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Fronto-Temporal Lobar Degeneration: Fronto-Temporal Dementia, Progressive Aphasia, Semantic Dementia.
  1. JOHN HODGES

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    Fronto-Temporal Lobar Degeneration: Fronto-Temporal Dementia, Progressive Aphasia, Semantic Dementia. Edited by: j s snowden, david neary, and d m mann. (Pp 227; £55.00). Published by Churchill Livingstone, Edinburgh 1996. ISBN 0443047650.

    The three editors of this book have played a central part in the renaissance of interest in the clinical, neuropsychological, and neuropathological aspects of non-Alzheimer dementias. This book is based on their truly remarkable experience of some 200 patients with lobar atrophy studied over the past decade, 40 of whom have reached postmortem. It represents, therefore, an unequalled source of information and is essential reading for all those working in the area.

    After a historical introduction, the initial chapters are dedicated to the three princinpal syndromes under consideration: frontotemporal dementia, progressive aphasia, and semantic dementia. Each section integrates clinical neurology with neuropsychology, radiology, and pathology. There are also very useful chapters which deal with differential diagnosis and the relation of lobar atrophy to motor neuron disease. The final chapters are more theoretically oriented and cover the role of the frontal lobes in behaviour and aspects of semantic memory. Besides the integrated approach and the highly readable style, the other strength of the book is the liberal use of clinical vignettes and useful summaries at the end of each chapter. The quality of illustrations is very high but more MRI images would perhaps have been desirable.

    Some readers naive to the field may emerge confused by the current terminologies, which cross levels of analysis: the newly adopted term, frontotemporal dementia (which has replaced dementia of frontal type), has obvious neuroanatomical connotations, whereas semantic dementia and progressive aphasia are syndrome terms which do not imply any direct anatomy or pathology. The relation between frontotemporal dementia and semantic dementia is perhaps one of the more perplexing aspects of the current classification. Personally I would prefer use of the older term for a dementia of frontal type.

    The fact that neurodegenerative diseases can produce very circumscribed cognitive deficits has been one of the most surprising and fascinating discoveries in recent years. This book admirably illustrates the value of careful analysis of such cases, both for the understanding of the dementias and of normal cognitive processes. I can wholeheartedly recommend it.

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