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Self-blame in major depression: a randomised pilot trial comparing fMRI neurofeedback with self-guided psychological strategies
- Tanja Jaeckle, Steven C. R. Williams, Gareth J. Barker, Rodrigo Basilio, Ewan Carr, Kimberley Goldsmith, Alessandro Colasanti, Vincent Giampietro, Anthony Cleare, Allan H. Young, Jorge Moll, Roland Zahn
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- Journal:
- Psychological Medicine / Volume 53 / Issue 7 / May 2023
- Published online by Cambridge University Press:
- 02 December 2021, pp. 2831-2841
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Background
Overgeneralised self-blame and worthlessness are key symptoms of major depressive disorder (MDD) and have previously been associated with self-blame-selective changes in connectivity between right superior anterior temporal lobe (rSATL) and subgenual frontal cortices. Another study showed that remitted MDD patients were able to modulate this neural signature using functional magnetic resonance imaging (fMRI) neurofeedback training, thereby increasing their self-esteem. The feasibility and potential of using this approach in symptomatic MDD were unknown.
MethodThis single-blind pre-registered randomised controlled pilot trial probed a novel self-guided psychological intervention with and without additional rSATL-posterior subgenual cortex (BA25) fMRI neurofeedback, targeting self-blaming emotions in people with insufficiently recovered MDD and early treatment-resistance (n = 43, n = 35 completers). Participants completed three weekly self-guided sessions to rebalance self-blaming biases.
ResultsAs predicted, neurofeedback led to a training-induced reduction in rSATL-BA25 connectivity for self-blame v. other-blame. Both interventions were safe and resulted in a 46% reduction on the Beck Depression Inventory-II, our primary outcome, with no group differences. Secondary analyses, however, revealed that patients without DSM-5-defined anxious distress showed a superior response to neurofeedback compared with the psychological intervention, and the opposite pattern in anxious MDD. As predicted, symptom remission was associated with increases in self-esteem and this correlated with the frequency with which participants employed the psychological strategies in daily life.
ConclusionsThese findings suggest that self-blame-rebalance neurofeedback may be superior over a solely psychological intervention in non-anxious MDD, although further confirmatory studies are needed. Simple self-guided strategies tackling self-blame were beneficial, but need to be compared against treatment-as-usual in further trials. https://doi.org/10.1186/ISRCTN10526888
Neuroanatomical changes in people with high schizotypy: relationship to glutamate levels
- Gemma Modinos, Alice Egerton, Anna McLaughlin, Katrina McMullen, Veena Kumari, David J. Lythgoe, Gareth J. Barker, André Aleman, Steve C. R. Williams
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- Journal:
- Psychological Medicine / Volume 48 / Issue 11 / August 2018
- Published online by Cambridge University Press:
- 04 December 2017, pp. 1880-1889
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Background
Cortical glutamatergic dysfunction is thought to be fundamental for psychosis development, and may lead to structural degeneration through excitotoxicity. Glutamate levels have been related to gray matter volume (GMV) alterations in people at ultra-high risk of psychosis, and we previously reported GMV changes in individuals with high schizotypy (HS), which refers to the expression of schizophrenia-like characteristics in healthy people. This study sought to examine whether GMV changes in HS subjects are related to glutamate levels.
MethodsWe selected 22 healthy subjects with HS and 23 healthy subjects with low schizotypy (LS) based on their rating on a self-report questionnaire for psychotic-like experiences. Glutamate levels were measured in the bilateral anterior cingulate cortex (ACC) using proton magnetic resonance spectroscopy, and GMV was assessed using voxel-based morphometry.
ResultsSubjects with HS showed GMV decreases in the rolandic operculum/superior temporal gyrus (pFWE = 0.045). Significant increases in GMV were also detected in HS, in the precuneus (pFWE = 0.043), thereby replicating our previous finding in a separate cohort, as well as in the ACC (pFWE = 0.041). While the HS and LS groups did not differ in ACC glutamate levels, in HS subjects ACC glutamate was negatively correlated with ACC GMV (pFWE = 0.026). Such association was absent in LS.
