1
|
Feng XY, Shen TT, Wu QC, Wang J, Ni P, Liu J, Zhou XP, Hu H, Luo WF. A novel approach to treating post-stroke depression: administration of Botulinum Toxin A via local facial injection. Front Neurol 2024; 15:1372547. [PMID: 38957350 PMCID: PMC11217355 DOI: 10.3389/fneur.2024.1372547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 05/20/2024] [Indexed: 07/04/2024] Open
Abstract
Background Post-stroke depression (PSD) is a frequent complication following a stroke, characterized by prolonged feelings of sadness and loss of interest, which can significantly impede stroke rehabilitation, increase disability, and raise mortality rates. Traditional antidepressants often have significant side effects and poor patient adherence, necessitating the exploration of more suitable treatments for PSD. Previous researchers and our research team have discovered that Botulinum Toxin A (BoNT-A) exhibits antidepressant effects. Therefore, our objective was to assess the efficacy and side effects of BoNT-A treatment in patients with PSD. Methods A total of 71 stroke patients meeting the inclusion criteria were allocated to the two group. 2 cases were excluded due to severe neurological dysfunction that prevented cooperation and 4 cases were lost follow-up. Ultimately, number of participants in the BoNT-A group (n = 32) and Sertraline group (n = 33). Treatment efficacy was evaluated 1, 2, 4, 8 and 12 weeks post-treatment. Results There were no significant differences in baseline characteristics between the two groups (p > 0.05). Both groups exhibited comparable treatment efficacy, with fewer side effects observed in the BoNT-A group compared to the Sertraline group. BoNT-A therapy demonstrated significant effects as early as the first week (p < 0.05), and by the 12th week, there was a notable decrease in neuropsychological scores, significantly lower than the baseline level. The analysis revealed significant differences in measurements of the Hamilton Depression Scale (HAMD) (F(770) = 12.547, p = 0.000), Hamilton Anxiety Scale (HAMA) (F(951) = 10.422, p = 0.000), Self-Rating Depression Scale (SDS) (F(1385) = 10.607, p = 0.000), and Self-Rating Anxiety Scale (SAS) (F(1482) = 11.491, p = 0.000). Conclusion BoNT-A treatment effectively reduces depression symptoms in patients with PSD on a continuous basis.
Collapse
Affiliation(s)
- Xiao-Yan Feng
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Department of Neurology, Wuxi No.2 People's Hospital, Jiangnan University Medical Center, Wuxi, China
| | - Ting-Ting Shen
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Qian-Chang Wu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jun Wang
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Ping Ni
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jing Liu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Xu-Ping Zhou
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Hua Hu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Wei-Feng Luo
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| |
Collapse
|
2
|
Demchenko I, Swiderski A, Liu H, Jung H, Lou W, Bhat V. Botulinum Toxin Injections for Psychiatric Disorders: A Systematic Review of the Clinical Trial Landscape. Toxins (Basel) 2024; 16:191. [PMID: 38668616 PMCID: PMC11054929 DOI: 10.3390/toxins16040191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/28/2024] [Accepted: 04/08/2024] [Indexed: 04/29/2024] Open
Abstract
Botulinum toxin type A (BONT-A) has shown promise in improving the mood-related symptoms of psychiatric disorders by targeting muscles linked to the expression of negative emotions. We conducted a systematic review of past and ongoing efficacy trials of BONT-A therapy for psychiatric disorders to identify relevant trends in the field and discuss the refinement of therapeutic techniques. A comprehensive search for published clinical trials using BONT-A injections for psychiatric disorders was performed on 4 May 2023 through OVID databases (MEDLINE, Embase, APA PsycINFO). Unpublished clinical trials were searched through the ClinicalTrials.gov and International Clinical Trial Registry Platform public registries. The risk of bias was assessed using the JBI Critical Appraisal tools for use in systematic reviews. We identified 21 studies (17 published, 4 unpublished clinical trials) involving 471 patients. The studies focused on evaluating the efficacy of BONT-A for major depressive, borderline personality, social anxiety, and bipolar disorders. BONT-A was most commonly injected into the glabellar area, with an average dose ranging between 37.75 U and 44.5 U in published studies and between 32.7 U and 41.3 U in unpublished trials. The results indicated significant symptom reductions across all the studied psychiatric conditions, with mild adverse effects. Thus, BONT-A appears to be safe and well-tolerated for psychiatric disorders of negative affectivity. However, despite the clinical focus, there was a noted shortage of biomarker-related assessments. Future studies should focus on pursuing mechanistic explorations of BONT-A effects at the neurobiological level.
Collapse
Affiliation(s)
- Ilya Demchenko
- Interventional Psychiatry Program, St. Michael’s Hospital—Unity Health Toronto, 193 Yonge Street, Toronto, ON M5B 1M4, Canada; (I.D.); (A.S.); (H.L.)
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
- Institute for Biomedical Engineering, Science, and Technology (iBEST), Keenan Research Centre for Biomedical Science, St. Michael’s Hospital—Unity Health Toronto, 209 Victoria Street, Toronto, ON M5B 1T8, Canada
| | - Alyssa Swiderski
- Interventional Psychiatry Program, St. Michael’s Hospital—Unity Health Toronto, 193 Yonge Street, Toronto, ON M5B 1M4, Canada; (I.D.); (A.S.); (H.L.)
| | - Helen Liu
- Interventional Psychiatry Program, St. Michael’s Hospital—Unity Health Toronto, 193 Yonge Street, Toronto, ON M5B 1M4, Canada; (I.D.); (A.S.); (H.L.)
| | - Hyejung Jung
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada
| | - Wendy Lou
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada
| | - Venkat Bhat
- Interventional Psychiatry Program, St. Michael’s Hospital—Unity Health Toronto, 193 Yonge Street, Toronto, ON M5B 1M4, Canada; (I.D.); (A.S.); (H.L.)
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
- Institute for Biomedical Engineering, Science, and Technology (iBEST), Keenan Research Centre for Biomedical Science, St. Michael’s Hospital—Unity Health Toronto, 209 Victoria Street, Toronto, ON M5B 1T8, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada
- Neuroscience Research Program, St. Michael’s Hospital—Unity Health Toronto, 209 Victoria Street, Toronto, ON M5T 3M7, Canada
| |
Collapse
|
3
|
Shu H, Shen T, Deng W, Cao J, Xu Y, Liu J, Zhou X, Luo WF. Comparative effectiveness of two different doses of botulinum toxin A for the treatment of mild to moderate depression. J Affect Disord 2024; 350:824-830. [PMID: 38246284 DOI: 10.1016/j.jad.2024.01.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 12/02/2023] [Accepted: 01/14/2024] [Indexed: 01/23/2024]
Abstract
OBJECTIVE Botulinum toxin A has been shown to be effective in managing depression. This study aimed to evaluate the antidepressant and antianxiety effects of two different doses of botulinum toxin A in patients with mild to moderate depression. METHODS A total of 140 patients diagnosed with mild to moderate depression at the Department of Neurology of the Second Affiliated Hospital of Soochow University from September 2020 to September 2021 were enrolled for the study. The patients were allocated into two groups and treated with two different doses of botulinum toxin A (50 units or 100 units). Depression scores (HAMD, HAMA, SDS, and SAS) were evaluated at baseline and 1, 2, 4, 8, and 12 weeks after treatment. RESULTS There was a significant improvement in the depressive and anxiety symptoms following treatment with the botulinum toxin A after 12 weeks compared to the baseline. However, there were no significant differences between the two groups. Further, the factor scores of anxiety/somatization, blocking, sleep disorder, and cognitive disorder were significantly decreased after 12 weeks of treatment with 50 units of botulinum toxin A compared to the baseline (P < 0.05). Further, the factor scores of somatic and mental anxiety were significantly decreased at different time points after treatment with 50 units of botulinum toxin A compared to the baseline (P < 0.05). CONCLUSION Local injections of 50 units and 100 units of botulinum toxin A shows equal efficacy. Therefore, 50 units of botulinum toxin A could be used clinically to manage mild to moderate depression.
Collapse
Affiliation(s)
- Haiyang Shu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Tingting Shen
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Wenjing Deng
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Jiaqian Cao
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Yingying Xu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Jing Liu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Xuping Zhou
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China.
| | - Wei Feng Luo
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China.
| |
Collapse
|
4
|
De la Torre Canales G, Poluha RL, Bonjardim LR, Ernberg M, Conti PCR. Botulinum toxin-A effects on pain, somatosensory and psychosocial features of patients with refractory masticatory myofascial pain: a randomized double-blind clinical trial. Sci Rep 2024; 14:4201. [PMID: 38378855 PMCID: PMC10879180 DOI: 10.1038/s41598-024-54906-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 02/18/2024] [Indexed: 02/22/2024] Open
Abstract
The antinociceptive effect of BoNT-A have been well documented in animal studies; however, results of few but well-designed randomized placebo-controlled clinical trials about BoNT-A efficacy in masticatory myofascial pain (MFP) are inconsistent. Therefore, the present randomized, double-blind, placebo-controlled clinical trial evaluated the efficacy of BoNT-A in patients with refractory MFP. Twenty-eight patients with pain reduction of less than 30% despite conservative treatment and with an average pain intensity of > 50 mm on the visual analogue scale (VAS) participated. Patients were randomly assigned to receive a total of 80 U of BoNT-A or saline solution (SS) injected into the masseter and anterior temporalis muscles. Pain intensity (VAS), quantitative sensory testing (QST), conditioned pain modulation (CPM), and psychosocial status were examined. Follow-up was performed at 1 and 6 months. For repeated-measure comparisons between evaluation times, Friedman test with Bonferroni correction was used for pain and somatosensory variables and the Wilcoxon test for the psychosocial variables. The Mann-Whitney test was used for all comparisons between groups. The BoNT-A group had a significant decrease in pain intensity at follow-ups compared with the SS group (p < 0.001). QST assessment revealed higher pressure pain threshold values in the masseter muscle for BoNT-A group compared to SS (p < 0.03) at all follow-ups. No differences were found for mechanical pain threshold and wind-up ratio values (p > 0.05) in the entire study. The BoNT-A group presented the most efficient CPM effect (p < 0.03) only at the 1 month follow-up in the masseter muscle. There was a significant time effect for BoNT-A in all psychosocial variables (p < 0.05) and a drug effect in the Central Sensitization Inventory (p < 0.01), Pittsburgh Sleep Quality Index (p < 0.004), and Healthy Survey 36 (p < 0.05) at 6 months follow-up. The study demonstrates that a single injection-session of BoNT-A has positive effects on the hall pain spectrum of patients with refractory masticatory myofascial pain.
