Norman geschwind: Selected publications on language, behavior, and epilepsy. Orrin devinsky, Steven C. Schacter, Newton, MA, Butterworth-Heinemann, 1997 601 pp

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    Reviews Clinical Applications of Neurotropic Factors Edited by Stuart A p j l Philadelphia, Lippincott-Raven, 1997 209 pp, illustrated $95.00

    In this decade, the neurotrophins have been one of the most exciting areas of neuroscience and neurology. Beginning with a series of basic science discoveries and observations, in vitro experiments of their biological activity, and in vivo experi- ments under pathological conditions, this area has blossomed into the clinical arena in an extraordinarily short time. Dr Apfel, who has taken an important role in the latter two of these areas, edited this monograph on the current state of the clinical applications of neurotrophins. For someone like my- self, grounded in the clinical sciences, I found this to be an extremely useful book in a rapidly moving field.

    The first chapter provides an overview of the basic biology of the neurotrophic factors: nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), NT-3, NT-4/5, ciliary neurotrophic factor (CNTF), insulin growth factors (IGF), fibroblast growth factors, epidermal growth factor, transforming growth factor, glial cell line-derived neurotro- phic factor (GDNF), adrenocorticotropic hormone (ACTH), and melanocyte-stimulating hormone peptides. While pre- senting a complex amount of material, Dr Apfel distills it so that it is easily understood. This chapter alone has 316 references.

    Chapter 2 presents the intellectual underpinnings of matching the just-described neurotrophic factors to clinical problems. This is followed by seven chapters, five written by Dr Apfel, one co-authored with Dr Thomas Van De Water, and one written solely by Dr Samuel Koszer, on specific neu- rological indications for growth factor therapy. These chap- ters are of particular use to basic scientists and those in in- dustry, since each chapter begins with an overview of the neurological disease, relatively simplified from the clinicians standpoint, and ends with discussion of specific neurotrophic factors that might be valuable in those disorders. In chapters in which neurotrophic factors either have been applied or are under study, Dr Apfel succinctly summarizes the ongoing state of information.

    The last chapter deals with the difficult issue of delivering these drugs to the central nervous system, a topic of much discussion in industry circles.

    Clinical Applications of Neurotropic Factors has two minor shortcomings. First, in a rapidly moving field in which sig- nificant papers are being published weekly, concern arises that this book may be out of date shortly. Fundamental in- formation that is needed to understand these new papers is well presented, however, and the book will thus form a back- bone and reference for those interested in the field.

    Second, although the title of the book is Clinical Applica- tions of Neurotropic Factors, this has been a disappointing area in practice to date, a fact that is not well synthesized in this volume. This may reflect the fact that several of the relevant studies were not available at the time the book was written. However, there is a fundamental question as to the real clin- ical application of these compounds. The excitement in the

    laboratory has not been matched by the results in the clinic, which is not well stressed here. All the neurotrophins have extraordinarily positive results in vitro and in in vivo animal studies, yet the results in the human arena have been disap- pointing. CNTF, one of the weaker agents, was found to be too toxic and ineffective in amyotrophic lateral sclerosis. BDNF was not able to pass phase I11 clinical trials success- fully and for the most part has been dropped from clinical development. IGF-1, also tried in amyotrophic lateral sclero- sis, was not approved by the FDA Advisory Panel. NT-3 is still in the early phases of development, but it is uncertain how this will be further developed. GDNF is similarly in the early stages of development and further developments are awaited. NGF, the initially discovered neurotrophin, has completed its phase I1 clinical trial, and there are an ongoing phase I11 studies in diabetic neuropathy and HIV-associated neuropathy. I would have enjoyed Dr Apfels view on this issue, given both his leadership in the experimental studies underlying the clinical trials and his participation in numer- ous clinical trials.

    In sum, this is an excellent monograph on clinical appli- cations of neurotrophic factors. This book will appeal both to basic scientists for its material on clinical disorders and potential applications and to clinicians for the basic science aspects of the neurotrophins.

    David Cornblatb, M D Baltimore, M D

    Norman Geschwind: Selected Publications on Language, Behavior, and Epilepsy Edited by Orrin Devinsky and Steven C. Scbacter Newton, MA, Butterwortb-Heinemann, 1997 601 PP

    Reading this collection of writings by Dr Norman Geschwind brings this reviewer to the brink of weep- ing with mixed sadness and joy-sadness because Geschwind is no longer alive and joy because so much of him lives in these pieces of writing. Even when writing with collaborators or as second (usually senior) author, Geschwind comes through in his own inimitable voice and with his singular impact.