ConclusionsOur study shows that GMV findings in schizotypy are related to glutamate levels, supporting the hypothesis that glutamatergic function may lead to structural changes associated with the expression of psychotic-like experiences.
Contributors
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- By Christoph Bachhuber, Maria Carme Belarte, Anna Maria Bietti Sestieri, Emma Blake, Helena Bonet-Rosado, Shlomo Bunimovitz, Despina Catapoti, John F. Cherry, Derek B. Counts, Mariassunta Cuozzo, Marian H. Feldman, Kevin D. Fisher, Lin Foxhall, Michael L. Galaty, Raphael Greenberg, Alessandro Guidi, Yannis Hamilakis, Ömür Harmanşah, Tamar Hodos, Sarah Janes, Morag M. Kersel, Carl Knappett, Zvi Lederman, Thomas P. Leppard, Katina T. Lillios, Consuelo Mata-Parreño, Sandra Montón Subías, Irene Nikolakopoulou, Massimo Osanna, Giulio Palumbi, John K. Papadopoulos, William A. Parkinson, Mieke Prent, Damià Ramis, Corinna Riva, R. Gareth Roberts, Alonso Rodríguez Díaz, Marisa Ruiz-Gálvez, Joan Sanmartí, Davide Tanasi, Helena Tomas, Carlo Tronchetti, Nicholas C. Vella, Jaime Vives-Ferrándiz Sánchez, Jennifer M. Webb, Yuval Yekutieli
- Edited by A. Bernard Knapp, University of Glasgow, Peter van Dommelen, Brown University, Rhode Island
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- Book:
- The Cambridge Prehistory of the Bronze and Iron Age Mediterranean
- Published online:
- 18 December 2014
- Print publication:
- 12 January 2015, pp xiii-xvi
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- By Iftikhar Ahmed, Chris Allen, Sani H. Aliyu, Pawel Bogucki, Darshan H. Brahmbhatt, Ewen Cameron, Peter M. F. Campbell, Jane Chalmers, Wendy Chamberlain, Tony Coll, Gareth Corbett, Julia Czuprynska, Carla Davies, Mark Dayer, Edward Fathers, Mark Fish MD MRCP, Zoë Fritz MA MRCP, Jonathan Fuld, Luke Gompels, Daniel E. Greaves, Emma Greig, Stephen Haydock, Matthew R. Hayman, Jonathan Hills, John Kalk, Catherine Laversuch, Cliff Mann, Deepak Mannari, Rudi Matull, Marko Nikolić, Marguerite Paffard, Kate R. Petheram, Lucy Pollock, Kobus Preller, Christopher J. S. Price, Peter J. Pugh, Charlotte Rutter, Gillian Sims, Robert A. Stone, David Tate, Paul D. Thomas, Satish Thomas William, Andrew Thompson, Marianne Tinkler, Gareth Walker, Stuart Walker, Nic Wenninke, Christopher Westall, Duncan Whitehead, Rob Whiting, Penny Williams, Cally Williamson, Mohamed Yousuf
- Edited by Stephen Haydock, Duncan Whitehead, Zoë Fritz
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- Book:
- Acute Medicine
- Published online:
- 05 November 2014
- Print publication:
- 30 October 2014, pp viii-x
