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The neuropathology of dementia, 2nd edition
  1. L F Haas

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    Edited by M Esiri, M-Y Lee, J Q Trojanowski. Published by Cambridge University Press, Cambridge, 2004, £195.00, pp 563. ISBN 0-5218-1915-6

    Inspecting the hardcover graphics of this new edition your reviewer was startled to find blazoned his comments on the previous, and first, edition to encourage your purchase. It is therefore clear that I am a supporter of this enterprise in principle – though modesty will prevail and I will not flaunt my prescience in remarking on the desirability of this latest, and any subsequent, redrafting.

    I regret that this review will not take the form of a direct comparison between the present and previous editions since my recollection of the former is based on a fading and rose-tinted affection, rather than direct consultation with the source material. Obsessionality is a professional hazard in neuropathology—either acquired or innate—but in my case it does not extend to detailed record keeping of book loans. I hope the trainee who chose to keep the book has had much joy of it. No doubt his extended loan reflects the esteem he/she felt for the educational value of the first edition.

    There is no doubt that the present book is considerably larger, reflecting significant increased content. However there is no flab, and the overall size and scope are, respectively, manageable and focussed. The book has acquired distinguished American co-editors in place of Dr James Morris (whose career trajectory has taken him deep into health service management) but much of James’s contribution remains, suitably updated, as a core of practical advice related to the diagnostic process in dementia neuropathology, and the particular pathologies associated with Alzheimer’s disease and Vascular dementia. The latter section particularly reflects his welcome and homespun wisdom in an area fraught with unresolved problems of clinicopathological correlation. I am glad they have retained it. Similarly the contribution to the text by Professor Esiri shares this feeling of direct personal tutoring from an approachable expert. The editors have also retained the previous structure, roughly summarisable as: what dementia is, where in the brain might be affected, how to go about a pathological survey of a dementia brain, and, finally, what you might find related to specific diagnostic categories. This comprehensive approach is now fleshed out by the introduction of more authors to bring expertise related to individuals’ conditions, additional “introductory” material about the clinical genetics of dementia (styled “molecular diagnosis” for some reason) and neuroimaging in dementia, and increased content reflecting on pathogenesis and research into relevant disease models. The book is now an edited multi-author compilation rather than a more personal distillation from a small group. Looking at the arithmetic there are 27 USA authors, 14 UK, and four others from Australia and Scandinavia—the latter empowered only to pronounce on alcohol and dementia and CADASIL. Bar this small non-cross Atlantic contingent the chapters work out at 11 USA and 10 UK, with two mixed, illustrating a previously unrecognised American propensity for job sharing.

    The content is uniformly well presented and informative. Referencing largely peters out in 2002 indicating the long lead time for this type of book but this is not a bad thing. The modern tendency to rush into print with one’s latest minor observation on, for example, yet another apoptotic or oxidation marker contributes little to the overall progress of neuropathological research in neurodegeneration. The purpose of a book like this is to record those aspects of the understanding of dementia disorders that withstand time and become part of the accepted wisdom rather than twitching with every modish straw in the wind.

    The imaging chapter is an especially fine thing with dazzling illustration and some alarming jargon. Continuum-mechanical warping using calculations based on Cauchy-Navier equations with variable Lamé elasticity coefficients, and purple brains, add a new and distracting element to a neuropathology book. However the integration of neuropathology and neuroimaging data is a highly desirable goal in clinical neuroscience and it would be luddite to reject it here. This content illustrates just how widely a “neuropathology” text needs to cast its net to retain its value in such an interdisciplinary world as neurodegeneration research and the clinical neuroscience of dementia.

    In summary, another triumph and an indispensable addition to this field. If I had any hope of getting the book back I would automatically loan it to any new neuropathology trainee, but its appeal is far broader and it should be studied by anyone entering dementia research from a tissue-based angle. For a quotable plug to blurb over the sleeve of the third edition I offer the publisher: “buy one, get one free”.

    Supplementary materials

    • The author of the book "The neuropathology of dementia, 2nd edition" is incorrectly listed in the book review as L F Haas. The correct author should read: Paul G Ince.

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