Customer Reviews

Anatomy of Neuropsychiatry: The New Anatomy of the Basal Forebrain and Its Implications for Neuropsychiatric Illness

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The "Anatomy of Neuropsychiatry: The New Anatomy of the Basal Forebrain and its implications for Neuropsychiatric illness" by Lennart Heimer, Gary W. Van Hoesen, Michael Trimble and Daniel S. Zahn," is lucid, accurate, concise (176 pages) and up to date (2008) book on the new paradigm shift in psychiatric thought to a more "neuroanatomic perspective."

The basal forebrain is a manifold that envelopes the telencephalic structures that include the septum, accumbens, substantia innominata, amygdala, and the orbitofrontal and temporal cortical regions. The main parts of the substantia innominata are the cholinergic and non-cholinergic neurons referred to as the magnocellular basal forebrain complex which includes the basal nucleus of Meynert.

These structures and their "parallel, segregated subcortical connections," form several "functional-anatomical systems," referred to as "macrosytems." Each macrosystem is in parallel with each other. These make up the neural basis for the behavioral repertoire involved in the overall "risk-benefit analysis" with its intrinsic directive to keep you alive. Memory, feelings, emotional expression, and thinking from the limbic and extrapyramidal now to the basal forebrain and it's "risk-benefit analysis."

The authors show the designations "psychiatric-neurologic," and/or neuropsychiatric-behavioral neurology," are different sides of the same coin. There is an excellent review of Nieuwenhuys expansion of the limbic system into the brainstem first researched by Nauta.

Despite the new anatomical discoveries, the continuing evolution and "eroding relevance of the Limbic System," and the conceptualizing of the Basal Forebrain Functional-Anatomical Systems, the core remains the Papez Circuit.

A Very Partial Table of Contents:
1. The Limbic System:
A Concept in Perpetual Search for a Definition
2. The Eroding Relevance of the Limbic System
The Triune Brain Concept and the Controversy Surrounding It
3. Alternative to the Limbic System
The Anatomy of the Basal Forebrain
The Ventral Striatopallidal System
Discovery of the Ventral Striatopallidal System
Cortico-Subcortical Reentrant Circuits (" Basal Ganglia Loops ")
Discovery of the Extended Amygdala (A Contested Concept?)
The Magnocellular Basal Forebrain System.
4. Greater Limbic Lobe
5. Cooperation and Competition of Macrosystem Outputs
Basal Forebrain Functional-Anatomical Systems (Microsystems)
Reticular Formation and Behavioral Synthesis
Clinical Disorders of Motivation

I would first like to preface my review by stating that I am a psychology (with an emphasis in Neuroscience courses) undergrad who bought the book to gauge how well I would understand the material, understanding the likelihood--despite having read around 15 neuroscience books the past two years--that much of it may be beyond my understanding. With that said, I must say I have not read a book that reduces the language to that which I can understand entirely--all the while refusing to oversimplify or reduce substance--as much as this one. Admittedly, this review cannot be authoritative, as I am just a student, but I am in utter amazement at how eloquent and precise the book is without engaging in pedantry over minutiae.

Prior to this book, I could confess to being slightly confused and accepting of the subjective quality of what constitutes a limbic system. Prior to this book, I could confess to being confused by the Nucleus Accumbens, Caudate, and Putamen, and why they differ. Prior to this book, I could confess to being befuddled over what constitutes the extended amygdala (I still think this could be called the striatal amygdala to reduce confusion, as it keeps the striatal part as simply descriptive), and what areas are part of the limbic 'system' or lobe as the authors and Broca declare.

The book put into context clinical disorders like Parkinson's, and how its progression as a disease reflected the afferents accepted by the dorsal and ventral striatum. It put into context addiction, highlighted with sheer brilliance the core-shell dichotomy and work showing the importance of certain 'islands' in the striatum as possibly (even if only metaphorically) relative to arrested development and drug abuse.

I cannot, in words, express my satisfaction with this book enough. Recommended for all those interested in the brain who have read enough to know basic anatomy of the brain.

As a fortunate participant in one of the symposia that engendered this textbook, I congratulate the co-authors on compiling a text worthy of Dr. Heimer's legacy. The previous reviewer summarized nicely the highlights of the text, but did not mention how truly unique and special the attached DVD of Dr. Heimer's dissections is as a supplement. Dr. Heimer was a master at teaching the beauty of neuroanatomy and these videos are a lasting tribute to that capacity. Well done.

Trimble has made a cottage industry out of blaming patients for their physical injuries and diseases. This book classifies ME (CFS) as a "disorder of motivation." And in Somatoform Disorders Trimble includes ME (CFS) and Fibromyalgia as somatoform disorders noting that people with ME show "Abnormal Illness Behaviour" like avoiding exercise, remaining bedbound and "often adopting a wheelchair lifestyle and a destiny of dependence." There are over 4,000 articles in peer reviewed medical journals showing frank biological pathology in ME. Trimble's antiscience bias makes him difficult to believe on any medical topic.