Collapse
Affiliation(s)
- Giancarlo De la Torre Canales
- Division of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, and The Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden.
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, Almada, Portugal.
- Bauru Orofacial Pain Group, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil.
| | - Rodrigo Lorenzi Poluha
- Department of Dentistry, State University of Maringá, Paraná, Brazil
- Bauru Orofacial Pain Group, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Leonardo Rigoldi Bonjardim
- Bauru Orofacial Pain Group, Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
- Bauru Orofacial Pain Group, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Malin Ernberg
- Division of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, and The Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden
| | - Paulo César Rodrigues Conti
- Bauru Orofacial Pain Group, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
5
|
Modulation of amygdala activity for emotional faces due to botulinum toxin type A injections that prevent frowning. Sci Rep 2023; 13:3333. [PMID: 36849797 PMCID: PMC9971043 DOI: 10.1038/s41598-023-29280-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 02/01/2023] [Indexed: 03/01/2023] Open
Abstract
According to the facial feedback hypothesis, when we see an angry or happy face, we contract or flex the relevant muscles to recreate the expression to assist in identifying and experiencing the emotion reflected. We investigated the facial feedback hypothesis by using botulinum toxin type A (onabotulinumtoxinA; onabotA) injections to induce temporary paralysis in the glabellar muscles (responsible for frowning) and measured functional brain activity during the processing of emotional faces. Ten females viewed pictures of happy and angry faces during two functional magnetic resonance imaging (fMRI) scan sessions: one prior (Pre) to onabotA and one following (Active) onabotA injections. We found Pre vs. Active onabotA modulation of activity in the amygdala for both happy and angry faces, as well as modulation of activity in the fusiform gyrus for happy faces. Consistent with our predictions, preventing frowning through inhibition of glabellar muscle contraction altered amygdala processing for emotional faces. The modulation of amygdala and fusiform gyrus activity following onabotA may reflect compensatory processes in a neuroanatomical circuit involved in emotional processing that is engaged when facial feedback is impaired. These data contribute to a growing literature suggesting that inhibition of glabellar muscle contraction alters neural activity for emotional processing.Clinical Trials.gov registration number: NCT03373162.
Collapse
|
6
|
Rahman E, Mosahebi A, Carruthers JDA, Carruthers A. The Efficacy and Duration of Onabotulinum Toxin A in Improving Upper Facial Expression Lines With 64-Unit Dose Optimization: A Systematic Review and Meta-Analysis With Trial Sequential Analysis of the Randomized Controlled Trials. Aesthet Surg J 2023; 43:215-229. [PMID: 36099476 DOI: 10.1093/asj/sjac253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/08/2022] [Accepted: 09/08/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Onabotulinumtoxin A (Onabot A) was the first treatment to be approved for aesthetic indications, namely glabellar lines (GLs), crow's feet lines (CFLs), and forehead lines (FHLs), with a cumulative dose of 64 U. OBJECTIVES The aim of this study was to conduct a meta-analysis to combine the available data for approved doses for GLs, CFLs, and FHLs to explore the effect and duration of simultaneous treatment with Onabot A. METHODS PubMed/MEDLINE, Embase, and other national clinical trial registries were searched for randomized controlled trials from January 2010 to July 2022. The meta-analysis, trial sequential analysis, and investigator-assessed time to return to nonresponder status in GLs, CFLs, and FHLs following Onabot A were plotted to elicit a cumulative dose-adjusted response curve based on Kaplan-Meier analysis with a log-rank test. RESULTS Fourteen randomized controlled trials were eligible for quantitative analysis. A total of 8369 subjects were recruited across the trials. The meta-analysis results show that Onabot A is very effective in reducing moderate to severe GLs, CFLs, and FHLs. The cumulative Z-curve for GLs, CFLs, and FHLs also exceeds the required information size (RIS). Kaplan-Meier analysis with a log-rank test demonstrated that simultaneous treatment of GLs, CFLs, and FHLs requires 182 days (95% CI = 179, 215 days) (P < 0.00002) to return to nonresponder status. CONCLUSIONS Treatment of the upper facial expression lines with Onabot A is effective, and the approved cumulative dose of 64 U gives longer-lasting effects. LEVEL OF EVIDENCE: 1
Collapse
Affiliation(s)
- Eqram Rahman
- Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK and an evidence-based medicine editor of Aesthetic Surgery Journal
| | - Afshin Mosahebi
- Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK and a research section editor of Aesthetic Surgery Journal
| | - Jean D A Carruthers
- Department of Ophthalmology, University of British Columbia, Vancouver, BC, Canada
| | - Alastair Carruthers
- Department of Dermatology, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
7
|
Coles NA, March DS, Marmolejo-Ramos F, Larsen JT, Arinze NC, Ndukaihe ILG, Willis ML, Foroni F, Reggev N, Mokady A, Forscher PS, Hunter JF, Kaminski G, Yüvrük E, Kapucu A, Nagy T, Hajdu N, Tejada J, Freitag RMK, Zambrano D, Som B, Aczel B, Barzykowski K, Adamus S, Filip K, Yamada Y, Ikeda A, Eaves DL, Levitan CA, Leiweke S, Parzuchowski M, Butcher N, Pfuhl G, Basnight-Brown DM, Hinojosa JA, Montoro PR, Javela D LG, Vezirian K, IJzerman H, Trujillo N, Pressman SD, Gygax PM, Özdoğru AA, Ruiz-Fernandez S, Ellsworth PC, Gaertner L, Strack F, Marozzi M, Liuzza MT. A multi-lab test of the facial feedback hypothesis by the Many Smiles Collaboration. Nat Hum Behav 2022; 6:1731-1742. [PMID: 36266452 DOI: 10.1038/s41562-022-01458-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 09/07/2022] [Indexed: 01/14/2023]
Abstract
Following theories of emotional embodiment, the facial feedback hypothesis suggests that individuals' subjective experiences of emotion are influenced by their facial expressions. However, evidence for this hypothesis has been mixed. We thus formed a global adversarial collaboration and carried out a preregistered, multicentre study designed to specify and test the conditions that should most reliably produce facial feedback effects. Data from n = 3,878 participants spanning 19 countries indicated that a facial mimicry and voluntary facial action task could both amplify and initiate feelings of happiness. However, evidence of facial feedback effects was less conclusive when facial feedback was manipulated unobtrusively via a pen-in-mouth task.
Collapse
Affiliation(s)
- Nicholas A Coles
- Center for the Study of Language and Information, Stanford University, Palo Alto, CA, USA.
| | - David S March
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Fernando Marmolejo-Ramos
- Center for Change and Complexity in Learning, University of South Australia, Adelaide, South Australia, Australia
| | - Jeff T Larsen
- Department of Psychology, University of Tennessee, Knoxville, TN, USA
| | - Nwadiogo C Arinze
- Department of Psychology, Alex Ekwueme Federal University Ndufu-Alike, Abakaliki, Nigeria
| | - Izuchukwu L G Ndukaihe
- Department of Psychology, Alex Ekwueme Federal University Ndufu-Alike, Abakaliki, Nigeria
| | - Megan L Willis
- School of Behavioural and Health Sciences, Australian Catholic University, Strathfield, New South Wales, Australia
| | - Francesco Foroni
- School of Behavioural and Health Sciences, Australian Catholic University, Strathfield, New South Wales, Australia
| | - Niv Reggev
- Department of Psychology, Ben-Gurion University, Be'er Sheva, Israel
- Zlotowski Center for Neuroscience, Ben-Gurion University, Be'er Sheva, Israel
| | - Aviv Mokady
- Department of Psychology, Ben-Gurion University, Be'er Sheva, Israel
| | | | | | | | - Elif Yüvrük
- Department of Psychology, Ege University, Izmir, Turkey
| | - Aycan Kapucu
- Department of Psychology, Ege University, Izmir, Turkey
| | - Tamás Nagy
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Nandor Hajdu
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Julian Tejada
- Department of Psychology, Federal University of Sergipe, São Cristóvão, Brazil
| | - Raquel M K Freitag
- Vernacular Languages Department, Federal University of Sergipe, São Cristóvão, Brazil
| | | | - Bidisha Som
- Department of Humanities and Social Sciences, Indian Institute of Technology Guwahati, Guwahati, India
| | - Balazs Aczel
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | | | - Sylwia Adamus
- Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Katarzyna Filip
- Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Yuki Yamada
- Faculty of Arts and Science, Kyushu University, Fukuoka, Japan
| | - Ayumi Ikeda
- Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
| | - Daniel L Eaves
- School of Biomedical, Nutritional and Sport Sciences, Newcastle University, Newcastle upon Tyne, UK
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | | | | | - Michal Parzuchowski
- Center of Research on Cognition and Behavior, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Natalie Butcher
- Department of Psychology, Teesside University, Middlesbrough, UK
| | - Gerit Pfuhl
- Department of Psychology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Dana M Basnight-Brown
- Department of Psychology, United States International University-Africa, Nairobi, Kenya
| | - José A Hinojosa
- Universidad Complutense, Madrid, Spain
- Universidad Nebrija, Madrid, Spain
| | - Pedro R Montoro
- Departamento de Psicología Básica 1, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | - Lady G Javela D
- Programa de Psicología, Universidad del Rosario, Bogotá, Colombia
| | | | - Hans IJzerman
- LIP/PC2s, Université Grenoble Alpes, Grenoble, France
- Institut Universitaire de France, Paris, France
| | | | - Sarah D Pressman
- Department of Psychological Science, University of California, Irvine, CA, USA
| | - Pascal M Gygax
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Asil A Özdoğru
- Department of Psychology, Üsküdar University, İstanbul, Turkey
| | - Susana Ruiz-Fernandez
- FOM University of Applied Sciences, Essen, Germany
- Leibniz-Institut für Wissensmedien, Tübingen, Germany
| | | | - Lowell Gaertner
- Department of Psychology, University of Tennessee, Knoxville, TN, USA
| | - Fritz Strack
- Department of Psychology, University of Würzburg, Würzburg, Germany
| | - Marco Marozzi
- Department of Environmental Sciences, Informatics and Statistics, Ca' Foscari University of Venice, Venice, Italy
| | - Marco Tullio Liuzza
- Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy
| |
Collapse
|
8
|
Glabellar Botulinum Toxin Injection Improves Depression Scores: A Systematic Review and Meta-Analysis. Plast Reconstr Surg 2022; 150:211e-220e. [PMID: 35588104 DOI: 10.1097/prs.0000000000009240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Depression is a leading cause of disability worldwide. Preliminary evidence suggests that glabellar onabotulinumtoxinA injections improve depression scores with few side effects compared to current first-line antidepressant medications. The authors' review reports on these studies, hypothesizing that glabellar onabotulinumtoxinA injections can be an alternative safe and effective treatment for depression. METHODS A systematic review and meta-analysis of the relevant literature was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, Cochrane Library, Embase, and Scopus databases were searched in August of 2020 using the keywords ["botox" OR "botulinum"] AND ["mood" OR "depression"] for articles published between 1980 and 2020. Prospective studies and randomized controlled trials on the use of glabellar onabotulinumtoxinA injections for the primary purpose of treating depression were considered. The primary endpoint for the meta-analysis was the mean difference in primary depression scores after treatment, along with a second endpoint of the standardized mean difference in depression scores among treated patients including all nine studies. RESULTS Of the 499 reviewed articles, nine studies were included that reported improvement in mean depression scores from baseline. All five randomized controlled trials reported an improvement in mean depression scores at 6 weeks after treatment, with a weighted average change of -8.39 points ( p < 0.0001). The aggregate standardized mean difference from baseline to the primary endpoint across all nine prospective studies was -1.61 SD ( p < 0.0001). CONCLUSION Meta-analysis and systematic review of the included studies provide support for an antidepressant effect of glabellar onabotulinumtoxinA injections.
