: The Neurobehavioral Consequences of Multiple Sclerosis

Abstract

Jenna has multiple sclerosis, and her life journey is one of the stories that are worth narrating. During one of her visits to her consultant’s office, she paused and looked wistfully out the ground-floor office window. ‘It was now late September, and on this cloudless, chilly day, the maple was in full fall foliage. “How lovely”, she murmured to herself, her gaze arrested by the blaze of color. She fell silent, a shaft of late afternoon sunlight falling across her finely chiseled features, the subtle interplay of light and shadow accentuating her melancholy with Caravaggio-like effect’. Finding references to Caravaggio’s style and even poetic alliterations (‘full fall foliage’) does not often happen within medical writings. However, this is arguably a representative sample from Anthony Feinstein’s new book on the neuropsychiatry of multiple sclerosis. Feinstein is equally talented as a clinician and as a writer. As a clinical scientist, he is a world-renown neuropsychiatrist who needs no introduction. His clinical activity at the multiple sclerosis clinic spans three decades: during that time he has assessed and treated thousands of people. He has painstakingly collected their unique life stories, which share the challenge presented by living with multiple sclerosis. By his own admission, he has created the fictional people who populate his new book ‘by reworking, modifying, altering, combining, trimming, expanding, and reinventing the gist of these real-life stories’. Feinstein’s eloquent case histories focus on the psychiatric disorders that often accompany the neurological manifestations of multiple sclerosis: from the peculiar affective symptoms (pseudobulbar affect) to the kaleidoscopic changes in personality and behaviour. The most commonly reported cognitive difficulties – slowed information processing speed, impaired memory, and deficits in executive function – are presented in real-life scenarios, illustrating the impact on people’s everyday activities. Endorsed by the Consortium of Multiple Sclerosis Centers, this book also provides tailored recommendations for evidence-based therapeutic interventions. The comprehensive and up-to-date reference list at the end of the volume reflects its alignment with the latest science. Mind, Mood, and Memory: The Neurobehavioral Consequences of Multiple Sclerosis ideally complements Feinstein’s previous volume, titled The Clinical Neuropsychiatry of Multiple Sclerosis (1999). Any health professional involved in the care of people with multiple sclerosis would benefit from reading these books, regardless of their specialty. Thanks to Feinstein’s engaging and accessible style, his latest effort is equally appealing to people with multiple sclerosis and their families. Andrea E. Cavanna , Michael Trimble Neuropsychiatry Research Group, Birmingham and Solihull Mental Health NHS Foundation Trust and University of Birmingham, UK; School of Life and Health Sciences, Aston University, UK; and Sobell Department of Motor Neuroscience and Movement Disorders, UCL and Institute of Neurology, UK. Email: a.cavanna@nhs.net