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Botox: The Brain Effect

Dr. Patrick Treacy IACD Sao Paulo BRAZIL 2014

Article Rejuvenate Magazine 2006

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Can Botox Treat Depression?

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2006

tHowever, this report must be considered anecdotal as there were no

appropriate methods of control utilized. In addition, there were other

methodological weaknesses including limited follow-up, lack of

randomization, the absence of blind evaluation, and especially the small

number of individuals included. The method evaluating depression should

be more rigorous. Patients’ self-report of depressive symptoms by

administration of the BDI-II introduces a significant self-report bias. This is

of more concern because of the potential for secondary gain.

Addendum from the Editor of the

Journal of Dermatological Surgery

2006

tWhile the BDI-II is an accepted method of evaluating an individual’s level of

symptoms over time, self-report in isolation is not an acceptable method of

diagnosing depression. In order to ensure that patients’ psychiatric

symptoms are accurately classified, a thorough psychiatric interview must

be conducted, and a second blind evaluator would add some credibility.

That being said, this is an intriguing report, which fits with our clinical

impression. Obviously further work is merited on this important

observation.

ALASTAIR CARRUTHERS, FRCPC

Vancouver, Canada

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I must say that I was initially heartened to see

the study of the treatment of depression with

Botox as many doctors will reveal a similar

picture from their patient's own experience. I

examined Finzi's paper in the Journal of

Dermatologic Surgery and have concerns that

this doctor used a very small number of patients,

lacked a control group, had no psychiatrist

assessing the patients and even allowed the

patients to assess themselves. I noted in an

accompanying commentary, that editor Alastair

Carruthers, also cited a series of flaws with the

study and concluded that its finding must be

considered anecdotal. It is of more than passing

interest that this doctor has now filed a patent

concerning this treatment. If Botox does relieve

depression then this is not the paper to prove it. .

Dr. Patrick Treacy

Dublin Ireland .

2006

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Does Botox effect the Brain?

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In a functional neuroimaging study, Andreas Hennenlotter and

colleagues asked participants to perform a facial expression

imitation task in an fMRI scanner before and two weeks after

receiving botox injections in the corrugator supercilii muscle

used in frowning. During imitation of angry facial expressions,

botox decreased activation of brain regions implicated in

emotional processing and emotional experience (namely, the

amygdala and the brainstem), relative to activations before

botox injection. These findings show that facial feedback

modulates neural processing of emotional content, and that

botox changes how the human brain responds to emotional

situations. Hennenlotter et al., 2008

Functional MRI and glabellar botulinum injection

2008

These findings show that facial feedback modulates neural processing of emotional content,

and that botox changes how the human brain responds to emotional situations.

Hennenlotter et al., 2008

2008

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2012

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2012

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In the first randomized, controlled study on the effect of

botulinum toxin—known commercially as Botox—on

depression, researchers investigated whether it might aid

patients with major depressive disorder who had not

responded to antidepressant medications. Participants in the

treatment group were given a single dose (consisting of five

injections) of botulinum toxin in the area of the face between

and just above the eyebrows, whereas the control group was

given placebo injections. Depressive symptoms in the

treatment group decreased 47 percent after six weeks, an

improvement that remained through the 16-week study

period. The placebo group had a 9 percent reduction in

symptoms. The findings appeared in May in the Journal of

Psychiatric Research.

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Charles Darwin concluded work on The Descent of Man on 15 January 1871. On

17 January 1871, he started work on The Expression of the Emotions, employing

the unused material on emotional expression. He published on 22 August 1872.

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Facial expressions are motions or positions of the muscles

beneath the skin of the face. There are two brain pathways

associated with facial expression;

(1) voluntary expression involving the cortex.

(2) emotional expression originating in the extrapyramidal

motor system involving the subcortical nuclei.

Primary emotions are not associated with the cortex and are

displayed unconsciously.

2008

This is demonstrated in infants

before the age of two; they

display happiness, sadness,

fear, anger, degust and

surprise. Infants’ displays of

these emotions indicate that

they are not cortically related.

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Similarly, blind children also display emotions, proving that they

are subconscious rather than learned. The amygdala have a

significant role in the recognition of fear and negative emotions.

It is believed that the emotion disgust is recognized through

activation of the insula and basal ganglia.

2008

Happiness

Sadness

Fear

Anger

Disgust

Surprise.

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2008

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Charles Darwin was among the first to suggest that physiological

changes caused by an emotion had a direct impact on, rather than

being just the consequence of that emotion.

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The facial feedback hypothesis

states that facial movement can

influence emotional experience.

For example, an individual who is

forced to smile during a social event

will actually come to find the event

more of an enjoyable experience.

The free expression by outward

signs of an emotion intensifies it.

On the other hand, the repression,

as far as this is possible, of all

outward signs softens our

emotions... Even the simulation of

an emotion tends to arouse it in our

minds. Charles Darwin 1872

2008

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2008

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When the muscles that control frowning are frozen, a person tends to smile more –

the act of smiling produces feelings of happiness. Displaying expressions of positive

emotions can actually put you in a good mood

2014

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eEffect on where we inject patient

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Obrigado!