Collapse
|
9
|
Wollmer MA, Magid M, Kruger THC, Finzi E. Treatment of Depression with Botulinum Toxin. Toxins (Basel) 2022; 14:383. [PMID: 35737044 PMCID: PMC9231293 DOI: 10.3390/toxins14060383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/06/2022] [Accepted: 05/12/2022] [Indexed: 02/01/2023] Open
Abstract
Injection of botulinum toxin (BoNT) into the glabellar region of the face is a novel therapeutic approach in the treatment of depression. This treatment method has several advantages, including few side effects and a long-lasting, depot-like effect. Here we review the clinical and experimental evidence for the antidepressant effect of BoNT injections as well as the theoretical background and possible mechanisms of action. Moreover, we provide practical instructions for the safe and effective application of BoNT in the treatment of depression. Finally, we describe the current status of the clinical development of BoNT as an antidepressant and give an outlook on its potential future role in the management of mental disorders.
Collapse
Affiliation(s)
- Marc Axel Wollmer
- Asklepios Clinic North-Ochsenzoll, Asklepios Campus Hamburg, Medical Faculty, Semmelweis University, 22419 Hamburg, Germany
| | - Michelle Magid
- Dell Medical School, University of Texas at Austin, Austin, TX 78712, USA;
| | - Tillmann H. C. Kruger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, 30625 Hannover, Germany;
- Center for Systems Neuroscience, 30559 Hannover, Germany
| | - Eric Finzi
- Department of Psychiatry & Behavioral Sciences, George Washington School of Medicine, Washington, DC 20037, USA;
| |
Collapse
|
10
|
Wu Y, Alleva JM, Broers NJ, Mulkens S. Attitudes towards cosmetic surgery among women in China and the Netherlands. PLoS One 2022; 17:e0267451. [PMID: 35446909 PMCID: PMC9022849 DOI: 10.1371/journal.pone.0267451] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 04/09/2022] [Indexed: 11/24/2022] Open
Abstract
Around the world, an increasing number of people, predominantly women, are choosing to undergo cosmetic surgery-despite the associated health risks. This study aimed to promote a better cross-cultural understanding of the correlates and predictors of favorable attitudes toward cosmetic surgery among women in China (an Eastern country where cosmetic surgery is increasing most rapidly) and the Netherlands (a Western country). Questionnaire data were obtained from 763 adult women; 245 were Chinese women in China (Mage = 29.71), 265 were Chinese women in the Netherlands (Mage = 25.81), and 253 were Dutch women (Mage = 29.22). Facial appearance concerns and materialistic belief were significant predictors of favorable attitudes towards cosmetic surgery for all three cultural groups. Body appreciation was a significant positive predictor among Chinese women in both China and the Netherlands, whereas age and beauty-ideal internalization were significant positive predictors only among Chinese women in China. The findings and their implications are discussed with respect to the characteristics of Chinese culture that could explain the identified differences between Chinese and Dutch women.
Collapse
Affiliation(s)
- Yi Wu
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Jessica M. Alleva
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Nick J. Broers
- Department of Methodology and Statistics, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Sandra Mulkens
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine, and Life Sciences; School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
11
|
Wu Y, Mulkens S, Alleva JM. Body image and acceptance of cosmetic surgery in China and the Netherlands: A qualitative study on cultural differences and similarities. Body Image 2022; 40:30-49. [PMID: 34801810 DOI: 10.1016/j.bodyim.2021.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/19/2021] [Accepted: 10/19/2021] [Indexed: 10/19/2022]
Abstract
There is an established relationship between acceptance of cosmetic surgery and psychological factors, including body image. However, qualitative research among diverse cultural groups is needed to provide a more fine-grained understanding of the influences on women's attitudes towards cosmetic surgery. In this study, 20 Chinese and 20 Dutch women aged 18-50 years (MChinese = 34.20; MDutch = 34.70) participated in one-on-one semi-structured interviews. Data were analyzed using reflexive thematic analysis. We identified three themes that captured the factors that women perceived to foster favorable attitudes towards cosmetic surgery: (a) sociocultural pressures (e.g., normalization of cosmetic surgery, appearance-focused peers); (b) intrapersonal characteristics (e.g., beauty-ideal internalization, social comparison); and (c) benefits of beauty (e.g., attracting men, socioeconomic benefits). Conversely, two themes captured the factors perceived to reduce favorable attitudes towards cosmetic surgery: (a) intrapersonal characteristics (e.g., unconditional body acceptance, self-confidence); and (b) external considerations (e.g., health risks, financial costs). Overall, Chinese and Dutch participants shared many similarities in their opinions about what might affect cosmetic surgery consideration. The most striking cross-cultural differences concerned perceived socioeconomic benefits of beauty (mainly Chinese women) and women's conceptualization of body appreciation. This study may enable a more comprehensive understanding about the factors influencing Chinese and Dutch women's attitudes towards cosmetic surgery, and the nuances in these relationships across these cultures.
Collapse
Affiliation(s)
- Yi Wu
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands.
| | - Sandra Mulkens
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine, and Life Sciences; School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Jessica M Alleva
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| |
Collapse
|
12
|
Wang C, Zhu X, Xia L, Xie P, Tian X, Shang J, Han Q. Botulinum toxin A improves psychological distress in patients with hemifacial spasm. Acta Neurol Belg 2022; 122:43-49. [PMID: 33515182 DOI: 10.1007/s13760-021-01601-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/12/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study aimed at assessing mental health in patients with hemifacial spasm (HFS) and determined the effect of botulinum toxin type A (BTX-A) on psychological distress in patients with HFS. METHODS Ninety-five HFS patients and 95 age- and sex-matched healthy controls were enrolled. Symptom checklist-90 (SCL-90) scores were used to measure psychological distress in HFS patients and healthy controls. The mental health status of HFS patients was also evaluated by SCL-90, before and after the injection of BTX-A. Moreover, for those patients with abnormal mental health, efficacy outcomes after treatment with BTX-A were compared with a propensity score-matched historical cohort without BTX-A treatment. RESULTS The mean scores for interpersonal sensitivity, phobia, anxiety, depression, and somatization were significantly higher among HFS patients than healthy people (P < 0.05). There was no significant difference between female patients and male patients in HFS group (P > 0.05). There were significant improvements in somatization, interpersonal sensitivity, depression, anxiety, and phobia scores before and after treatment (P < 0.05). At 2 months, more patients experienced an improvement in psychological distress in the BTX-A group (61.29% versus 38.71%; P = 0.03). CONCLUSION Patients with HFS are often accompanied by somatization, interpersonal sensitivity, depression, anxiety, and phobia. Our findings suggest that BTX-A can improve these symptoms. However, further well-designed prospective studies are warranted to validate our findings.
Collapse
Affiliation(s)
- Chengyun Wang
- Department of Neurology, Huai'an First People's Hospital, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, No. 1 Huanghe West Road, Huai'an, 223000, Jiangsu, China
| | - Xiangyu Zhu
- ICU, The Second People's Hospital of Huai'an, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, 223000, Jiangsu, China
| | - Lei Xia
- Department of Neurology, Huai'an First People's Hospital, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, No. 1 Huanghe West Road, Huai'an, 223000, Jiangsu, China
| | - Peng Xie
- Department of Neurosurgery, The Second People's Hospital of Huai'an, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, 223000, Jiangsu, China
| | - Xiangyang Tian
- Department of Neurology, Huai'an First People's Hospital, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, No. 1 Huanghe West Road, Huai'an, 223000, Jiangsu, China
| | - Jin Shang
- Department of Neurology, Huai'an First People's Hospital, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, No. 1 Huanghe West Road, Huai'an, 223000, Jiangsu, China.
| | - Qiu Han
- Department of Neurology, Huai'an First People's Hospital, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, No. 1 Huanghe West Road, Huai'an, 223000, Jiangsu, China.
| |
Collapse
|
13
|
Pałasz A, Krzystanek M. Spider Neurotoxins as Modulators of NMDA Receptor Signaling. Neuromolecular Med 2021; 24:250-256. [PMID: 34562203 PMCID: PMC9402494 DOI: 10.1007/s12017-021-08692-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/14/2021] [Indexed: 11/26/2022]
Abstract
Molecules that selectively act on N-methyl-D-aspartate (NMDA) receptors may have a multidirectional effect by modulating the activity of NMDARs, affecting their active sites as well as by changing the composition of their subunits. The results of the clinical trials conducted so far in mood disorders and schizophrenia indicate that such agents may become new effective drugs for the treatment of these diseases. Number of spider neurotoxins e.g. ctenitoxins extracted from Phoneutria sp. venom act as potent and selective NMDAR blockers that do not disturb cortical and hippocampal glutamate signaling, LTP generation and synaptic neurochemistry. Possibly this intriguing kind of promising neuroregulatory peptides and polyamines can be clinically applicable in a wide spectrum of neuropsychiatric disorders, including epilepsy, neurotrauma and ischemic injuries. These novel medications can potentially be helpful in the future treatment of stroke and several neurodegenerative diseases.
