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An atlas of Alzheimer's disease. The encyclopedia of visual medicine series
  1. DAVID M A MANN

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    An atlas of Alzheimer's disease. The encyclopedia of visual medicine series. Edited by mony j de leon (Pp149, £59.00). Published by Parthenon Publishing, Carnforth, 1999. ISBN 1-85070-912-2.

    In just 149 pages and nine separately authored chapters, Professor De Leon has produced a practical guide to the clinical, radiological, and pathological features of Alzheimer's disease, principally aimed at junior hospital doctors, nurses, and other paramedical workers, as well as general practitioners, with an interest in the disorder. The book is beautifully illustrated, and the many diagrams are helpful and informative. Reisberg relates the changes in daily life that affect patients with Alzheimer's disease, from the very beginnings of change through to the very end of life. The accompanying drawings are delightful and bring home the misery of the illness in a very real way. The utility of functional imaging in persons at risk of Alzheimer's disease is discussed and lavishly illustrated by Jagust. A detailed anatomy of the hippocampus and associated structures by De Leon follows, chronicling the early involvement of these regions and emphasising the value of MRI in differentiating persons with mild cognitive impairment, as well as frank dementia, from cognitively intact people. However, here, the reader is left with the (misleading) impression that MRI can act as a sensitive diagnostic for Alzheimer's disease, neglecting that equivalent degrees of hippocampal atrophy can occur in patients with other forms of dementia—for example, frontotemporal dementia. Braak eloquently covers the topographic origins and spread of the pathological changes. Iqbal reviews the structure of the neurofibrillary tangle and its affects on neuron function. The role of glial cells in the formation and removal of amyloid is discussed by Wegiel and its chemical properties by Wisniewski. Poirier reviews genetic factors, although the book suffers somewhat here from the advances made in this area since its publication in 1999. For example, the number of causative mutations in the presenilin-1 gene listed has now nearly trebled and the identity of the presenilin proteins, their function, and relation to amyloid formation are much better understood. None the less, overall, this is an excellent book that will have great appeal. I would recommend a look, even its purchase, particularly as the author's royalties are being donated towards the establishment of a young researcher fund.

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