The last two decades have seen a dramatic increase in the number of published neuropsychological studies. Nowhere is this more evident than in the investigation of the psychological consequences of degenerative brain diseases. Studies on the biological, neuropsychological, and social changes resulting from such disorders as Alzheimer's disease, multiple sclerosis, and Huntington's disease abound. This book is primarily a survey of the neuropsychological research focused on these chronic neurological conditions. My objective is to make this research more accessible to clinicians who work with patients who have degenerative brain diseases and to students encountering these patients in the course of their training.
The motivation to review this work came from my involvement in studies of the cognitive function of patients with brain disorders. Much of our present knowledge of cognitive systems and functional neuroanatomy comes from the experimental study of patients with brain lesions. However, from the outset it must be acknowledged that my perspective is that of a clinical psychologist, concerned with all aspects of the impact of brain damage on the lives of those affected. Consequently, I have interpreted neuropsychology in a broad way to allow inclusion of studies of the psychosocial consequences of brain changes for both patients and their caregivers. All clinicians involved with the management of braininjured clients in any capacity will be aware that there is more to working with such clients than documenting their cognitive deficits. The neuropsychological consequences of brain disorders need to be placed in the psychosocial context of individual clients and their families if interventions and support are to be effectively planned. I have endeavored to make this a significant theme of each chapter.
In the first part of this book, the range of neuropsychological measures available for the assessment of patients with degenerative brain diseases are introduced. In Part 2, research involving patients with degenerative diseases is considered. The biological basis of each disorder, and the consequent neuropsychological and psychosocial deficits, are reviewed in turn. Each of the diseases reviewed herein has its own unique clinico-pathological character, causing different psychological effects, and providing different adaptive challenges. Alzheimer's disease causes a pervasive dementia, and a progressive loss of insight, but few motor or physical deficits. In amytrophic lateral sclerosis and progres-