Collapse
Affiliation(s)
- Artur Pałasz
- Department of Histology, Faculty of Medical Sciences, Medical University of Silesia, ul. Medyków 18, 40-752, Katowice, Poland.
| | - Marek Krzystanek
- Department of Psychiatry and Psychotherapy, Clinic of Psychiatric Rehabilitation, Faculty of Medical Sciences in Katowice, Medical University of Silesia, ul. Ziolowa 45/47, 40-635, Katowice, Poland
| |
Collapse
|
14
|
Zhang Q, Wu W, Fan Y, Li Y, Liu J, Xu Y, Jiang C, Tang Z, Cao C, Liu T, Chen LH, Hu H, Luo W. The safety and efficacy of botulinum toxin A on the treatment of depression. Brain Behav 2021; 11:e2333. [PMID: 34423572 PMCID: PMC8442586 DOI: 10.1002/brb3.2333] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/22/2021] [Accepted: 08/02/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Effective strategy for the treatment of depression is limited. This study was to evaluate the safety and efficacy of botulinum toxin A (BoNT/A) in the treatment of depression. METHODS Seventy-six patients were assigned to the BoNT/A group (n = 52) and sertraline control group (n = 24). For the BoNT/A group, BoNT/A was injected into the frowning muscle, depressor muscle, occipital frontalis muscle, lateral canthus, and bilateral temporal region at 20 sites. Five units per site and a total of 100 units of BoNT/A were given. Patients in the sertraline control group were medicated with sertraline 50-200 mg (114.58 ± 52.08 mg) per day. Depression was assessed by the 17-item Hamilton Depression Scale (HAMD-17), 14-item Hamilton Anxiety Scale (HAMA-14), Self-rating Depression Scale (SDS), and Self-rating Anxiety Scale (SAS). All participants were followed up for 12 weeks. RESULTS Scores of HAMD, HAMA, SDS, and SAS decreased significantly in both BoNT/A and sertraline groups after treatment for 12 weeks. Overall, there were no differences in decreased magnitude between the two groups (p > .05). The HAMA, SDS, and SAS results showed that the onset time of BoNT/A was earlier than that of sertraline. Side effects rates were 15.38% for BoNT/A and 33.33% for sertraline. CONCLUSION This study demonstrated significant antidepressant effects of BoNT/A. The efficacy of BoNT/A was comparable with established antidepressant sertraline. The onset time of BoNT/A was earlier than sertraline, and the proportion of side effects was less than sertraline. Therefore, BoNT/A could be a safe and effective option for the treatment of depression.
Collapse
Affiliation(s)
- Qilin Zhang
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Wenqi Wu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yuxin Fan
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yang Li
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jing Liu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yingying Xu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Caixia Jiang
- Department of Psychiatry, Suzhou Guangji Hospital, the Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Zhen Tang
- Department of Psychiatry, Suzhou Guangji Hospital, the Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Cong Cao
- Institute of Neuroscience, Soochow University, Suzhou, China.,Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psychiatric-Diseases, Soochow University, Suzhou, China
| | - Tong Liu
- Institute of Pain Medicine and Special Environmental Medicine, Nantong University, Jiangsu, China
| | - Li-Hua Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Nantong University, Jiangsu, China
| | - Hua Hu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Weifeng Luo
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University, Suzhou, China.,Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psychiatric-Diseases, Soochow University, Suzhou, China
| |
Collapse
|
15
|
Affatato O, Moulin TC, Pisanu C, Babasieva VS, Russo M, Aydinlar EI, Torelli P, Chubarev VN, Tarasov VV, Schiöth HB, Mwinyi J. High efficacy of onabotulinumtoxinA treatment in patients with comorbid migraine and depression: a meta-analysis. J Transl Med 2021; 19:133. [PMID: 33789668 PMCID: PMC8011097 DOI: 10.1186/s12967-021-02801-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/19/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Migraine and depression are highly prevalent and partly overlapping disorders that cause strong limitations in daily life. Patients tend to respond poorly to the therapies available for these diseases. OnabotulinumtoxinA has been proven to be an effective treatment for both migraine and depression. While many studies have addressed the effect of onabotulinumtoxinA in migraine or depression separately, a growing body of evidence suggests beneficial effects also for patients comorbid with migraine and depression. The current meta-analysis systematically investigates to what extent onabotulinumtoxinA is efficient in migraineurs with depression. METHODS A systematic literature search was performed based on PubMed, Scopus and Web of Science from the earliest date till October [Formula: see text], 2020. Mean, standard deviation (SD) and sample size have been used to evaluate improvement in depressive symptoms and migraine using random-effects empirical Bayes model. RESULTS Our search retrieved 259 studies, eight of which met the inclusion criteria. OnabotulinumtoxinA injections administered to patients with both chronic migraine and major depressive disorder led to mean reduction of [Formula: see text] points (CI [[Formula: see text]], [Formula: see text]) in the BDI scale, of [Formula: see text] points (CI [[Formula: see text]], [Formula: see text]) in the BDI-II scale and of [Formula: see text] points (CI [[Formula: see text]], [Formula: see text]) in the PHQ-9 scale, when evaluating depressive symptoms. In the case of the migraine-related symptoms, we found mean reductions of [Formula: see text] (CI [[Formula: see text]], [Formula: see text]) points in the HIT6 scale, [Formula: see text] (CI [[Formula: see text]], [Formula: see text]) in the MIDAS scale, [Formula: see text] (CI [[Formula: see text]], [Formula: see text]) points in the VAS scale and of [Formula: see text] (CI [[Formula: see text]], [Formula: see text]) migraine episodes per month. Comorbid patients showed slightly better improvements in BDI, HIT6 scores and migraine frequency compared to monomorbid patients. The latter group manifested better results in MIDAS and VAS scores. CONCLUSION Treatment with onabotulinumtoxinA leads to a significant reduction of disease severity of both chronic migraine and major depressive disorder in patients comorbid with both diseases. Comparative analyses suggest an equivalent strong effect in monomorbid and comorbid patients, with beneficial effects specifically seen for certain migraine features.
Collapse
Affiliation(s)
- Oreste Affatato
- Department of Neuroscience, University of Uppsala, Uppsala, Sweden.
| | - Thiago C Moulin
- Department of Neuroscience, University of Uppsala, Uppsala, Sweden
| | - Claudia Pisanu
- Department of Neuroscience, University of Uppsala, Uppsala, Sweden.,Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Victoria S Babasieva
- Department of Neuroscience, University of Uppsala, Uppsala, Sweden.,Department of Pharmacology, Institute of Pharmacy, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Marco Russo
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Elif I Aydinlar
- Department of Neurology, Acibadem University School of Medicine, Istanbul, Turkey
| | - Paola Torelli
- Headache Centre, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Vladimir N Chubarev
- Department of Pharmacology, Institute of Pharmacy, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Vadim V Tarasov
- Department of Pharmacology, Institute of Pharmacy, I. M. Sechenov First Moscow State Medical University, Moscow, Russia.,Institute for Translational Medicine and Biothechnology, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Helgi B Schiöth
- Department of Neuroscience, University of Uppsala, Uppsala, Sweden.,Institute for Translational Medicine and Biothechnology, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Jessica Mwinyi
- Department of Neuroscience, University of Uppsala, Uppsala, Sweden
| |
Collapse
|
16
|
Schulze J, Neumann I, Magid M, Finzi E, Sinke C, Wollmer MA, Krüger THC. Botulinum toxin for the management of depression: An updated review of the evidence and meta-analysis. J Psychiatr Res 2021; 135:332-340. [PMID: 33578275 DOI: 10.1016/j.jpsychires.2021.01.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/07/2021] [Accepted: 01/15/2021] [Indexed: 12/18/2022]
Abstract
Botulinum toxin (BTX) treatment of glabellar frown lines is one of the most common procedures in aesthetic medicine. In addition to its cosmetic effect, the neurotoxin has been shown to have a positive influence on mood and affect. Several randomized clinical trials (RCTs) have examined the effect of botulinum toxin on the treatment of depression. Combining the results of the five RCTs in a random effects meta-analysis revealed that patients treated with BTX showed a more intense improvement of depressive symptoms in comparison to subjects that received placebo injections (d = 0.98). Despite methodological limitations, the results of this study emphasize the effectiveness of BTX in the treatment of depression and therefore pave the way for its use in the field of psychiatry.
Collapse
Affiliation(s)
- Jara Schulze
- Hannover Medical School, Division of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - Insa Neumann
- Asklepios Clinic North - Ochsenzoll, Asklepios Campus Hamburg, Medical Faculty, Semmelweis University, Langenhorner Chaussee 560, 22419, Hamburg, Germany
| | - Michelle Magid
- Department of Psychiatry, Dell Medical School, University of Texas at Austin, 1601 Trinity St., Bldg. B, Stop Z0600, Austin, TX, 78712, USA
| | - Eric Finzi
- Department of Psychiatry and Behavioral Sciences, George Washington School of Medicine, 2120 L Street, NW, Suite 600, Washington, DC, 20037, USA
| | - Christopher Sinke
- Hannover Medical School, Division of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - M Axel Wollmer
- Asklepios Clinic North - Ochsenzoll, Asklepios Campus Hamburg, Medical Faculty, Semmelweis University, Langenhorner Chaussee 560, 22419, Hamburg, Germany
| | - Tillmann H C Krüger
- Hannover Medical School, Division of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany; Center for Systems Neuroscience, Bünteweg 2, 30559 Hannover, Germany.
| |
Collapse
|
17
|
Li Y, Liu T, Luo W. Botulinum Neurotoxin Therapy for Depression: Therapeutic Mechanisms and Future Perspective. Front Psychiatry 2021; 12:584416. [PMID: 33967844 PMCID: PMC8102733 DOI: 10.3389/fpsyt.2021.584416] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 03/29/2021] [Indexed: 12/16/2022] Open
Abstract
Depression is one of the most common mental disorders, which causes global burden. Antidepressants and psychotherapies are the mainstay of treatment for depression, which have limited efficacy. Thus, alternative approaches for preventing and treating depression are urgently required. Recent clinical trials and preclinical researches have clarified that peripheral facial injection of botulinum neurotoxin type A (BoNT/A) is a rapid, effective and relative safe therapy for improving some symptoms of depression. Despite its safety and efficacy, the underlying therapeutic mechanisms of BoNT/A for depression remains largely unclear. In the present review, we updated and summarized the clinical and preclinical evidence supporting BoNT/A therapy for the treatment of depression. We further discussed the potential mechanisms underlying therapeutic effects of BoNT/A on depression. Notably, we recently identified that the anti-depressant effects of BoNT/A associated with up-regulation of 5-HT levels and brain-derived neurotrophic factor (BDNF) expression in the hippocampus in a preclinical mouse model. In summary, these studies suggest that BoNT/A therapy is a potential effective and safe intervention for the management of depression. However, fundamental questions remain regarding the future prospects of BoNT/A therapy, including safety, efficacy, dose-response relationships, identification of potential predictors of response, and the precise mechanisms underlying BoNT/A therapy.
