The degree of neuropsychological dysfunction across multiple domains was examined in individuals suffering from chronic fatigue syndrome (CFS). In this descriptive study, a similar series of neuropsychological tests was administered to a group of CFS patients and healthy participants. More specifically, CFS patients (n = 141) who met the 1994 Case Definition criteria were compared to 76 healthy control participants on tests of memory, attention (concentration), speed of information processing, motor speed, and executive functioning. On the 18 measures administered, CFS patients scored 1 standard deviation below the healthy mean on nine measures and scored 2 standard deviations below the healthy mean on four of the measures. Moreover, results indicated that CFS patients were more likely than healthy controls to fail (1.6 SD below the healthy mean) at least one test in each of the following domains: attention, speed of information processing, and motor speed, but not on measures of memory and executive functioning. Finally, CFS patients demonstrated a greater total number of tests failed across domains. (JINS, 2004, 10, 278–285.)

Cognitive deficits following ventromedial prefrontal damage (VM-PFD) have been elusive, with most studies reporting primarily emotional and behavioral changes. The present case illustrates the utility of a process approach to assessing cognitive deficits following VM-PFD. At age 26, C.D. acquired bilateral VM-PFD, more so in the left frontal region, following a penetrating head injury. Despite exemplary premorbid academic and military performances, his subsequent history suggests dramatic occupational and social changes, reminiscent of Phineas Gage. In fact, lesion analysis revealed similar structural damage to that estimated of Gage. C.D.'s scores on the vast majority of neuropsychological measures were average to superior (e.g., Verbal IQ = 119). However, on several new process measures, particularly those that quantify error rates on multilevel executive function and memory tasks, C.D. exhibited marked impairments. From his pattern of deficits, C.D. appeared to sacrifice accuracy for speed and to adopt liberal response strategies, implicating problems with cognitive inflexibility, impulsivity, and disinhibition. The current findings suggest that VM-PFD may be associated with a wider spectrum of cognitive deficits than previously characterized. (JINS, 2004, 10, 453–465.)

Hines finds it impossible to make distinctions between the terms “sex” and “gender,” hence their refreshing, non-political interchangeability in her new book. After examining hormonal and brain-based data, Hines concludes that science cannot yet inform us which differences are determined biologically, socially, and/or both.

Neuroradiological and neuropathological investigations have found evidence of diffuse brain damage in the frontal and temporal lobes, corpus callosum, and fornices in patients who have sustained a mild traumatic brain injury (TBI). However, neuropsychological assessments of these patients do not typically target many of the subtle information processing deficits that may arise from diffuse damage involving the frontotemporal regions of the brain as well as white matter pathology, including the corpus callosum. Consequently, we have a limited understanding of the deficits that may be attributable to temporary or permanent disruptions to these functional pathways. This study assessed a group of mild TBI patients (N = 40) and a matched control group (N = 40) on a number of standard neuropsychological tests of selective and sustained attention, verbal and non-verbal fluency, and verbal memory. In addition, reaction time (RT) tasks, requiring both the inter- and intra-hemispheric processing of visual and tactile information, were used to assess the functional integrity of the tracts that are likely to be affected by diffuse damage. In the 1st month after sustaining their injury, the mild TBI group demonstrated deficits in attention, non-verbal fluency, and verbal memory. They also demonstrated slower visual and tactile RTs, with the visual RTs of mild TBI patients being more affected by increased task difficulty and the need to transfer information across the corpus callosum, than did their matched controls. (JINS, 2004, 10, 286–297.)

Cognitive Rehabilitation: A Clinical Neuropsychological Approach. W. Brouwer, E. van Zomeren, I. Berg, A. Bouma, and E. de Haan (Eds.). 2002. Amsterdam: Boom Publishers. 296 pp.

Neuropsychological Interventions: Clinical Research and Practice. P.J. Eslinger (Ed.). 2002. New York: The Guilford Press. 360 pp., $50.00.

Cognitive dysfunction is the sine qua non of brain injury. Rehabilitation of cognitive deficits is therefore central to the treatment of persons with brain injury. Nevertheless, advances in the treatment of various cognitive functions have been slow to occur. In all likelihood this slow pace reflects the complex nature of brain function and brain injury as well as the challenges that researchers encounter when they conduct research with real world populations whose condition may be evolving. Yet, brain injury treatment shows promise. After reading both of these books, the reader will have the sense that our approaches are becoming more scientific, that there are large gaps in our knowledge, with variability in knowledge across cognitive domains, and that there is still much art in the treatment of cognitive deficits. These two books provide valuable information of a complementary nature on the status of brain injury care.