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- By Tom Abbott, Gareth L. Ackland, Hollman D. Aya, Berthold Bein, Karim Bendjelid, Matthieu Biais, Elizabeth J. Bridges, Maxime Cannesson, Cédric Carrié, Alice Carter, Maurizio Cecconi, Daniel Chappell, Jason H. Chua, Gary Colins, Diego Orbegozo Cortes, Lester A. H. Critchley, Daniel De Backer, Katia Donadello, Eric Edison, Byron D. Fergerson, Tong J. Gan, Michael T. Ganter, Leslie M. Garson, Christoph K. Hofer, Christoph Ilies, James M. Isbell, Matthias Jacob, Mazyar Javidroozi, Zeev N. Kain, Elisa Kam, Gautam Kumar, Yannick Le Manach, Sheldon Magder, Aman Mahajan, Gerard R. Manecke, Paul E. Marik, Joseph Meltzer, Debra R. Metter, Timothy E. Miller, Xavier Monnet, Michael Mythen, Rudolph Nguyen, Rupert Pearse, Michael R. Pinsky, Davinder Ramsingh, Steffen Rex, Andrew Rhodes, Joseph Rinehart, Mathieu Sèrié, Aryeh Shander, Nils Siegenthaler, Ann B. Singleton, Faraz Syed, Jean-Louis Teboul, Robert H. Thiele, Shermeen B. Vakharia, Trung Vu, Nathan H. Waldron, David Walker, William Wilson
- Edited by Maxime Cannesson, University of California, Irvine, Rupert Pearse
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- Book:
- Perioperative Hemodynamic Monitoring and Goal Directed Therapy
- Published online:
- 05 September 2014
- Print publication:
- 04 September 2014, pp vii-x
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- By Frank Andrasik, Melissa R. Andrews, Ana Inés Ansaldo, Evangelos G. Antzoulatos, Lianhua Bai, Ellen Barrett, Linamara Battistella, Nicolas Bayle, Michael S. Beattie, Peter J. Beek, Serafin Beer, Heinrich Binder, Claire Bindschaedler, Sarah Blanton, Tasia Bobish, Michael L. Boninger, Joseph F. Bonner, Chadwick B. Boulay, Vanessa S. Boyce, Anna-Katharine Brem, Jacqueline C. Bresnahan, Floor E. Buma, Mary Bartlett Bunge, John H. Byrne, Jeffrey R. Capadona, Stefano F. Cappa, Diana D. Cardenas, Leeanne M. Carey, S. Thomas Carmichael, Glauco A. P. Caurin, Pablo Celnik, Kimberly M. Christian, Stephanie Clarke, Leonardo G. Cohen, Adriana B. Conforto, Rory A. Cooper, Rosemarie Cooper, Steven C. Cramer, Armin Curt, Mark D’Esposito, Matthew B. Dalva, Gavriel David, Brandon Delia, Wenbin Deng, Volker Dietz, Bruce H. Dobkin, Marco Domeniconi, Edith Durand, Tracey Vause Earland, Georg Ebersbach, Jonathan J. Evans, James W. Fawcett, Uri Feintuch, Toby A. Ferguson, Marie T. Filbin, Diasinou Fioravante, Itzhak Fischer, Agnes Floel, Herta Flor, Karim Fouad, Richard S. J. Frackowiak, Peter H. Gorman, Thomas W. Gould, Jean-Michel Gracies, Amparo Gutierrez, Kurt Haas, C.D. Hall, Hans-Peter Hartung, Zhigang He, Jordan Hecker, Susan J. Herdman, Seth Herman, Leigh R. Hochberg, Ahmet Höke, Fay B. Horak, Jared C. Horvath, Richard L. Huganir, Friedhelm C. Hummel, Beata Jarosiewicz, Frances E. Jensen, Michael Jöbges, Larry M. Jordan, Jon H. Kaas, Andres M. Kanner, Noomi Katz, Matthew S. Kayser, Annmarie Kelleher, Gerd Kempermann, Timothy E. Kennedy, Jürg Kesselring, Fary Khan, Rachel Kizony, Jeffery D. Kocsis, Boudewijn J. Kollen, Hubertus Köller, John W. Krakauer, Hermano I. Krebs, Gert Kwakkel, Bradley Lang, Catherine E. Lang, Helmar C. Lehmann, Angelo C. Lepore, Glenn S. Le Prell, Mindy F. Levin, Joel M. Levine, David A. Low, Marilyn MacKay-Lyons, Jeffrey D. Macklis, Margaret Mak, Francine Malouin, William C. Mann, Paul D. Marasco, Christopher J. Mathias, Laura McClure, Jan Mehrholz, Lorne M. Mendell, Robert H. Miller, Carol