Editorial - Hindawi

Editorial

Up to the earlier part of this century, neurology and psychiatry were recognised as closely overlapping clinical disciplines but in later decades the two specialities had an uneasy relationship in the United Kingdom and the United States (although not so much in the rest of Europe). More recently, several independent changes have each contributed to a greater reunion between them. Pioneered by Norman Geschwind and others, neurology has increasingly recognised and studied the mechanisms by which brain disease affects behaviour; such effects are sometimes remarkably selective. Over roughly the same period, neuropsychology has developed as a powerful basic science to investigate the brain organisation of memory, cognition and behaviour. The ability to understand the biological processes involved in brain function has catalysed a shift in psychiatry to a much more biological approach. To some extent, professionals have sought to maintain independence of activity. Thus, the last twenty years have seen the growth of subdisciplines of behavioural neurology, cognitive neurology, biological psychiatry and neuropsychiatry, amongst others, and much discussion has taken place in attempting to define the boundaries of these subdisciplines. Indeed, the British Neuropsychiatry Association recently canvassed its members on their views on the distinctions between these subdisciplines. In truth, however, they are all united by the common goal of attempting to understand the biological basis of behaviour in its most global sense.

Behavioural Neurology was initiated by Dr Andrew Lees as Foundation Editor in full recognition of this shift in approach of neurologists and psychiatrists in order to represent a common clinical ground that was poorly represented in the journals at that time. Despite the clear need for greater input of clinicians into behavioural neurology, and the need to integrate independent but related disciplines, however, it remains true that, until recently, this section of neurology received inadequate attention, particularly in the UK. My personal thanks and congratulations go out to Andrew, therefore, for his success in initiating the Journal in the first place and nurturing its steady but progressive development. In conjunction with Rapid Communications of Oxford as publishers, Behavioural Neurology is now a high quality publication which is attracting substantial numbers of good manuscripts. I am delighted that Andrew has chosen to remain on the Editorial Board and I hope to continue to profit from his experience.

The strengths of Behavioural Neurology need to be built upon by one further process of integration. Anyone working in clinical medicine will recognise the difficulty in bringing together different clinical specialities. It is at least as great a step to bring together the activities of clinicians and basic scientists, an observation that is reflected, in general, in the widely different readerships of different specialist journals and attendances at different specialist conferences. The subspecialities of clinical medicine involved in understanding abnormal brain function can be complemented by a parallel list of subspecialities of basic science involved in the study of cognitive neuroscience, cognitive psychology, neuropsychology, psychophysiology and psychopharmacology. Evidence is also taken from broader specialities including neuropathology, neurochemistry, neuroimaging and neurophysiology. Human cognitive neuroscience is an explosive research area, not only because of improved technologies to investigate brain function in vivo, but also because of recognition of the strength of interdisciplinary research across relevant clinical and basic science subspecialities.

Behavioural Neurology needs to recognise these developments. Under my editorship, therefore, I strive to build upon the strengths of the Journal established so far by attracting papers that cut across the disciplines of clinical medicine and basic science and to assist me in this task I have invited Professor Andrew Mayes to join me as an Associate Editor. We continue to welcome papers primarily from behavioural neurology, neuropsychiatry and neuropsychology. However, we also seek submissions which link an understanding of specific aspects of cognition and behaviour with an analysis of underlying biological mechanisms. Most readers of the Journal would need little exposition of this concept: neuroimaging techniques have provided major advances in our ability to analyse regional brain function during the conduct of a cognitive or motor task; psychopharmacology has been the tool to investigate the neurochemical basis of specific cognitive processes; and psychophysiology and neurophysiology have provided evidence on the physiological basis of specific cognitive processes. These are all major growth areas and the Journal would welcome submissions from these disciplines. In other areas, integration is less well developed. For example, whilst neuropathology is critical to our understanding of human cognitive disorders, disappointingly seldom have links been established between specific cognitive dysfunction in life and the neuropathological findings after death. Techniques of molecular medicine are allowing us to define genetic and metabolic markers for human disease but the techniques have so far only begun to scratch the surface

of defining predisposition to cognitive failure. A genetic basis for some, if not all, forms of Alzheimer's disease appears clear but further work is required to explain for example why some chronic alcoholics develop Korsakoff's syndrome and others do not, why some people with Herpes simplex virus develop encephalitis and others do not, why Lewy bodies spread to the cortex in some patients with Parkinson's disease but not others; and why some individuals suffer age-related cognitive decline more than others. Molecular medicine may well assist us in these goals. In recognition of all of these developments, we would wish Behavioural Neurology to be a journal that is read by both clinicians and basic scientists involved in the study of human cognitive disorders.

Against this background, we are delighted to devote the first volume under the new editorship to the abstracts of the conference on Dementia in Parkinson's disease which takes place in Jerusalem, Israel in March 1994 as an official satellite symposium of the International Symposium of Parkinson's Disease. We are also pleased to delegate editorship of this volume to Professor Amos Korczyn who is the organiser of that conference. In the longer term, we look to an expansion that parallels the clinical and research areas that the Journal serves.

H.1. Sagar Editor

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