The brain cannot function normally without the cooperation of other vital organ systems. Outside the brain, perhaps no other organ system is more important to maintaining normal neurologic and cognitive processes than the cardiovascular system. Less clear, however, is how various alterations in cardiac or vascular function specifically affect behavior and thought.
The creators of the new book, Neurovascular Neuropsychology, aim to address this topic by providing a potential model for neuropsychology, in which the focus is as much on causal mechanisms as it is on the measurement of cognitive and behavioral outcomes. Topics covered in the 19 chapters range from frequently encountered cerebrovascular disorders, such as stroke and aneurysmal subarachnoid hemorrhage, to less common entities such as cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy and mitochondrial encephalopathy lactic acidosis with stroke-like episodes. The latter portion of the book is devoted to the psychological impact of systemic diseases, including congestive heart failure, cardiac arrest, diabetes mellitus, and hypertension and to issues related to the treatment and rehabilitation of neurovascular neurocognitive disorders.
Given the decidedly clinical bent with which the chapters are written, it is clear that neuroimagers are not meant to be the target audience of the book. With the exception of a chapter dedicated to functional imaging in stroke recovery, content pertaining to imaging occupies only a small portion of the text and is clearly written for the nonradiologist. Nonetheless, the book provides insightful commentary on the links between blood, brain, and thought, which will certainly pique the curiosity of those of us with an active interest in functional brain imaging, and it gives us a number of glimpses into the future of research in the field.
