The Behavioral Neurology of White Matter (PDF)

Behavioral neurology is founded on lesions of cortical gray matter, but recently the contributions of cerebral white matter to cognitive and emotional dysfunction have also attracted attention. The Behavioral Neurology of White Matter surveys this broad and fascinating field from a clinical perspective. Stimulated by recent improvements in neuroimaging, white matter has been carefully studied, and its role in the operations of cognition and emotion clarified by correlations with clinical observations. The relevance of normal and abnormal white matter to behavioral neurology is apparent in every context where this question has been examined: in development, aging, and in a host of diseases, intoxications, and injuries. Since the first edition of this book in 2001, steady advances have been made in understanding the neurobiology of white matter and its clinical significance; this edition provides a comprehensive update on this rapidly expanding field. Every chapter has been extensively rewritten, including a comprehensive revision of the account of the neuropsychiatry of white matter, a particularly challenging area. The syndrome of white matter dementia is discussed in detail, and its refinement with new information is considered along with the proposal of mild cognitive dysfunction as a precursor syndrome in many clinical settings. In addition, two new chapters have been added, one on the emerging area of white matter changes associated with neurodegenerative disorders such Alzheimer's Disease, and another on neurologic aspects of white matter including intriguing new information on white matter plasticity. A unifying theme is the concept of connectivity, as it is clear the white matter forms an essential component of the widespread distributed neural networks by which cognition and emotion are organized. In addition to the microconnectivity within gray matter that subserves information processing, the macroconnectivity of white matter enables information transfer - both are critical for the functions of the human mind.