Collapse
Affiliation(s)
- Yang Li
- Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Tong Liu
- Institute of Pain Medicine and Special Environmental Medicine, Nantong University, Nantong, China.,College of Life Sciences, Yanan University, Yanan, China
| | - Weifeng Luo
- Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| |
Collapse
|
18
|
Nestor MS, Fischer D, Arnold D. "Masking" our emotions: Botulinum toxin, facial expression, and well-being in the age of COVID-19. J Cosmet Dermatol 2020; 19:2154-2160. [PMID: 32592268 PMCID: PMC7361553 DOI: 10.1111/jocd.13569] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 06/18/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND The globally devastating effects of COVID-19 breach not only the realm of public health, but of psychosocial interaction and communication as well, particularly with the advent of mask-wearing. METHODS A review of the literature and understanding of facial anatomy and expressions as well as the effect of botulinum toxin on emotions and nonverbal communication. RESULTS Today, the mask has become a semi-permanent accessory to the face, blocking our ability to express and perceive each other's facial expressions by dividing it into a visible top half and invisible bottom half. This significantly restricts our ability to accurately interpret emotions based on facial expressions and strengthens our perceptions of negative emotions produced by frowning. The addition of botulinum toxin (BTX)-induced facial muscle paralysis to target the muscles of the top (visible) half of the face, especially the corrugator and procerus muscles, may act as a therapeutic solution by its suppression of glabellar lines and our ability to frown. The treatment of the glabella complex not only has been shown to inhibit the negative emotions of the treated individual but also can reduce the negative emotions in those who come in contact with the treated individual. CONCLUSIONS Mask-wearing in the wake of COVID-19 brings new challenges to our ability to communicate and perceive emotion through full facial expression, our most effective and universally shared form of communication, and BTX may offer a positive solution to decrease negative emotions and promote well-being for both the mask-wearer and all who come in contact with that individual.
Collapse
Affiliation(s)
- Mark S. Nestor
- Center for Clinical and Cosmetic ResearchAventuraFLUSA
- Department of Dermatology and Cutaneous SurgeryUniversity of MiamiMiller School of MedicineMiamiFLUSA
- Department of SurgeryDivision of Plastic SurgeryUniversity of MiamiMiller School of MedicineMiamiFLUSA
| | | | - David Arnold
- Center for Clinical and Cosmetic ResearchAventuraFLUSA
| |
Collapse
|
19
|
In Response to Dayan SH et al, “Assessment of the Impact of Perioral Rejuvenation With Hyaluronic Acid Filler on Projected First Impressions and Mood Perceptions”. Dermatol Surg 2020; 46:856. [DOI: 10.1097/dss.0000000000001880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
20
|
Sarwer DB. Body image, cosmetic surgery, and minimally invasive treatments. Body Image 2019; 31:302-308. [PMID: 30704847 DOI: 10.1016/j.bodyim.2019.01.009] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 01/21/2019] [Accepted: 01/21/2019] [Indexed: 12/20/2022]
Abstract
Over the past 60 years, a growing body of research has investigated the psychological aspects of cosmetic surgery and related minimally-invasive treatments. While the earliest studies were influenced by psychoanalytic thinking, much of the work over the past several decades has been influenced by Thomas Cash's cognitive-behavioral theory of body image and has focused on the appearance concerns of patients who seek these procedures. The majority of individuals interested in the procedures report heightened dissatisfaction typically focused on the feature being considered for treatment. Studies from around the world also have suggested that between 5-15% of patients who present for cosmetic procedures meet diagnostic criteria for body dysmorphic disorder (BDD). While individuals with BDD typically do not report a reduction in their BDD symptoms following a cosmetic procedure, the great majority of patients without the disorder do report improvement in body image. The paper reviews this literature and also discusses the role of body image in three newer areas of plastic surgery-body contouring after massive weight loss, genital procedures (either for cosmetic purposes or as part of gender reassignment), and vascularized composite allotransplantation, including face and hand transplantation.
Collapse
Affiliation(s)
- David B Sarwer
- College of Public Health, Temple University, United States.
| |
Collapse
|
21
|
Coles NA, Larsen JT, Kuribayashi J, Kuelz A. Does Blocking Facial Feedback Via Botulinum Toxin Injections Decrease Depression? A Critical Review and Meta-Analysis. EMOTION REVIEW 2019. [DOI: 10.1177/1754073919868762] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Researchers have proposed that blocking facial feedback via glabellar-region botulinum toxin injections (GBTX) can reduce depression. Random-effects meta-analyses of studies that administered GBTX to individuals with depression indicate that, 6 weeks postintervention, GBTX groups were significantly less depressed compared to placebo groups ( d = 0.83) and pretreatment levels ( d = 1.57). However, we noted the following concerns: (a) effect sizes were extraordinarily large, (b) authors failed to provide information to compute 51% of relevant effect sizes, (c) 96% of effect sizes came from studies conducted by investigators with conflicts of interest, (d) there is some evidence of publication bias, and (e) studies used ineffective blinding procedures. These considerations suggest that confidence in GBTX as a treatment for depression is premature.
Collapse
Affiliation(s)
| | | | | | - Ashley Kuelz
- Department of Psychology, University of Tennessee, USA
| |
Collapse
|
22
|
Patient Satisfaction and Patients' Family or Significant Other Perceptions After OnabotulinumtoxinA Treatment: A Prospective Cross-Sectional Study. Dermatol Surg 2019; 45:1069-1079. [PMID: 30762713 DOI: 10.1097/dss.0000000000001764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND OnabotulinumtoxinA treatment is associated with improved emotional well-being in patients. OBJECTIVE This study aimed to determine satisfaction with onabotulinumtoxinA treatment in patients naive to neurotoxin treatment and patients with previous experience with the procedure and evaluate treatment impact on patients' partners, "significant others," or close family members. MATERIALS AND METHODS Patients' satisfaction and their family's/significant other's perception to treatment outcome were assessed in a prospective, cross-sectional study using standardized questionnaires. RESULTS OnabotulinumtoxinA treatment was associated with high patient satisfaction ranging from 80% to 100%. Study patients (61 patients) reported that their faces appeared to be more balanced and symmetrical (mean difference, 1.05) and that they looked much better in photographs (mean difference, 1.43), with their significant others also noting the improvement in appearance. Overall, 98% of patients expressed that they would undergo retreatment, and 100% expressed that they would recommend the procedure to others. The main obstacle for treatment repetition was economic constraints (26%). CONCLUSION OnabotulinumtoxinA treatment is one of the most precise and predictable cosmetic treatments available, with high patient satisfaction (97%). A positive outcome of onabotulinumtoxinA treatment, as expressed by patients surveyed using standardized questionnaires, was the appreciation and acceptance by those in close contact with them.
Collapse
|
23
|
Wollmer MA, Magid M, Kruger THC, Finzi E. The Use of Botulinum Toxin for Treatment of Depression. Handb Exp Pharmacol 2019; 263:265-278. [PMID: 31691857 DOI: 10.1007/164_2019_272] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
A series of clinical studies have shown that botulinum toxin can treat major depression. Subjects suffering from unipolar depression may experience a quick, strong, and sustained improvement in the symptoms of depression after a single glabellar treatment with botulinum toxin.Preliminary data suggest that botulinum toxin therapy may also be effective in the treatment of other mental disorders characterized by an excess of negative emotions, such as borderline personality disorder.The mood-lifting effect of botulinum toxin therapy is probably mediated by the interruption of a proprioceptive feedback loop from the facial musculature to the emotional brain.
Collapse
Affiliation(s)
- M Axel Wollmer
- Asklepios Clinic North-Ochsenzoll, Asklepios Campus Hamburg, Medical Faculty, Semmelweis University, Hamburg, Germany.
| | - Michelle Magid
- Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Tillmann H C Kruger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, Hannover, Germany
| | - Eric Finzi
- Department of Psychiatry and Behavioral Sciences, George Washington School of Medicine, Washington, DC, USA
| |
Collapse
|
24
|
Loron AM, Ghaffari A, Poursafargholi N. Personality Disorders among Individuals Seeking Cosmetic Botulinum Toxin Type A (BoNTA) Injection, a Cross-Sectional Study. Eurasian J Med 2018; 50:164-167. [PMID: 30515036 DOI: 10.5152/eurasianjmed.2018.17373] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective Body dysmorphic disorder, narcissistic personality disorder, and histrionic personality disorders are the most frequent personality disorders in patients seeking cosmetic interventions. Botulinum toxin type A (BoNTA) injection for cosmetic purpose is the most popular among non-surgical cosmetic procedures and is also the second common aesthetic treatment in Iran. The current study aimed to assess personality disorders in people who were referred for BoNTA injection in Ardabil, Iran. To the best of our knowledge, this is the first study on personality disorders in applicants for cosmetic BoNTA injection in Iran. Materials and Methods In a descriptive cross-sectional study, 200 eligible applicants for cosmetic BoNTA injection were selected by non-probability sampling. Firstly, the participants' demographic data were recorded in data gathering forms. Then their personality characteristics were evaluated via the Milton Clinical Multiaxial Inventory 3rd edition, which is a standardized self-report questionnaire for the assessment of personality disorders and clinical syndromes. Results Narcissistic personality trait was the most common (34.5%) followed by histrionic personality trait (27%), and obsessive personality trait was the least common personality trait (4%) in patients seeking BoNTA injection. Anxiety disorder had the highest frequency of clinical syndromes (46%) among the participants in this study, somatization had 25.5%, and dysthymia had the lowest frequency (11%). Conclusion The current study concluded that narcissistic and histrionic personality traits and anxiety and somatization symptoms are higher in applicants for cosmetic BoNTA injection.