    The section introductions by the editors, Orrin Devinsky and Steven Schachter, are not only informative but warmly celebratory of the special person whose writings are featured. The informative side of the section introductions will be valuable to novices because they provide a historical and neu- rological context within which the writings on each general topic can be framed and better comprehended or appreci- ated. Some of the biographical anecdotes recounted in the introductory portions are familiar to anyone who trained un- der Dr Geschwind, whereas others, such as the personal ex- periences of Dr Devinsky, are delightful additional Ge- schwindian lore.

    Everyone who is in the least interested in behavioral neu- rology or cognitive neuroscience will want to own or have access to this book. It is perfect introductory material for a fellow in behavioral neurology. It is full of nostalgic flavor for the old-timers.

    My only complaint about this book is related to poor

    688 Copyright 0 1998 by the American Neurological Association

  • proofreading. Meaning is sometimes compromised, as when to command is rendered to common (p 127).

    Martha Bridge Denckla, M D Baltimore, M D

    The History of Neuroscience in Autobiography, Volume 1 Edited by Larv R. Squire Washington, DC, Society for Neuroscience, 1996 607 pp, illustrated

    This volume is the first in a project of the Society for Neu- roscience to collect autobiographical essays from leaders and founders of the discipline. Neuroscience is a sufficiently young endeavor to make this possible. In the 196Os, F. 0. Schmitt popularized the term and concept of neuroscience to encompass the biophysics, anatomy, physiology, chemistry, and psychology related to the nervous system into an inte- grated discipline-a discipline extending from molecules to mind. It was not until 1970 that the inaugural meeting of the Society to Neuroscience was held. Most of the attendees are still alive to recount the adventure.

    Larry Squires and a committee of the Society have col- lected 17 autobiographical essays from prominent neurosci- entists, including Albe-Fessard, Axelrod, Bishop, Bullock, Diamond, Galambos, Hamburger, Hodgkin, Hubel, Jasper, Katz, Kety, Libet, Sokoloff, Sprague, von Euler, and Young. Each essay deals with the writers early life and notes people who influenced his or her career-families, teachers in sec- ondary schools and universities, and mentors and colleagues. The number of authors who reminisce on interacting with one another is striking, as are the recurring influences of Ad- rian, Eccles, Gerard, Granit, Hill, Kuffler, Magoun, Mont- castle, and Schmitt. The pieces also describe the joys of dis- covery and the pleasures of teaching a younger generation.

    The volume is easy and entertaining to read. The rewards of engagement in a burgeoning field are clearly protrayed in a very personal fashion. I look forward to Volume 2.

    Richard T Johnson, M D Baltimore, M D

    Books Received An Atlas of Neonatal Brain Sonography By Paul Govaert and Linda S. de Vries London, Mac Keith, 1997 363 pp, illustrated, $85.00

    Neurofibromatosis Type 1 in Childhood By l\;zthryn North London, MacKeith, 1997 132 pp, illustrated $47.95

    Advances in Neurochemistry, Vol 8: Magnetic Resonance Spectroscopy and Imaging in Neurochemistry Edited by Herman Bachehrd New York, Plenum, 1997 413 pp, illustrated, $115.00

    Advances in Experimental Medicine and Biology, Vol 413: Optical Imaging of Brain Function and Metabolism 2 Physiological Basis and Comparison to Other Functional Neuroimaging Method Edited by Arno Ellringer and ULrich Dirnagl New York, Plenum, 1997 249 pp, illustrated, $85.00

    Autonomic Nerves By Lind? Wiikon-Pauwels, Patricia A. Stewart, and Elizabeth J. Akesson Ontario, Canada, BC Decker, 1997 248 pp, illustrated, $42.95

    Critical Issues in Neuropsychology: Detection of Malingering during Head Injury Litigation Edited by Cecil R. Reynolds New firk, Plenum, 1998 291 pp, $45.00

    The Prefrontal Cortex: Anatomy, Physiology, and Neuropsychology of the Frontal Lobe, ed 3 By joaquin M. Fuster Philadelphia, Lippincott-Raven, 1997 352 pp, illustrated, $79.00

    The Temporal Lobe and Limbic System By Pierre Glaor New York, Oxford, 1997 865 pp, dlustrated, $135.00

    Critical Issues in Neuropsychology: Contemporary Approaches to Neuropsychological Assessment Edited by Gerald Goldstein and Theresa M . Incagnoli New York, Plenum, 1997 420 pp, $65.00

    Acoustical Signal Processing in the Central Auditory Syste