Bowers et al. (2006) cite my 1984 review of the neuropsychology of facial expression (Rinn, 1984) as “the underlying impetus” for their recent investigation of facial expression in Parkinson's disease (PD). In that paper, I noted that impaired basal ganglia function in PD results in diminished spontaneous expressive facial movements, yet it produces no true paralysis for volitionally induced facial movements. Bowers et al. take my statements a step further: “According to Rinn (1984), patients with Parkinson's disease (PD) have little difficulty posing facial emotions when explicitly told to do so. They just fail to do so spontaneously.” They also quote me as describing Parkinson's disease as “the ‘model system’ for subcortical, basal ganglia influences on facial expression.” Bowers then goes on to demonstrate that the facial expression deficiencies of PD patients are not confined to a lack of spontaneous emotional movements (the masked face), and that volitionally posed facial expressions in PD are also aberrant [i.e., slow (bradykinesic) and of diminished amplitude].

Mild Cognitive Impairment: International Perspectives. Holly A. Tuokko and David F. Hultsch (Eds.). 2006. New York: Taylor & Francis, 319 pp., $99.00 (HB).

As neuropsychologists, it is our job to differentiate normal from abnormal. We act as arbiters of behavior, defining “impairments” and using normative data and estimates of premorbid functioning to delineate post-injury or post-disease decline. Although one is obviously inclined to steer the diagnostic process in such a way as to comply with the prevailing taxonomy, because of the categorical nature of our classification system, this task is most difficult at the border zones, those areas that lie somewhere between “normal” and “abnormal.” The categories applicable to “abnormal ageing” have varied greatly over the years and are still evolving. Mild cognitive impairment or MCI is one such border zone category, which is believed to be a precursor to dementia in some patients. As with most border zone diagnostic entities, those patients at the cusp of the border will always be most difficult to classify. There will be certain low functioning “normal” people who score marginally low on our tests. Likewise, there will be certain high functioning “abnormal” people who score similarly. Even when the line is drawn with confidence and the MCI diagnosis is rendered, what does one impart to the patient about prognosis given the lack of clear relationship between the diagnosis and conversion to dementia, as well as the lack of clear relationship between the diagnosis and underlying brain pathology? It is a difficult and uncomfortable label because we know that a certain percentage we assign this moniker will “get better” (or is it regression to the mean?), become demented (or do they have less cognitive reserve?), or stay the same (or do they have more cognitive reserve?). The research literature behind abnormal ageing is incredibly diverse with regard to populations studied, methods of assessment, cut-offs utilized, nature and number of cognitive domains considered, and the extent to which subjective patient complaints are considered. As the heterogeneity in this construct becomes more apparent, there is need to increase the number of available labels as evidenced by evolving concepts like “amnestic MCI.” Thus, from a historical and clinical perspective, applying the term “MCI” is a bit like throwing a rock at a moving target.

The Neuroscience of Human Relationships: Attachment and the Developing Social Brain, by Louis Cozolino. 2006. New York: W.W. Norton & Co., 272 pp., $35.00 (HB).

It is not often that one picks up a book where the author illustrates points by using scientific data gathered through the use of the world's most sophisticated technologies, and experiences in a martial art founded on principles of harmonizing with energy fields. The discipline of psychology has developed over the decades into numerous branches (just see the list of divisions for the American Psychological Association), each of which has focused on exploring a topic deeply. The trade-off for this depth of knowledge or understanding, unfortunately, has often been a decided lack of cross-pollination from other branches. Louis Cozolino attempts to bring together two worlds, that of data-driven neuroscience and of subjective, introspective, relationship-oriented psychotherapy. And, whereas there are places where he may not be completely successful, it makes for a very interesting read.

The Clinical Neuropsychiatry of Stroke: Cognitive, Behavioral, and Emotional Disorders following Vascular Brain Injury. Second Edition, by Robert G. Robinson. 2006. Cambridge, UK: Cambridge University Press, 470 pp., $150.00 (HB)

Many researchers have explored the development of emotional and psychiatric disorders following stroke. Few individuals, however, have dedicated years of clinical research to the topic or have the depth of knowledge required to critically evaluate the existent large body of literature. In the second edition of The Neuropsychiatry of Stroke, Dr. Robert Robinson eloquently summarizes and reviews major findings, including his own work and that of other investigators of emotional and psychiatric functioning after stroke and other brain injuries. In the first edition of The Clinical Neuropsychiatry of Stroke (1998), Robinson explored factors associated with the development of neuropsychiatric disorders following stroke. In this second edition, the original text is updated with recent studies on the development of neuropsychiatric disorders, such as poststroke depression, mania, and anxiety. A cogent argument is presented for a second edition, noting that the number of publications related to poststroke depression alone between 1998 and 2004 had more than doubled compared to the prior 7-year period (1990 to 1997).