Collapse
Affiliation(s)
| | - Azra Ghaffari
- Department of Psychology, Islamic Azad University Ardabil Branch, Ardabil, Iran
| | | |
Collapse
|
25
|
Lewis MB. The interactions between botulinum-toxin-based facial treatments and embodied emotions. Sci Rep 2018; 8:14720. [PMID: 30283017 PMCID: PMC6170457 DOI: 10.1038/s41598-018-33119-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 09/04/2018] [Indexed: 11/23/2022] Open
Abstract
Botulinum toxin (BTX) injections reduce muscle mobility and are commonly used to treat the appearance of glabellar frown lines. Research shows that this cosmetic treatment leads to a reduction in depression. This reduction is consistent with the theory of embodied emotions because patients have a reduced ability to frown and so receive less negative feedback associated with this action. The current research explored this effect and three further hypotheses for the effects of cosmetic BTX injections based on embodied emotions. It was hypothesised that treatment of crow's feet (or laughter lines) would reduce mood as patients' Duchenne smiles would be impaired. It was hypothesised that facial BTX treatments would impair emotional expression recognition because the ability to mimic emotions would be reduced. Finally, it was hypothesised that, as BTX treatments prevent facial expressions associated with sexual excitement, sexual function would be impaired after treatment. Twenty four BTX-treated and twelve matched participants (all female) were tested before and after treatment. Results found that BTX treatment of laughter lines was associated with increased depression scores. Further, BTX treatment was associated with reduced emotion recognition ability and sexual function. The current results add to our knowledge of the psychological effects of injections of powerful neurotoxins and broaden the scope of the embodiment of emotions.
Collapse
Affiliation(s)
- Michael B Lewis
- School of Psychology, Cardiff University, Cardiff, CF10 3AT, UK.
| |
Collapse
|
26
|
|
27
|
Guerzoni S, Pellesi L, Baraldi C, Cainazzo MM, Negro A, Martelletti P, Pini LA. Long-term Treatment Benefits and Prolonged Efficacy of OnabotulinumtoxinA in Patients Affected by Chronic Migraine and Medication Overuse Headache over 3 Years of Therapy. Front Neurol 2017; 8:586. [PMID: 29163347 PMCID: PMC5676047 DOI: 10.3389/fneur.2017.00586] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 10/19/2017] [Indexed: 01/03/2023] Open
Abstract
Background Chronic migraine (CM) affects about the 2% of the general population and it has been recognized as one of the most-disabling conditions worldwide by the World Health Organization. CM is often associated with the overuse of abortive medication, which determines the worsening of headache itself and the development of a secondary headache called medication overuse headache. The management of these associated conditions is difficult, but a growing amount of evidence is pointing out the effectiveness and the good safety profile of OnabotulinumtoxinA (OnabotA). Despite this, data on OnabotA effects and safety in long-term use lack. The purpose of the present article is to retrospectively assess the efficacy and safety of OnabotA in a cohort of chronic migraineurs with drug overuse from the 18th month of treatment until the third year. Materials and methods 90 chronic migraineurs with medication overuse were enrolled between January 2013 and February 2017. All patients were treated with OnabotA according to PREEMPT dictates. Before every injection session the headache index, the analgesic consumption, the visual analog scale for pain score, the 36-items short form health survey questionnaire score, the 6-items headache impact test (HIT-6) score and the Zung self-rating anxiety and depression scale scores were collected. Adverse events were carefully registered. A simple linear regression was performed to explore the mean changes in the abovementioned parameters for a single injection session and mean comparison tests were performed using the one-way analysis of variance followed by Tukey–Kramer post-hoc test. Results A significantly improvement for a single injection was registered for all the above-mentioned parameters. Headache index, analgesic consumption, visual analog pain scale, and 6-items HIT-6 scores were significantly lower than baseline from the 18th month of treatment onwards. The 36-items short form health survey questionnaire scores were significantly higher than baseline at every injections session from the 18th months onwards. Zung scales did not change. No serious adverse events were assessed and no adverse events-related drop-outs were seen. Conclusion OnabotA effectiveness and safety last until 3 years of therapy, raising the possibility of the use of this therapy even for many years in CM prevention.
Collapse
Affiliation(s)
- Simona Guerzoni
- Headache and Drug Abuse Research Centre, Policlinico Hospital, Department of Diagnostic Medicine, Clinical and Public Health, University of Modena e Reggio Emilia, Modena, Italy
| | - Lanfranco Pellesi
- Headache and Drug Abuse Research Centre, Policlinico Hospital, Department of Diagnostic Medicine, Clinical and Public Health, University of Modena e Reggio Emilia, Modena, Italy
| | - Carlo Baraldi
- Headache and Drug Abuse Research Centre, Policlinico Hospital, Department of Diagnostic Medicine, Clinical and Public Health, University of Modena e Reggio Emilia, Modena, Italy
| | - Michela Maria Cainazzo
- Headache and Drug Abuse Research Centre, Policlinico Hospital, Department of Diagnostic Medicine, Clinical and Public Health, University of Modena e Reggio Emilia, Modena, Italy
| | - Andrea Negro
- Regional Referral Headache Centre, Sant'Andrea Hospital, Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Paolo Martelletti
- Regional Referral Headache Centre, Sant'Andrea Hospital, Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Luigi Alberto Pini
- Headache and Drug Abuse Research Centre, Policlinico Hospital, Department of Diagnostic Medicine, Clinical and Public Health, University of Modena e Reggio Emilia, Modena, Italy.,Center for Neuroscience and Neurotechnology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena e Reggio Emilia, Modena, Italy
| |
Collapse
|
28
|
Scharschmidt D, Preiß S, Brähler E, Fischer T, Borkenhagen A. [Body experience and self-esteem after minimally invasive skin rejuvenation : Study of female patients using botulinum toxin A and/or dermal fillers]. Hautarzt 2017; 68:959-967. [PMID: 29052749 DOI: 10.1007/s00105-017-4066-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND More and more people worldwide and also in Germany are using botulinum toxin type A (BoNT-A) and hyaluronic acid injections for skin rejuvenation. OBJECTIVE Study on body image and self-esteem of women with BoNT-A and/or hyaluronic acid filler treatment. MATERIAL AND METHODS A total of 145 women who requested BoNT-A and/or hyaluronic acid injections completed a survey comprised of the body dysmorphic disorder questionnaire, the Rosenberg self-esteem scale and questionnaires on the attitudes and motives on measures for optimization of the body and demographic features. Using this instrument data on the body image and self-esteem as well as attitudes and motives for utilization of minimally invasive skin rejuvenation were collated. RESULTS Female users of minimally invasive skin rejuvenation showed an overall higher socioeconomic status and an above average high monthly income. They lived in a partnership more often in comparison to women of equal age living in Berlin. The users of BoNT-A and/or hyaluronic acid fillers showed no conspicuous differences in body image and self-esteem. They showed a moderately positive attitude to body optimization procedures and 91% achieved their standard weight with a body mass index (BMI) of ≤25 kg/m2 in comparison to 56% of German women in the same age range (25 to ≥75 years old). CONCLUSION In the first study of body image and self-esteem in users of BoNT‑A and/or dermal fillers in German women, the users showed no signs of body dysmorphic patterns or disorders of self-esteem.
Collapse
Affiliation(s)
- D Scharschmidt
- Praxis Berlin, Haut-und Lasercentrum Berlin-Potsdam, Richard-Strauss-Str. 27, 14193, Berlin, Deutschland
| | - S Preiß
- Klinik für Plastische Brust- und Rekonstruktive Chirurgie, Städt. Krankenhaus Dresden-Neustadt, Dresden, Deutschland
| | - E Brähler
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Mainz, Mainz, Deutschland
| | - T Fischer
- Praxis Berlin, Haut-und Lasercentrum Berlin-Potsdam, Richard-Strauss-Str. 27, 14193, Berlin, Deutschland
| | | |
Collapse
|
29
|
Giordano CN, Matarasso SL, Ozog DM. Injectable and topical neurotoxins in dermatology: Indications, adverse events, and controversies. J Am Acad Dermatol 2017; 76:1027-1042. [PMID: 28522039 DOI: 10.1016/j.jaad.2016.11.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 11/03/2016] [Accepted: 11/06/2016] [Indexed: 12/27/2022]
Abstract
The use of neuromodulators for therapeutic and cosmetic indications has proven to be remarkably safe. While aesthetic and functional adverse events are uncommon, each anatomic region has its own set of risks of which the physician and patient must be aware before treatment. The therapeutic usages of botulinum toxins now include multiple specialties and multiple indications. New aesthetic indications have also developed, and there has been an increased utilization of combination therapies to combat the effects of global aging. In the second article in this continuing medical education series, we review the prevention and treatment of adverse events, therapeutic and novel aesthetic indications, controversies, and a brief overview of combination therapies.
Collapse
Affiliation(s)
| | - Seth L Matarasso
- Department of Dermatology, University of California, San Francisco School of Medicine, San Francisco, California
| | - David M Ozog
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan.
| |
Collapse
|
30
|
Finzi E, Rosenthal NE. Emotional proprioception: Treatment of depression with afferent facial feedback. J Psychiatr Res 2016; 80:93-96. [PMID: 27344227 DOI: 10.1016/j.jpsychires.2016.06.009] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 06/10/2016] [Indexed: 11/29/2022]
Abstract
We develop the concept of emotional proprioception, whereby the muscles of facial expression play a central role in encoding and transmitting information to the brain's emotional circuitry, and describe its underlying neuroanatomy. We explore the role of facial expression in both reflecting and influencing depressed mood. The circuitry involved in this latter effect is a logical target for treatment with botulinum toxin, and we review the evidence in support of this strategy. Clinical trial data suggest that botulinum toxin is effective in treating depression. We discuss the clinical and theoretical implications of these data. This novel treatment approach is just one example of the potential importance of the cranial nerves in the treatment of depression.
