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Chapter 26 - Treatment of Depression with Botulinum Toxin

Published online by Cambridge University Press:  02 November 2023

By
M. Axel Wollmer ,
Michelle Magid ,
Tillmann H. C. Kruger  and
Eric Finzi
Edited by
Daniel Truong ,
Dirk Dressler ,
Mark Hallett ,
Christopher Zachary  and
Mayank Pathak
Daniel Truong
Affiliation:
University of California, Riverside
Dirk Dressler
Affiliation:
Hannover Medical School
Mark Hallett
Affiliation:
National Institutes of Health (NIH)
Christopher Zachary
Affiliation:
University of California, Irvine
Mayank Pathak
Affiliation:
Truong Neuroscience Institute
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Summary

The glabellar region of the face harbors the so called grief muscles (corrugator and procerus muscles). Combined contraction of the corrugator muscle and the medial part of the frontalis muscle account for facial features of emotional distress like the ’omega melancholicum’ or Veraguth’s folds and can be observed frequently in patients suffering from mental disorders including depression.

According to the facial feedback hypothesis, the facial expression of emotions generates proprioceptive feedback signals that can maintain and reinforce the expressed emotions. Relaxation of glabellar muscles by means of botulinum toxin (BoNT) injections may not only give the face a less negative and more positive expression, but may also interrupt the described feedback loop and thereby lead to a less negative and more positive emotional state.

This chapter summarizes the studies showing the effect of BoNT treatment on depression, illustrates the pertinent facial expressions and the underlying muscles that produce grief expression and shows the recommended injection sites along with dose recommendations.

Keywords

Depressiongrief musclesomega melancholicumVeraguth’s foldsfacial feedback hypothesis
Type
Chapter
Information
Manual of Botulinum Toxin Therapy , pp. 218 - 222
Publisher: Cambridge University Press
Print publication year: 2023

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References

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