Milligan, Beth Mineo, Simon W. Moore, Jennifer Morgan, Charbel E-H. Moussa, Martin Munz, Randolph J. Nudo, Joseph J. Pancrazio, Theresa Pape, Alvaro Pascual-Leone, Kristin M. Pearson-Fuhrhop, P. Hunter Peckham, Tamara L. Pelleshi, Catherine Verrier Piersol, Thomas Platz, Marcus Pohl, Dejan B. Popović, Andrew M. Poulos, Maulik Purohit, Hui-Xin Qi, Debbie Rand, Mahendra S. Rao, Josef P. Rauschecker, Aimee Reiss, Carol L. Richards, Keith M. Robinson, Melvyn Roerdink, John C. Rosenbek, Serge Rossignol, Edward S. Ruthazer, Arash Sahraie, Krishnankutty Sathian, Marc H. Schieber, Brian J. Schmidt, Michael E. Selzer, Mijail D. Serruya, Himanshu Sharma, Michael Shifman, Jerry Silver, Thomas Sinkjær, George M. Smith, Young-Jin Son, Tim Spencer, John D. Steeves, Oswald Steward, Sheela Stuart, Austin J. Sumner, Chin Lik Tan, Robert W. Teasell, Gareth Thomas, Aiko K. Thompson, Richard F. Thompson, Wesley J. Thompson, Erika Timar, Ceri T. Trevethan, Christopher Trimby, Gary R. Turner, Mark H. Tuszynski, Erna A. van Niekerk, Ricardo Viana, Difei Wang, Anthony B. Ward, Nick S. Ward, Stephen G. Waxman, Patrice L. Weiss, Jörg Wissel, Steven L. Wolf, Jonathan R. Wolpaw, Sharon Wood-Dauphinee, Ross D. Zafonte, Binhai Zheng, Richard D. Zorowitz
- Edited by Michael Selzer, Stephanie Clarke, Leonardo Cohen, Gert Kwakkel, Robert Miller, Case Western Reserve University, Ohio
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- Book:
- Textbook of Neural Repair and Rehabilitation
- Published online:
- 05 May 2014
- Print publication:
- 24 April 2014, pp ix-xvi
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- By Frank Andrasik, Melissa R. Andrews, Ana Inés Ansaldo, Evangelos G. Antzoulatos, Lianhua Bai, Ellen Barrett, Linamara Battistella, Nicolas Bayle, Michael S. Beattie, Peter J. Beek, Serafin Beer, Heinrich Binder, Claire Bindschaedler, Sarah Blanton, Tasia Bobish, Michael L. Boninger, Joseph F. Bonner, Chadwick B. Boulay, Vanessa S. Boyce, Anna-Katharine Brem, Jacqueline C. Bresnahan, Floor E. Buma, Mary Bartlett Bunge, John H. Byrne, Jeffrey R. Capadona, Stefano F. Cappa, Diana D. Cardenas, Leeanne M. Carey, S. Thomas Carmichael, Glauco A. P. Caurin, Pablo Celnik, Kimberly M. Christian, Stephanie Clarke, Leonardo G. Cohen, Adriana B. Conforto, Rory A. Cooper, Rosemarie Cooper, Steven C. Cramer, Armin Curt, Mark D’Esposito, Matthew B. Dalva, Gavriel David, Brandon Delia, Wenbin Deng, Volker Dietz, Bruce H. Dobkin, Marco Domeniconi, Edith Durand, Tracey Vause Earland, Georg Ebersbach, Jonathan J. Evans, James W. Fawcett, Uri Feintuch, Toby A. Ferguson, Marie T. Filbin, Diasinou Fioravante, Itzhak Fischer, Agnes Floel, Herta Flor, Karim Fouad, Richard S. J. Frackowiak, Peter H. Gorman, Thomas W. Gould, Jean-Michel Gracies, Amparo Gutierrez, Kurt Haas, C.D. Hall, Hans-Peter Hartung, Zhigang He, Jordan Hecker, Susan J. Herdman, Seth Herman, Leigh R. Hochberg, Ahmet Höke, Fay B. Horak, Jared C. Horvath, Richard L. Huganir, Friedhelm C. Hummel, Beata Jarosiewicz, Frances E. Jensen, Michael