Collapse
Affiliation(s)
- Eric Finzi
- George Washington School of Medicine & Health Sciences, Washington, DC, 20037, USA.
| | | |
Collapse
|
31
|
Chang BL, Wilson AJ, Taglienti AJ, Chang CS, Folsom N, Percec I. Patient Perceived Benefit in Facial Aesthetic Procedures: FACE-Q as a Tool to Study Botulinum Toxin Injection Outcomes. Aesthet Surg J 2016; 36:810-20. [PMID: 26780945 DOI: 10.1093/asj/sjv244] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There are numerous methods of assessing patient satisfaction with botulinum toxin type A neuromodulation of the glabellar rhytids. As the use of aesthetic neuromodulation increases both in breadth and number of procedures, there is a need for more comprehensive tools to evaluate patient-reported outcomes. The FACE-Q is a recently validated patient-reported outcome instrument that can be used to measure patient perceptions of botulinum toxin type A neuromodulation. OBJECTIVES This study used the FACE-Q to assess patient satisfaction following botulinum toxin type A neuromodulation of the glabellar rhytids. METHODS 57 female patients completed the FACE-Q, a survey that evaluates patients' satisfaction with their facial appearance. After this baseline survey, the patients received injections of one of onabotulinumtoxinA (Botox, Allergan, Dublin, Ireland), abobotulinumtoxinA (Dysport, Galderma, Lausanne, Switzerland), or incobotulinumtoxinA (Xeomin, Merz Pharmaceuticals, Frankfurt am Main, Germany) in the glabella. Two weeks post-injection, the patients completed the FACE-Q again. The percentage changes in patient responses were tabulated to determine how neuromodulation affects patient satisfaction with their facial appearance. The percentage changes for each of the neurotoxin groups were compared to determine if patient satisfaction with neuromodulation varies with the type of neurotoxin. RESULTS Patient satisfaction with their overall facial appearance increased by 28% following neuromodulation. Patients stated that they believe they look an average of 5.6 years younger post-neuromodulation. There were no significant differences among the treatment groups. CONCLUSIONS The FACE-Q demonstrates that patients are more satisfied by their overall facial appearance and age appearance following neuromodulation of their glabellar rhytids. Patients are equally satisfied with the improvement of their facial appearance regardless of which neurotoxin they received. LEVEL OF EVIDENCE 2: Therapeutic.
Collapse
Affiliation(s)
- Brian L Chang
- From the Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA
| | - Anthony J Wilson
- From the Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA
| | - Anthony J Taglienti
- From the Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA
| | - Catherine S Chang
- From the Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA
| | - Nancy Folsom
- From the Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA
| | - Ivona Percec
- From the Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA
| |
Collapse
|
32
|
Abstract
OBJECTIVE The goal of this review was to consolidate the evidence concerning the efficacy of botulinum toxin type A (onabotulinumtoxinA) in depression. METHODS We searched MEDLINE, EMBASE, Cochrane, and Scopus through May 5, 2014, for studies evaluating the efficacy of botulinum toxin A in depression. Only randomized controlled trials were included in the meta-analysis. A pooled mean difference in primary depression score, and pooled odds ratio for response and remission rate with 95% confidence interval (CI) were estimated using the random-effects model. Heterogeneity was assessed using Cochran Q test and χ statistic. RESULTS Of the 639 articles that were initially retrieved, 5 studies enrolling 194 subjects (age 49±9.6 y) were included in the systematic review, and 3 randomized controlled trials enrolling 134 subjects were included in the meta-analysis. The meta-analysis showed a significant decrease in mean primary depression scores among patients who received botulinum toxin A compared with placebo (-9.80; 95% CI, -12.90 to -6.69) with modest heterogeneity between the studies (Cochran Q test, χ=70). Response and remission rates were 8.3 and 4.6 times higher, respectively, among patients receiving botulinum toxin A compared with placebo, with no heterogeneity between the studies. The 2 studies excluded from the meta-analysis also found a significant decrease in primary depression scores in patients after receiving botulinum toxin A. A few subjects had minor side effects, which were similar between the groups receiving botulinum toxin and those receiving placebo. CONCLUSIONS This study suggests that botulinum toxin A can produce significant improvement in depressive symptoms and is a safe adjunctive treatment for patients receiving pharmacotherapy for depression. Future trials are needed to evaluate the antidepressant effect per se of botulinum toxin A and to further elucidate the underlying antidepressant mechanism of botulinum toxin A.
Collapse
|
33
|
Ibragić S, Matak I, Dračić A, Smajlović A, Muminović M, Proft F, Sofić E, Lacković Z, Riederer P. Effects of botulinum toxin type A facial injection on monoamines and their metabolites in sensory, limbic and motor brain regions in rats. Neurosci Lett 2016; 617:213-7. [PMID: 26876447 DOI: 10.1016/j.neulet.2016.02.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 12/15/2015] [Accepted: 02/10/2016] [Indexed: 10/22/2022]
Abstract
Despite its toxicity, botulinum neurotoxin type A (BTX-A) is a valuable therapeutic agent for several motor, autonomic and pain disorders. Numerous studies have described its peripheral as well as central effects. Using reversed-phase High Performance Liquid Chromatography with Electrochemical Detection (HPLC-ED) and gradient elution, we quantified the concentrations of dopamine (DA), noradrenaline (NA), serotonin (5-HT) and their metabolites in 10 brain regions, ipsilateral and contralateral from the site of unilateral BTX-A administration (5 U/kg) into the rat whisker pad. In regions associated with nociception and pain processing we also examined possible BTX-A effects in combination with formalin-induced inflammatory orofacial pain. The dominant BTX-A effects on the monoamines and their metabolites were insignificant. The only significant increase caused by BTX-A alone was that of NA in striatum and serotonin in hypothalamus. While antinociceptive effects of BTX-A are most probably not related to central monoamine concentrations, the localized increased NA and 5-HT concentrations might play a role in reported BTX-A efficacy for the treatment of depression.
Collapse
Affiliation(s)
- S Ibragić
- Department of Chemistry, Faculty of Science, University of Sarajevo, Zmaja od Bosne 33-35, Sarajevo, Bosnia and Herzegovina
| | - I Matak
- Department of Pharmacology and Croatian Brain Research Institute, University of Zagreb School of Medicine, Šalata 11, 10000 Zagreb, Croatia
| | - A Dračić
- Department Pharmacology and Toxicology, Veterinary faculty Sarajevo, Zmaja od Bosne 90, Sarajevo, Bosnia and Herzegovina
| | - A Smajlović
- Department Pharmacology and Toxicology, Veterinary faculty Sarajevo, Zmaja od Bosne 90, Sarajevo, Bosnia and Herzegovina
| | - M Muminović
- Department Pharmacology and Toxicology, Veterinary faculty Sarajevo, Zmaja od Bosne 90, Sarajevo, Bosnia and Herzegovina
| | - F Proft
- Center of Mental Health, Clinic and Policlinic for Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, 97080 Würzburg, Germany
| | - E Sofić
- Department of Chemistry, Faculty of Science, University of Sarajevo, Zmaja od Bosne 33-35, Sarajevo, Bosnia and Herzegovina; Department of Pharmacoinformatics and Pharmacoeconomics, Faculty of Pharmacy, University of Sarajevo, Zmaja od Bosne 8, Sarajevo, Bosnia and Herzegovina
| | - Z Lacković
- Department of Pharmacology and Croatian Brain Research Institute, University of Zagreb School of Medicine, Šalata 11, 10000 Zagreb, Croatia
| | - P Riederer
- Center of Mental Health, Clinic and Policlinic for Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, 97080 Würzburg, Germany.
| |
Collapse
|
34
|
[Psychopharmacology of anxiety and depression: Historical aspects, current treatments and perspectives]. ANNALES PHARMACEUTIQUES FRANÇAISES 2015; 74:93-118. [PMID: 26472602 DOI: 10.1016/j.pharma.2015.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 08/25/2015] [Accepted: 09/02/2015] [Indexed: 01/08/2023]
Abstract
Pharmacological treatment of acute anxiety still relies on benzodiazepines, while chronic anxiety disorders and depression are treated with different antidepressants, according to specific indications. The monoaminergic axis is represented by two families which are being developed: (i) serotonin-norepinephrine-dopamine reuptake inhibitors (SNDRI), also called triple reuptake inhibitors (TRI), for the treatment of depression (amitifadine), (ii) multimodal antidepressants for depression and anxiety disorders (generalized anxiety disorder mainly) (tedatioxetine, vortioxetine and vilazodone). Third-generation antipsychotics (aripiprazole, lurasidone, brexpiprazole, cariprazine) appear relevant in the treatment of resistant depression and some anxiety disorders. Among the modulators of the glutamatergic axis, promising compounds include: (i) ionotropic regulators of NMDA receptors: esketamine, AVP-923 and AVP-786, CERC-301, rapastinel (Glyx-13), NRX-1074 developed for depression, rapastinel and bitopertine developed for obsessive compulsive disorder, (ii) metabotropic glutamate receptors modulators: decoglurant and basimglurant developed for depression and mavoglurant developed for obsessive compulsive disorder.
Collapse
|
35
|
Kruger THC, Wollmer MA. Depression--An emerging indication for botulinum toxin treatment. Toxicon 2015; 107:154-7. [PMID: 26415901 DOI: 10.1016/j.toxicon.2015.09.035] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 09/10/2015] [Accepted: 09/22/2015] [Indexed: 11/19/2022]
Abstract
The treatment of glabellar frown lines with botulinum toxin injection is one of the most prevalent procedures in esthetic medicine. It is possible that the popularity of this intervention is not only owing to its cosmetic effect but also to modulatory effects on mood and affectivity. Recently, a series of studies including three randomized controlled trials have consistently shown that such effects can be used in the treatment of depression. Predominantly female patients suffering from partly chronic and treatment resistant unipolar depression experienced a quick, strong and sustained improvement in depressive symptoms after a single glabellar treatment with botulinum toxin A as a sole or adjunctive therapy. If these findings are further corroborated in additional studies, the ever-growing spectrum of applications for botulinum toxin may spread into the field of psychiatry, showing that the superficial paralysis of facial muscles may, probably via proprioceptive feedback mechanisms, have profound effects on the emotional brain.
