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Behaviour and mood disorders in focal brain lesions

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    Behaviour and mood disorders in focal brain lesions. Edited byjulien bogousslavsky and jeffrey l cummings. (Pp554, £49.95). Published by Cambridge University Press, Cambridge, 2000. ISBN 0-521-77482-9.

    This book has arisen because of the comparative dearth of studies examining the emotional and behavioural consequences of focal brain lesions and, if nothing else provides a useful compendium of this literature in 18 chapters written by experts in the field. The first three chapters set the scene by providing a conceptual overview and discussions of methodological issues. The rest are devoted to specific topics and generally take the form of either examinations of the evidence for the localisation of specific neuropsychiatric syndromes (depression, mania, obsessive compulsive disorder, psychosis) or reviews of the effects of lesions of particular structures (thalamus, basal ganglia, frontal lobe, temporal lobe). In their overview, Cummings and Bogousslavsky group the disorders of mood, thought, affect, and motivation considered in this book under the rubric “fundamental dysfunctions“ which they point out are associated with interruptions of limbic and frontosubcortical circuitry. This diffuse nature of these circuits is reflected in the finding that lesions of disparate areas can produce, for example, psychotic phenomena and that lesions in specific structures—for example, thalamus or basal ganglia, can result in a range of behavioural and emotional abnormalities. It is thus often difficult to make strong inferences from this literature about the neural basis of emotion and behaviour. Indeed some chapters are essentially categorised lists of studies without much in the way of theoretical underpinning. Several chapters, by Habib (disorders of motivation), Eslinger and Geder (behavioural and emotional changes after focal frontal damage) and Tranel (neural correlates of violent behaviour), stand out. These stray from localisation and bring in evidence from basic neuroscience and human functional neuroimaging to inform and interpret fascinating case histories in terms of a functional neuroanatomy of emotion and behaviour.