Appreciating the Neurocognitive and Neuropsychiatric Impact of Movement Disorders

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.