Agitation Predicts Response of Depression to Botulinum Toxin Treatment in a Randomized Controlled Trial

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, whic...

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Autores principales: Wollmer, M. Axel, Kalak, Nadeem, Jung, Stefanie, de Boer, Claas, Magid, Michelle, Reichenberg, Jason S., Brand, Serge, Holsboer-Trachsler, Edith, Kruger, Tillmann H. C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3978251/
https://www.ncbi.nlm.nih.gov/pubmed/24744738
http://dx.doi.org/10.3389/fpsyt.2014.00036
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author Wollmer, M. Axel
Kalak, Nadeem
Jung, Stefanie
de Boer, Claas
Magid, Michelle
Reichenberg, Jason S.
Brand, Serge
Holsboer-Trachsler, Edith
Kruger, Tillmann H. C.
author_facet Wollmer, M. Axel
Kalak, Nadeem
Jung, Stefanie
de Boer, Claas
Magid, Michelle
Reichenberg, Jason S.
Brand, Serge
Holsboer-Trachsler, Edith
Kruger, Tillmann H. C.
author_sort Wollmer, M. Axel
collection PubMed
description 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.
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spelling pubmed-39782512014-04-17 Agitation Predicts Response of Depression to Botulinum Toxin Treatment in a Randomized Controlled Trial Wollmer, M. Axel Kalak, Nadeem Jung, Stefanie de Boer, Claas Magid, Michelle Reichenberg, Jason S. Brand, Serge Holsboer-Trachsler, Edith Kruger, Tillmann H. C. Front Psychiatry Psychiatry 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. Frontiers Media S.A. 2014-03-31 /pmc/articles/PMC3978251/ /pubmed/24744738 http://dx.doi.org/10.3389/fpsyt.2014.00036 Text en Copyright © 2014 Wollmer, Kalak, Jung, de Boer, Magid, Reichenberg, Brand, Holsboer-Trachsler and Kruger. http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Wollmer, M. Axel
Kalak, Nadeem
Jung, Stefanie
de Boer, Claas
Magid, Michelle
Reichenberg, Jason S.
Brand, Serge
Holsboer-Trachsler, Edith
Kruger, Tillmann H. C.
Agitation Predicts Response of Depression to Botulinum Toxin Treatment in a Randomized Controlled Trial
title Agitation Predicts Response of Depression to Botulinum Toxin Treatment in a Randomized Controlled Trial
title_full Agitation Predicts Response of Depression to Botulinum Toxin Treatment in a Randomized Controlled Trial
title_fullStr Agitation Predicts Response of Depression to Botulinum Toxin Treatment in a Randomized Controlled Trial
title_full_unstemmed Agitation Predicts Response of Depression to Botulinum Toxin Treatment in a Randomized Controlled Trial
title_short Agitation Predicts Response of Depression to Botulinum Toxin Treatment in a Randomized Controlled Trial
title_sort agitation predicts response of depression to botulinum toxin treatment in a randomized controlled trial
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3978251/
https://www.ncbi.nlm.nih.gov/pubmed/24744738
http://dx.doi.org/10.3389/fpsyt.2014.00036
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