Mental and Behavioral Dysfunction in Movement Disorders.
Marc-André Bédard, Yves Agid, Sylvain Chouinard, Stanley
Fahn, Amos D. Korczyn, and Paul Lespérance (Eds.). 2003. Totowa,
NH: Humana Press, Inc. 561 pp., $185.00 (HB).
Disorders having an impact on subcortical brain structures, such as
Parkinson's disease, Huntington's disease, and progressive
supranuclear palsy (to name a few), have long been known to disrupt basic
motor functions. We have also come to understand, however, that these
diseases result in cognitive and psychiatric alterations. Many of these
cognitive and psychiatric changes are often unrelated to the motor
abnormalities seen in these diseases, highlighting the multi-faceted
processes mediated by different subcortical structures. In addition, these
cognitive and behavioral changes can be more debilitating than the
movement deficits experienced by these patients. Thus, it is imperative
that clinicians further understand the characteristics of, and treatment
options for, these types of symptoms. Further, our understanding of the
mental and behavioral changes in these diseases has also informed us about
the role of the subcortical brain structures (and their connections) in
cognition and psychiatric functioning. From this work, it has become
increasingly clear that frontal-subcortical pathways play an important (if
not central) role in directing human activity.