Botox for the treatment of mental and psychological conditions

A new study finds that Botox injections can help relieve symptoms of mental health conditions such as depression and anxiety. BTX botulinum toxin injections, which are commonly referred to as “Botox”, are primarily used for cosmetic procedures, because they cause muscle relaxation, and when applied to certain areas of the face, Botox can reduce lines and wrinkles, according to EuroNews. Citing a study published in the journal Scientific Reports.

"Muscles of Sorrow"

Facial muscle relaxation has been the subject of a number of studies, as scientists seek to see if it can be used to relieve symptoms of mental health conditions. Specifically, the idea is that you can target what evolutionary biologist Charles Darwin called "grief muscles."

“This entire field of research using botulinum toxin as a treatment for mental disorders is based on the hypothesis of facial feedback,” said Dr. Axel Wollmer, a psychiatry expert and researcher at Semmelweis University in Hamburg and one of the lead authors on the study.

He added that this hypothesis dates back to Darwin and William James (known as the “father” of American psychology) in the nineteenth century, pointing out that it states that human facial expressions not only convey his emotional state to others, but also express it to him himself.

The theory is that while some facial expressions such as frowning are caused by negative emotions, the facial expressions themselves actually reinforce those emotions in a vicious cycle.

"One reinforces the other and may escalate to a critical level of emotional arousal that may be an issue in mental health conditions," Woolmer said.

Together with researchers from Hannover Medical School in Germany, Wollmer and his team set out to build on previous research in injecting Botox into the glabella region, the area of ​​the face above the nose and between the eyebrows, which often reflects a person's stress when experiencing negative emotions.

“Once the facial muscles are activated to express emotion, a body stimulus signal is generated, which returns from the face to the emotional brain and reinforces and maintains this emotional state,” Woolmer explained. It is only by the embodiment of these feelings that one really feels them as warm and full feelings, or once this embodiment is suppressed, the feelings subside and are not perceived as such.”

Borderline personality disorder

By relaxing the muscles of grief, researchers sought to capture what happens in the brain when the positive feedback loop is broken, so they examined 45 patients with borderline personality disorder (BPD), one of the most common personality disorders.

The team of researchers explained that patients with BPD suffer from "excess negative emotions", including anger and fear. Wollmer said BPD patients are "in a sense, a prototype of being overwhelmed over and over with a bunch of negative emotions that they can't really control." Then some of the study participants received Botox injections, while the control group received acupuncture.

Magnetic resonance imaging of the brain

Before the treatment and four weeks later, the participants were given a so-called emotional “go/no-go” task, in which they had to control their reactions to certain cues while seeing pictures of faces with different emotional expressions, while the researchers scanned their brains using functional magnetic resonance imaging. . The trial yielded mixed results, with both Botox and acupuncture patients showing similar improvement after treatment, but the team of researchers was motivated by two other results.

Through MRI scans, it was discovered for the first time how Botox injections modify the neurobiological aspects of BPD. MRI images showed a decrease in activity in the brain's amygdala in response to emotional stimuli.

“We discovered a calming effect on the amygdala, which is critically involved in processing negative emotions and is overactive in BDD patients,” Wollmer said, adding that the same effect was not seen in the control group treated with acupuncture.

The researchers also noted that Botox injections reduced the patients' impulsive behavior during the "go/no-go" task, and was associated with activation of frontal lobe regions of the brain that are involved in inhibitory control.

Botox treatment for depression

Previous research has looked at how Botox injections can break feedback loops in other areas of the face and body.

A 2021 meta-analysis examining data from 40 Botox-injected patients in a US Food and Drug Administration database found that anxiety disorders were 22 to 72 percent less common than patients who received other treatments for the same conditions. Similar research was conducted in 2020 on the stressful effects of Botox injections, which showed that it can be used to treat depression as well as prevent it.

Wollmer said that well-established treatments such as psychotherapy or antidepressants do not work well enough for about a third of patients with depression, “therefore, there is a need to develop new treatment options, and here Botox injections can have a role,” expressing his hope and his research team to see the results. , which has been investigated further in a larger Phase XNUMX clinical trial, where researchers will see if any other mental health conditions can be treated with the Botox injection approach.