Jöbges, Larry M. Jordan, Jon H. Kaas, Andres M. Kanner, Noomi Katz, Matthew S. Kayser, Annmarie Kelleher, Gerd Kempermann, Timothy E. Kennedy, Jürg Kesselring, Fary Khan, Rachel Kizony, Jeffery D. Kocsis, Boudewijn J. Kollen, Hubertus Köller, John W. Krakauer, Hermano I. Krebs, Gert Kwakkel, Bradley Lang, Catherine E. Lang, Helmar C. Lehmann, Angelo C. Lepore, Glenn S. Le Prell, Mindy F. Levin, Joel M. Levine, David A. Low, Marilyn MacKay-Lyons, Jeffrey D. Macklis, Margaret Mak, Francine Malouin, William C. Mann, Paul D. Marasco, Christopher J. Mathias, Laura McClure, Jan Mehrholz, Lorne M. Mendell, Robert H. Miller, Carol Milligan, Beth Mineo, Simon W. Moore, Jennifer Morgan, Charbel E-H. Moussa, Martin Munz, Randolph J. Nudo, Joseph J. Pancrazio, Theresa Pape, Alvaro Pascual-Leone, Kristin M. Pearson-Fuhrhop, P. Hunter Peckham, Tamara L. Pelleshi, Catherine Verrier Piersol, Thomas Platz, Marcus Pohl, Dejan B. Popović, Andrew M. Poulos, Maulik Purohit, Hui-Xin Qi, Debbie Rand, Mahendra S. Rao, Josef P. Rauschecker, Aimee Reiss, Carol L. Richards, Keith M. Robinson, Melvyn Roerdink, John C. Rosenbek, Serge Rossignol, Edward S. Ruthazer, Arash Sahraie, Krishnankutty Sathian, Marc H. Schieber, Brian J. Schmidt, Michael E. Selzer, Mijail D. Serruya, Himanshu Sharma, Michael Shifman, Jerry Silver, Thomas Sinkjær, George M. Smith, Young-Jin Son, Tim Spencer, John D. Steeves, Oswald Steward, Sheela Stuart, Austin J. Sumner, Chin Lik Tan, Robert W. Teasell, Gareth Thomas, Aiko K. Thompson, Richard F. Thompson, Wesley J. Thompson, Erika Timar, Ceri T. Trevethan, Christopher Trimby, Gary R. Turner, Mark H. Tuszynski, Erna A. van Niekerk, Ricardo Viana, Difei Wang, Anthony B. Ward, Nick S. Ward, Stephen G. Waxman, Patrice L. Weiss, Jörg Wissel, Steven L. Wolf, Jonathan R. Wolpaw, Sharon Wood-Dauphinee, Ross D. Zafonte, Binhai Zheng, Richard D. Zorowitz
- Edited by Michael E. Selzer, Stephanie Clarke, Leonardo G. Cohen, Gert Kwakkel, Robert H. Miller, Case Western Reserve University, Ohio
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- Book:
- Textbook of Neural Repair and Rehabilitation
- Published online:
- 05 June 2014
- Print publication:
- 24 April 2014, pp ix-xvi
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- By Krista Adamek, Ana Luisa K. Albernaz, J. Marcio Ayres†, Andrew J. Baker, Karen L. Bales, Adrian A. Barnett, Christopher Barton, John M. Bates, Jennie Becker, Bruna M. Bezerra, Júlio César Bicca-Marques, Richard Bodmer, Jean P. Boubli, Mark Bowler, Sarah A. Boyle, Christini Barbosa Caselli, Janice Chism, Elena P. Cunningham, José Maria C. da Silva, Lesa C. Davies, Nayara de Alcântara Cardoso, Manuella A. de Souza, Stella de la Torre, Ana Gabriela de Luna, Thomas R. Defler, Anthony Di Fiore, Eduardo Fernandez-Duque, Stephen F. Ferrari, Wilsea M.B. Figueiredo-Ready, Tracy Frampton, Paul A. Garber, Brian W. Grafton, L. Tremaine Gregory, Maria L. Harada, Amy Harrison-Levine, Walter C. Hartwig, Stefanie Heiduck, Eckhard W. Heymann, André Hirsch, Leandro