We investigated whether the perception or production of a given line length in normal subjects varies according to where in peripersonal space the line is perceived or produced. We also investigated the influence of the direction of movement used to make the line. In Experiment 1, blindfolded normal subjects were asked to estimate distances while the examiner moved the subject's hand in proximal (medial) or distal (lateral) space, moving centripetally or centrifugally. The subjects showed a spatial effect, perceiving the same length as shorter in proximal space than distal space. This result could be related to either a proximal spatial attentional bias or an anisometric representation of spatial distances. In Experiment 2, we attempted to dissociate these hypotheses by studying blindfolded normal subjects, who were requested to produce horizontal lines of a given length (100 or 200 mm) in proximal versus distal peripersonal space using centripetal or centrifugal movements. Centrifugal movements in proximal space were the longest; centrifugal movements in distal space were the shortest; in between were the proximal centripetal and distal centripetal movements which did not differ from each other. These results suggest that in peripersonal space the perception of length in normal subjects is most consistent with anisometric mental representation where the size of mental representations of length units decreases as a function of the distance from the subject's midsagittal plane. Length production, however, may depend on an interaction of the anisometric mental representation and the premotor/intentional factors. (JINS, 2004, 10, 913–919.)

The starting point of this interesting compact book is the recognition that two camps of professionals specialize in understanding cognitive functions: neuroscientists who primarily evaluate healthy individuals, and clinicians who work with brain-injured patients. Each group has a select acquaintance with cognitive functions, conditioned by the populations that it addresses, while having more limited understanding of the cognitive processes associated with the other group. Thus, this book attempts to bridge health and disease by showing how normal cognitive functions may be corrupted by brain illness, and thereby foster an improved understanding of cognitive processes in general.

In the present study, the correspondence between clinician-assessed and self-reported neurocognitive performance was contrasted with scores obtained from psychometric neuropsychological tests in 148 psychiatric in-patients. Results revealed that self-reported cognitive functioning was strongly associated with depressive symptomatology but was only poorly related to psychometric neurocognitive performance, particularly in schizophrenia. After illness denial was controlled for, the overall association between subjective and objective test performance was slightly increased but still failed to reach significance in six out of eight analyses. In approximately 20% to 40% of all cases, clinicians judged memory performance to be normal despite substantial impairment revealed by neuropsychological test results (attention parameters: 7–51%). Since (ecological) validity and reliability have been demonstrated for many neurocognitive paradigms, the present results question the validity of non-psychometric neurocognitive assessment and call for a complementation of clinical judgment with neurocognitive assessment. Reasons for decreased sensitivity of self-reported and clinician-assessed neurocognitive functioning are discussed. (JINS, 2004, 10, 623–633.)

The Neuropsychological Evaluation of the Child. Ida Sue Baron. 2004. New York: Oxford University Press. 454 pp., $79.95 (HB).

It is with extreme pleasure that I write a review of this outstanding text, and also pride that I was selected to be the reviewer. When Dr. Lezak mailed me the book with a request to write a review for JINS, I literally called her and thanked her for this opportunity. I should note, this was not because I would receive a complimentary copy of The Neuropsychological Evaluation of the Child, as I had already purchased and read the text, and ordered an additional copy for my clinic and trainees' access. Dr. Baron has provided those of us in the field of child/pediatric neuropsychology with has long been needed: a general background on clinical issues in conducting neurocognitive assessments with children and adolescents, along with practical matters and concerns, such as how to cope with the varying needs of different referral sources, and providing feedback to parents. Moreover, and most essential, the text comprehensively reviews neuropsychological measures under all cognitive domains, and presents exhaustively researched historical and current normative data for the developmental population. This compilation is an excellently written book that is comprehensive, detailed, current, thoughtful, and an invaluable reference for every child and pediatric neuropsychologist. Indeed, our colleagues who specialize in adult neuropsychological evaluations would well benefit from reading the text because the clinical insights are germane to all ages, and the normative data will enrich their understanding of brain function and progression throughout the development years.