Collapse
Affiliation(s)
- Tillmann H C Kruger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, Germany
| | - M Axel Wollmer
- Asklepios Clinic North - Ochsenzoll, Asklepios Campus Hamburg, Medical Faculty, Semmelweis University, Germany.
| |
Collapse
|
36
|
Maasumi K, Thompson NR, Kriegler JS, Tepper SJ. Effect of OnabotulinumtoxinA Injection on Depression in Chronic Migraine. Headache 2015; 55:1218-24. [PMID: 26381856 DOI: 10.1111/head.12657] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The current study retrospectively evaluated patient reported outcomes (PROs) collected before and after at least 2 sessions of onabotulinumtoxinA (onabot) injections for chronic migraine. Depression was assessed by the Patient Health Questionnaire-9. METHOD Chronic migraineurs receiving onabot were identified. In addition to the Patient Health Questionnaire-9 (PHQ9), the European Quality of Life (QOL), 5-Dimension (EQ-5D) (QOL), Headache Impact Test (HIT6), and Pain Disability Index (PDI) were reviewed across ≥2 consecutive onabot injections for 6-12 months. Paired t-tests on patient's questionnaire scores before and after treatment were performed. Analysis of the PHQ9 was restricted to patients with pretreatment scores ≥ 10 (moderate to severe depression). Change in PHQ9 was the primary outcome, and other PROs were also evaluated. RESULTS Four hundred twenty-nine patients met the inclusion criteria, and data were gathered from 2010 to 2014. Average age was 45 years, with 85.5% female, and 92.1% Caucasian. There were 127 patients with PHQ9 scores ≥10 at baseline. Their PHQ9 scores improved from 14.4 (high-moderate) pre-onabot to 11.3 (low-moderate) post-onabot (P <.0001, 95% CI = -4.2 to -2.1); PDI improved from 4.3 to 3.8 (P = .0078, 95% CI = -0.7 to -0.1); EQ-5D improved from 0.74 to 0.77 (P = .0078; 95%CI = 0.01 to 0.04); HIT6 improved from 63.3 to 60.5 (P <.0001, 95%CI = -3.4 to -2.2). For comparison, in the PREEMPT onabot regulatory trials, HIT6 changed from 66 to 61.2 after 5 onabot injections at 24 weeks, P < .001. CONCLUSION Onabot injections in chronic migraine patients statistically improved depression scores in patients beginning with at least moderate depression and improved scores in headache and quality of life. Onabot injections also decreased impact of headache on daily life.
Collapse
Affiliation(s)
- Kasra Maasumi
- Cleveland Clinic Headache Center, Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Nicolas R Thompson
- Department of Quantitative Health Sciences and Neurological Institute Center for Outcomes Research and Evaluation, Cleveland, OH, USA
| | - Jennifer S Kriegler
- Cleveland Clinic Headache Center, Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Stewart J Tepper
- Cleveland Clinic Headache Center, Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| |
Collapse
|
37
|
Affiliation(s)
- Steven H Dayan
- Dr Dayan is a Clinical Assistant Professor, Department of Otolaryngology, University of Illinois, Chicago, Illinois
| |
Collapse
|
38
|
Abstract
The concept of aesthetic self-esteem was explored for utilization in the medical spa environment. The aims and purposes of the analysis were outlined. The literature review identified various uses of the self-esteem concept as well as published definitions of the word. Defining attributes were also explored and examined, including positive and negative connotations of self-esteem. Two tools were utilized to help aesthetic nurse specialists assess patients for self-esteem and assess for a possible mental illness that may present as low self-esteem. A culturally sensitive theoretical definition of self-esteem was constructed to fit the needs and environment of medical spas. A model case of this definition, as well as a borderline and contrary case, was presented. Antecedents and consequences, as well as empirical referents of the concept, were explored.
Collapse
Affiliation(s)
- Julie Bass Kaplan
- Julie Bass Kaplan, MSN, RN, CPSN, CANS, PHN, HCMT, established a cosmetic laser center in 1999. She loves the artistry of dermal fillers and neuromodulators and enjoys improving skin health with lasers. She especially loves to travel and teach injection and laser safety techniques. Julie also holds private training sessions in California with her company JBK Aesthetics LLC
| |
Collapse
|
39
|
Patient Satisfaction and Safety With Aesthetic OnabotulinumtoxinA After At Least 5 Years. Dermatol Surg 2015; 41 Suppl 1:S19-28. [DOI: 10.1097/dss.0000000000000275] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
40
|
Kim MJ, Neta M, Davis FC, Ruberry EJ, Dinescu D, Heatherton TF, Stotland MA, Whalen PJ. Botulinum toxin-induced facial muscle paralysis affects amygdala responses to the perception of emotional expressions: preliminary findings from an A-B-A design. BIOLOGY OF MOOD & ANXIETY DISORDERS 2014; 4:11. [PMID: 25694806 PMCID: PMC4332022 DOI: 10.1186/2045-5380-4-11] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 10/10/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND It has long been suggested that feedback signals from facial muscles influence emotional experience. The recent surge in use of botulinum toxin (BTX) to induce temporary muscle paralysis offers a unique opportunity to directly test this "facial feedback hypothesis." Previous research shows that the lack of facial muscle feedback due to BTX-induced paralysis influences subjective reports of emotional experience, as well as brain activity associated with the imitation of emotional facial expressions. However, it remains to be seen whether facial muscle paralysis affects brain activity, especially the amygdala, which is known to be responsive to the perception of emotion in others. Further, it is unknown whether these neural changes are permanent or whether they revert to their original state after the effects of BTX have subsided. The present study sought to address these questions by using functional magnetic resonance imaging to measure neural responses to angry and happy facial expressions in the presence or absence of facial paralysis. RESULTS Consistent with previous research, amygdala activity was greater in response to angry compared to happy faces before BTX treatment. As predicted, amygdala activity in response to angry faces was attenuated when the corrugator/procerus muscles were paralyzed via BTX injection but then returned to its original state after the effects of BTX subsided. This preliminary study comprises a small sample size and no placebo condition; however, the A-B-A design affords the present sample to serve as its own control. CONCLUSIONS The current demonstration that amygdala responses to facial expressions were influenced by facial muscle paralysis offers direct neural support for the facial feedback hypothesis. Specifically, the present findings offer preliminary causal evidence that amygdala activity is sensitive to facial feedback during the perception of the facial expressions of others. More broadly, these data confirm the utility of using BTX to address the effect of facial feedback on neural responses associated with the perception, in addition to the experience or expression of emotion.
Collapse
Affiliation(s)
- M Justin Kim
- Department of Psychological and Brain Sciences, Dartmouth College, 6207 Moore Hall, Hanover, NH 03755, USA
| | - Maital Neta
- Department of Psychology, B84 East Stadium, University of Nebraska-Lincoln, Lincoln, NE 68588-0156, USA
| | - F Caroline Davis
- US Army Natick Soldier Research Development and Engineering Center, Cognitive Science Research Team, 10 Kansas St., Natick, MA 01760, USA ; Department of Psychology, Tufts University, 490 Boston Avenue, Medford, MA 02155, USA
| | - Erika J Ruberry
- Department of Psychology, University of Washington, 119A Guthrie Hall, Seattle, WA 98195, USA
| | - Diana Dinescu
- Department of Psychology, University of Virginia, 102 Gilmer Hall, Charlottesville, VA 22904, USA
| | - Todd F Heatherton
- Department of Psychological and Brain Sciences, Dartmouth College, 6207 Moore Hall, Hanover, NH 03755, USA
| | - Mitchell A Stotland
- Department of Surgery (Plastic) and Pediatrics, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA ; Department of Surgery (Plastic and Craniofacial), Sidra Research and Medical Center, Doha, Qatar
| | - Paul J Whalen
- Department of Psychological and Brain Sciences, Dartmouth College, 6207 Moore Hall, Hanover, NH 03755, USA
| |
Collapse
|
41
|
Wollmer MA, Kalak N, Jung S, de Boer C, Magid M, Reichenberg JS, Brand S, Holsboer-Trachsler E, Kruger THC. Agitation predicts response of depression to botulinum toxin treatment in a randomized controlled trial. Front Psychiatry 2014; 5:36. [PMID: 24744738 PMCID: PMC3978251 DOI: 10.3389/fpsyt.2014.00036] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 03/18/2014] [Indexed: 11/13/2022] Open
Abstract
In a randomized, controlled trial (n = 30), we showed that botulinum toxin injection to the glabellar region produces a marked improvement in the symptoms of major depression. We hypothesized that the mood-lifting effect was mediated by facial feedback mechanisms. Here we assessed if agitation, which may be associated with increased dynamic psychomotor activity of the facial musculature, can predict response to the treatment. To test this hypothesis, we re-analyzed the data of the scales from our previous study on a single item basis and compared the baseline scores in the agitation item (item 9) of the Hamilton Depression Rating Scale (HAM-D) between responders (n = 9) and participants who did not attain response (n = 6) among the recipients of onabotulinumtoxinA (n = 15). Responders had significantly higher item 9 scores at baseline [1.56 + 0.88 vs. 0.33 + 0.52, t (13) = 3.04, d = 1.7, p = 0.01], while no other single item of the HAM-D or the Beck Depression Inventory was associated with treatment response. The agitation score had an overall precision of 78% in predicting response in a receiver operating characteristic (ROC) analysis (area under the curve, AUC = 0.87). These data provide a link between response to botulinum toxin treatment with a psychomotor manifestation of depression and thereby indirect support of the proposed facial feedback mechanism of action. Moreover, it suggests that patients with agitated depression may particularly benefit from botulinum toxin treatment.
Collapse
Affiliation(s)
- M Axel Wollmer
- Asklepios Clinic North - Ochsenzoll, Asklepios Campus Hamburg, Medical Faculty, Semmelweis University , Hamburg , Germany ; Psychiatric Clinics of the University of Basel , Basel , Switzerland
| | - Nadeem Kalak
- Psychiatric Clinics of the University of Basel , Basel , Switzerland
| | - Stefanie Jung
- Asklepios Clinic North - Ochsenzoll, Asklepios Campus Hamburg, Medical Faculty, Semmelweis University , Hamburg , Germany ; Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover , Hannover , Germany
| | - Claas de Boer
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover , Hannover , Germany
| | - Michelle Magid
- Department of Psychiatry, University of Texas Southwestern at Seton Family of Hospitals , Austin, TX , USA
| | - Jason S Reichenberg
- Department of Dermatology, University of Texas Southwestern at Seton Family of Hospitals , Austin, TX , USA
| | - Serge Brand
- Psychiatric Clinics of the University of Basel , Basel , Switzerland
| | | | - Tillmann H C Kruger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover , Hannover , Germany
| |
Collapse
|