Division of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Center for Systems Neuroscience, Hanover, Germany.
Sci Rep. 2022 Aug 20;12(1):14197. doi: 10.1038/s41598-022-17509-0.
Previous studies have indicated that glabellar botulinum toxin (BTX) injections may lead to a sustained alleviation of depression. This may be accomplished by the disruption of a facial feedback loop, which potentially mitigates the experience of negative emotions. Accordingly, glabellar BTX injection can attenuate amygdala activity in response to emotional stimuli. A prototypic condition with an excess of negative emotionality and impulsivity accompanied by elevated amygdala reactivity to emotional stimuli is borderline personality disorder (BPD). In order to improve the understanding of how glabellar BTX may affect the processing of emotional stimuli and impulsivity, we conducted a functional magnetic resonance imaging (fMRI) study. Our hypotheses were (1) glabellar BTX leads to increased activation in prefrontal areas during inhibition performance and (2) BTX decreases amygdala activity during the processing of emotional stimuli in general. Using an emotional go-/no-go paradigm during fMRI, the interference of emotion processing and impulsivity in a sample of n = 45 women with BPD was assessed. Subjects were randomly assigned to BTX treatment or serial acupuncture (ACU) of the head. After 4 weeks, both treatments led to a reduction in the symptoms of BPD. However, BTX treatment was specifically associated with improved inhibition performance and increased activity in the motor cortex. In addition, the processing of negative emotional faces was accompanied by a reduction in right amygdala activity. This study provides the first evidence that glabellar BTX injections may modify central neurobiological and behavioural aspects of BPD. Since the control treatment produced similar clinical effects, these neurobiological findings may be specific to BTX and not a general correlate of symptomatic improvement.
先前的研究表明，眉间注射肉毒毒素（BTX）可能会导致抑郁症状持续缓解。这可能是通过破坏面部反馈回路来实现的，从而减轻负面情绪的体验。因此，眉间 BTX 注射可以减轻杏仁核对情绪刺激的反应活性。边缘型人格障碍（BPD）是一种具有过多负性情绪和冲动性，同时伴有杏仁核对情绪刺激反应性升高的典型疾病。为了更好地理解眉间 BTX 如何影响情绪刺激和冲动性的处理，我们进行了一项功能性磁共振成像（fMRI）研究。我们的假设是：（1）眉间 BTX 可导致在执行抑制任务期间前额叶区域的活性增加；（2）BTX 可降低杏仁核在处理一般情绪刺激时的活性。我们使用 fMRI 进行情绪 Go/No-Go 范式，评估了 n=45 名 BPD 女性样本中情绪处理和冲动性的干扰。将受试者随机分配至 BTX 治疗或头部连续针刺（ACU）。4 周后，两种治疗均导致 BPD 症状的减轻。然而，BTX 治疗与抑制性能的改善和运动皮层活性的增加有关。此外，负面情绪面孔的处理伴随着右侧杏仁核活性的降低。这项研究首次提供了证据表明，眉间 BTX 注射可能会改变 BPD 的中枢神经生物学和行为方面。由于对照治疗产生了类似的临床效果，这些神经生物学发现可能是 BTX 特有的，而不是症状改善的一般相关因素。