Marian Annett's recent book on handedness and cerebral dominance was published a dozen years after Efron's (1990) declaration that the era of hemispheric specialization had ended. Why did that era not end for Annett? One answer is that Annett's work differed from that of the majority of laterality researchers. Even during the heyday of laterality studies, Annett remained aloof from the mainstream endeavor of characterizing left- and right-hemisphere functions. Instead, Annett pursued a line of laterality research that dealt primarily with handedness in the general population. She accumulated large quantities of data about human handedness and used those data to support her right-shift (RS) theory of the genetics of handedness. With the publication of her new book, the interested reader has convenient access to the fruits of a remarkably focused and durable research career.

In an uncertain world, people and other animals make their living by predicting which of alternative courses of action is likely to yield the best return. For humans the return might take many forms, such as material, financial, social, or esthetic, but the underlying currency involved for any species is “inclusive fitness,” the rate at which an animal's genes are propagated. Professor Glimcher demonstrates that Economics methods are applicable to decision-making under conditions of uncertainty, both at the behavioral and the neuronal level. This approach has been called neuro-economics, although “econometrics” characterizes it more precisely. Econometrics is the application of statistical and mathematical methods in the field of economics to test and quantify economic theories and the solution to economic problems. Specifically, individuals' decision-making benefits from knowing how likely a response is to be reinforced, and knowing the reinforcement's value. Even single neurons are sensitive to these variables. Glimcher reaches beyond the heavily studied neural substrate for sensation and response to predictive neural circuitry that factors in the prior probability of reward, and its expected value. Indeed, he and his colleagues have identified neurons in monkey's inferior parietal lobule whose firing rates reflect both probability and value.

Cognitive evaluation in developing countries is a difficult undertaking due to low levels of schooling and particularly the illiteracy still frequent in the elderly. This study was part of the epidemiologic evaluation of dementia in Catanduva, Brazil, and had the objective of comparing the performance of illiterate and literate nondemented elderly individuals in 2 tests of long-term memory—the delayed recall of a word list from the CERAD and the delayed recall of common objects presented as simple drawings from the Brief Cognitive Screening Battery (BCSB). Fifty-one elderly subjects (23 illiterates) were evaluated, and the performance of the illiterates and literates differed in the CERAD memory test, but not in the BCSB memory test. This test may be more suitable for the assessment of long-term memory in populations with a high frequency of illiterates, and therefore might prove to be a useful screening tool for the diagnosis of dementia. (JINS, 2004, 10, 634–638.)

In Search of Madness: Schizophrenia and Neuroscience, by Walter Heinrichs. (2001). New York: Oxford University Press. 368 pp., $19.95.

In Search of Madness: Schizophrenia and Neuroscience is a concise but thorough and even-handed review of the current status of research in schizophrenia. It is an amalgam of research studies distributed across numerous domains relevant to schizophrenia and represents a much expanded version of his 1993 review article in the American Psychologist. In particular, the book synthesizes aspects of neuropsychological functioning, genetic, behavioral and genetic markers, and the neurochemistry of schizophrenia with information on etiology and overt symptoms of the illness. One potentially controversial and central feature of this book is Heinrich's argument that schizophrenia is not one single illness but a heterogeneous syndrome. Heinrichs' rationale for conducting research on the studies is to exemplify the discrepancies between what researchers claim to be “common symptoms” of schizophrenia. For each topic covered, Heinrichs and colleagues combined all relevant research studies between 1980 and 1999 and performed a meta-analysis to better explain the overall status of such research. For example, regarding attention deficits on the Continuous Performance Test, he grouped all studies together between 1980 and 1999 and matched the studies according to patient sample (schizophrenia patients and controls) and measure used (the Identical Pairs version of the CPT). He then calculated the effect size to determine the variance attributed to the identified construct. This meticulous method was employed for each phenomenon that was examined.

Hepatitis C virus (HCV) can be detected in the brain (Radkowski et al., 2002) and investigators speculate that HCV has neuroinvasive properties (Forton et al., 2003) with direct effects on cerebral function. MRS studies show that the basal ganglia and white matter of individuals with HCV have abnormal choline/creatine ratios, indicating CNS inflammation or infection (Forton et al., 2003). Patients with HCV show defects in working memory and information processing speed (Forton et al., 2003; Hilsabeck et al., 2002), similar to patients with basal ganglia disorders and HIV (e.g., Heaton et al., 1995).