Jerusalinsky, Gareth Jones, Richard F. Kay, Martin M. Kowalewski, Shawn M. Lehman, Laura Marsh, Jesús Martinez, William A. Mason, Hope Matthews, Wynlyn McBride, Shona McCann-Wood, W. Scott McGraw, D. Jeffrey Meldrum, Sally P. Mendoza, Nohelia Mercado, Russell A. Mittermeier, Mirjam N. Nadjafzadeh, Marilyn A. Norconk, Robert Gary Norman, Marcela Oliveira, Marcelo M. Oliveira, Maria Juliana Ospina Rodríguez, Erwin Palacios, Suzanne Palminteri, Liliam P. Pinto, Marcio Port-Carvalho, Leila Porter, Carlos Portillo-Quintero, George Powell, Ghillean T. Prance, Rodrigo C. Printes, Pablo Puertas, P. Kirsten Pullen, Helder L. Queiroz, Luis Reginaldo R. Rodrigues, Adriana Rodríguez, Alfred L. Rosenberger, Anthony B. Rylands, Ricardo R. Santos, Horacio Schneider, Eleonore Z.F. Setz, Suleima S.B. Silva, José S. Silva Júnior, Andrew T. Smith, Marcelo C. Sousa, Antonio S. Souto, Wilson R. Spironello, Masanaru Takai, Marcelo F. Tejedor, Cynthia L. Thompson, Diego G. Tirira, Raul Tupayachi, Bernardo Urbani, Liza M. Veiga, Marianela Velilla, João Valsecchi, Jean-Christophe Vié, Tatiana M. Vieira, Suzanne E. Walker-Pacheco, Rob Wallace, Patricia C. Wright, Charles E. Zartman
- Edited by Liza M. Veiga, Universidade Federal do Pará, Brazil, Adrian A. Barnett, Roehampton University, London, Stephen F. Ferrari, Universidade Federal de Sergipe, Brazil, Marilyn A. Norconk, Kent State University, Ohio
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- Book:
- Evolutionary Biology and Conservation of Titis, Sakis and Uacaris
- Published online:
- 05 April 2013
- Print publication:
- 11 April 2013, pp xii-xv
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- By Richard Badenhausen, James J. Berg, John R. Boly, Richard R. Bozorth, Adrian Caesar, David Collard, Patrick Deer, Rainer Emig, Chris Freeman, Susannah Young-ah Gottlieb, Hugh Haughton, Alan Jacobs, Chris Jones, Edward Mendelson, Janet Montefiore, Steve Nicholson, Sean O’Brien, Michael O’Neill, Seamus Perry, Justin Quinn, Gareth Reeves, Stephen Regan, Michael Symmons Roberts, Tony Sharpe, Stan Smith, Andrew Thacker, Aidan Wasley, Keith Williams, Michael Wood, Gregory Woods, Matthew Worley, Tim Youngs
- Edited by Tony Sharpe, Lancaster University
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- Book:
- W. H. Auden in Context
- Published online:
- 05 February 2013
- Print publication:
- 21 January 2013, pp xi-xvi
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- By Gareth Allen, Rowan Burnstein, Mick Cafferkey, Joseph Carter, Jonathan Cole, Giles Critchley, Marek Czosnyka, Egidio J. da Silva, Bruce Downey, Susan Dutch, Jonathan J. Evans, Peter Farling, Judith Fewings, Clare N. Gallagher, Helen M. K. Gooday, Arun K. Gupta, Adel Helmy, Camilla Herbert, David A. Hilton, Peter J. Hutchinson, Roisin Jack, Thérèse Jackson, Deva S. Jeyaretna, Peter J. Kirkpatrick, W. Hiu Lam, Fiona Lecky, Paul McArdle, Duncan McAuley, William W. McKinlay, Chris Maimaris, Alexander R. Manara, Anjum Memon, Patrick Mitchell, H. C. Patel, Brian Pentland, Puneet Plaha, Ann-Marie Pringle, Richard Protheroe, Heinke Pülhorn, Robert Redfern, Jane V. Russell, Ayan Sen, Martin Smith, Fiona Summers, Matthew J. C. Thomas, Elfyn O. Thomas, I. Timofeev, Lorna Torrens, Rikin A. Trivedi, Martin B. Walker, Laurence Watkins, Ruwan Alwis Weerakkody, Peter C. Whitfield, Maggie Whyte, Maralyn Woodford
