Bedarf Janis Rebecca, Kebir Sied, Michelis Joan Philipp, Wabbels Bettina, Paus Sebastian
Department of Neurology, University of Bonn, Bonn.
Department of Neurology, University of Essen, Essen, Germany.
Neuropsychiatr Dis Treat. 2017 Jul 14;13:1861-1865. doi: 10.2147/NDT.S141066. eCollection 2017.
Depression is the most important nonmotor symptom in blepharospasm (BL). As facial expression influences emotional perception, summarized as the facial feedback hypothesis, we investigated if patients report fewer depressive symptoms if injections of botulinum neurotoxin (BoNT) include the "grief muscles" of the glabellar region, compared to treatment of orbicularis oculi muscles alone. Ninety BL patients were included, half of whom had BoNT treatment including the frown lines. While treatment pattern did not predict depressive symptoms overall, subgroup analysis revealed that in male BL patients, BoNT injections into the frown lines were associated with remarkably less depressive symptoms. We hypothesize that in BL patients presenting with dystonia of the eyebrow region, BoNT therapy should include frown line application whenever justified, to optimize nonmotor effects of BoNT denervation.
抑郁症是眼睑痉挛（BL）最重要的非运动症状。由于面部表情会影响情绪感知，这一观点被总结为面部反馈假说，我们研究了与仅治疗眼轮匝肌相比，当肉毒杆菌神经毒素（BoNT）注射包括眉间区域的“悲伤肌肉”时，患者报告的抑郁症状是否会减少。纳入了90例BL患者，其中一半接受了包括皱眉纹在内的BoNT治疗。虽然治疗模式总体上不能预测抑郁症状，但亚组分析显示，在男性BL患者中，向皱眉纹注射BoNT与显著更少的抑郁症状相关。我们假设，对于存在眉部区域肌张力障碍的BL患者，只要合理，BoNT治疗应包括应用于皱眉纹，以优化BoNT去神经支配的非运动效果。