I have always enjoyed doing book reviews and my task is easier when the book holds my interest and leaves me with a favorable impression. I was excited to review Matter of Mind as I enjoy reading anecdotes and clinical vignettes from outstanding neuroscientist and seasoned clinicians. The prospect of gaining some insight into the mind of Ken Heilman was a draw to me! I read the first edition of Heilman and Valenstein (1979) when I was in graduate school; the subsequent two editions hold prominent places on my office bookshelves. I eagerly embarked upon my review of this book, loaded as it appeared to be with rich clinical and scientific material.

The Handbook of Cognitive Neuropsychology: What Deficits Reveal About the Human Mind. Brenda Rapp (Ed.). 2001. Philadelphia: Psychology Press. 652 pp., $41.95 (PB).

Traditionally, research findings in cognitive neuropsychology have been used as theoretical bench marks for research in other areas of psychology attempting to explain brain-behavior relationships. Several branch disciplines in the behavioral sciences have used knowledge gained through studies in cognitive neuropsychology not only to help support theories developed in their respective areas, but also to advance more in-depth frameworks to better understand human behavior. However, within recent years there has tended to be greater emphasis placed on understanding what areas of the brain are involved in general cognitive functions, and researchers have tended to forget the intricacies of cognition. The explosion in the use of fMRI and other functional imaging techniques has helped to deemphasize the importance of understanding how cognitive processes can fractionate along important theoretical lines. As a result, we are often confronted with research that is devoid of theory and does little to advance our understanding of how the brain and mind work. In her edited book, The Handbook of Cognitive Neuropsychology: What Deficits Reveal About the Human Mind, Brenda Rapp has admirably assembled a collection of chapters that reminds us of the importance of how neurological patients can inform us about the mind, and, in my opinion, how such findings can and should be used to provide a theoretical road map to understanding brain-behavior relationships.

Pathways to Prominence in Neuropsychology: Reflections of Twentieth-Century Pioneers. Anthony Y. Stringer, Eileen L. Cooley, and Anne-Lise Christensen, 2002. New York: Psychology Press. 324 pp., $64.95.

Pathways to Prominence in Neuropsychology discusses the origin and development of research and clinical neuropsychology in the 20th century. This is an important first book to help us better understand where we have been, where we are, where we are going and who we are, but be forewarned that the writer of this review is extremely biased, believing that history is both interesting and potentially useful to enlighten our individual and collective journeys. The writing of history, its facts and interpretations, is fraught with challenges and pitfalls, especially when looking at ourselves. As the American humorist Herb Shiner once said, “Nothing has changed the course of history as much as the historian.

This study tested the hypothesis that the hippocampus has a relatively specific role in retaining information over delays. Thirty-seven subjects with probable Alzheimer's disease were evaluated with a verbal memory task and structural MRI. Cortical gray matter but not hippocampal volume predicted immediate free recall. In contrast, hippocampal volume was the best predictor of how well information was retained over a delay, even after controlling for levels of immediate recall. Results suggest that the role of the hippocampus is relatively specific to the consolidation of new memories. (JINS, 2004, 10, 639–643.)

A critical endeavor in every health-related field is the continued development of new technologies and instrumentation for improving diagnosis and treatment. For example, the field of neuroimaging has made astonishing advances with procedures such as functional MRI, MR spectroscopy, and MR diffusion tensor imaging. The field of neuropsychology has also recognized the importance of continually striving to develop new, more sensitive clinical measures. At the same time, the development of new tests or procedures does not guarantee that the instruments represent improvements in diagnosis or treatment. For this reason, ongoing studies of reliability and validity of new diagnostic instruments are also an important part of research in all health-related fields.

Minutes from the Thirty-Second Annual International Neuropsychological Society Meeting: Baltimore, Maryland

Members Present: Erin Bigler, Jason Brandt, Gordon Chelune, H. Branch Coslett, Bruce Crosson, Ritva Laaksonen, Ann Marcotte, Daniel Tranel, Faraneh Vargha-Khadem, Elizabeth Warrington, Ann Watts, Robert Bornstein (ex officio)

Members Absent: Lucia Braga, Leslie Gonzalez-Rothi, Sandra Weintraub