- Edited by Peter C. Whitfield, Elfyn O. Thomas, Fiona Summers, Maggie Whyte, Peter J. Hutchinson
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- Book:
- Head Injury
- Published online:
- 25 January 2010
- Print publication:
- 09 April 2009, pp ix-xii
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‘Ceruminoma’ – a defunct diagnosis
- Richard G. Mills, Tony Douglas-Jones, R. Gareth Williams
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- Journal:
- The Journal of Laryngology & Otology / Volume 109 / Issue 3 / March 1995
- Published online by Cambridge University Press:
- 29 June 2007, pp. 180-188
- Print publication:
- March 1995
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The clinical and pathological features of glandular tumours of the external auditory meatus are presented. Their heterogenous clinical and pathological features make the collective term ‘ceruminoma’ ambiguous andmisleading. The spectrum of pathological behaviour and histological features demonstrated by these interesting tumours necessitate a broader classification system. In our hospital 32 patients presented with tumours of the external auditory meatus over a 30-year period, of which seven were glandular in origin. A review of the histology of these glandular tumours enabled us to reclassify them as adenoma, cylindroma, adenoid cystic carcinoma or ceruminous adenocarcinoma. Together with the less common mucoepidermoid carcinoma and pleomorphic adenoma this subdivision forms a basis for a more meaningful classification system with prognostic and therapeutic implications specific to each tumour type. The term ‘ceruminoma’ should no longer be used unqualified.
Mycobacterium marches back
- R. Gareth Williams, Tony Douglas-Jones
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- Journal:
- The Journal of Laryngology & Otology / Volume 109 / Issue 1 / January 1995
- Published online by Cambridge University Press:
- 29 June 2007, pp. 5-13
- Print publication:
- January 1995
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The resurgence of tuberculosis world-wide and its association with HIV infection means a greater likelihood of otolaryngologists encountering the disease in one form or another. In this review the features of primary and secondary tuberculosis in various head and neck sites are described, and recent advances in diagnosis are discussed. For the otolaryngologists other important aspects such as infections with atypical mycobacteria, the differential diagnosis of cervical lymphadenopathy in HIV-infected patients, recently recognized problems in drug treatment, and the role of surgery in head and neck tuberculosis are also discussed.