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Developmental Disorders of the Frontostriatal System: Neuropsychological, Neuropsychiatric and Evolutionary Perspectives

Camden and Islington Community Health Services, Children's Centre, 4 Greenland Road, London NW1 0AS, UK

EDITED BY SIDNEY CROWN and ALAN LEE

By John L. Bradshaw. Hove: Psychology Press. 2001. 304 pp. £39.95 (hb). ISBN 1 84169 226 3

The 1990s were designated the Decade of the Brain, and this is celebrated by the publication of John Bradshaw's well-researched and scholarly account of the frontostriatal system and the six main disorders resulting from its dysfunction. Over the past 10 years there have been enormous advances in understanding of brain processes through increasingly sophisticated imaging techniques, and Bradshaw draws extensively on information from functional magnetic resonance studies, integrating it with other biological structural and neurochemical knowledge.

I was pleased to read that he is dissatisfied with a modular approach to neuroscience that emphasises splitting into discrete systems: these are arbitrary artificial constructs designed solely for our convenience of describing biological phenomena. All parts of the brain are dependent on other parts for biological function and none is independent of other bodily systems. Psychiatry and paediatrics are two medical specialities that take a very holistic view of patients and Bradshaw's perspective is welcome.

The frontal region of the brain has undergone the greatest evolutionary change in man and is proportionately far larger than in any other animal. It is now recognised to be the place where memory, reasoning, and emotional and social functions are processed and is described by the author as the ‘seat of our personality which underlies the essence of humanity’. The five parallel frontostriatal circuits and their different but overlapping functions are described in chapter two, and chapter three is a helpful account of the basal ganglia, about which ‘so little is known’. These systems are responsible for the ‘what, how and when’ of voluntary responses and actions.

The next six chapters cover the six main disorders of frontostriatal circuits, presenting a careful description of the clinical, epidemiological, genetic, neurodevelopmental, neuroimaging, neurochemical and therapeutic aspects of each disorder. As a paediatrician, I found the chapters on Tourette syndrome, attention-deficit hyperactivity disorder and autism particularly interesting and relevant. However, the accounts of obsessive—compulsive disorder, schizophrenia and depression were very informative, offering insight into the paediatric implications and neurodevelopmental issues involved.

This book will increase the knowledge of most people who deal with patients with these six disorders and should therefore improve their management. I recommend it for the reference shelf and for the personal library of anyone interested in the theoretical basis of emotional problems.

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Bellman, M. Search for Related Content PubMed Articles by Bellman, M.