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European Archives of Psychiatry and Clinical Neuroscience

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29.03.2023 | Original Paper

Effects of glabellar botulinum toxin injections on resting-state functional connectivity in borderline personality disorder

verfasst von: Jara Schulze, Christopher Sinke, Insa Neumann, M. Axel Wollmer, Tillmann H. C. Kruger

Erschienen in: European Archives of Psychiatry and Clinical Neuroscience | Ausgabe 1/2024

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Abstract

Meta-analyses suggest a sustained alleviation of depressive symptoms through glabellar botulinum toxin (BTX) injections. This can be explained by the disruption of facial feedback loops, which may moderate and reinforce the experience of negative emotions. Borderline personality disorder (BPD) is characterized by excessive negative emotions. Here, a seed-based resting-state functional connectivity (rsFC) analysis following BTX (N = 24) or acupuncture (ACU, N = 21) treatment in BPD is presented on areas related to the motor system and emotion processing. RsFC in BPD using a seed-based approach was analyzed. MRI data were measured before and 4 weeks after treatment. Based on previous research, the rsFC focus was on limbic and motor areas as well as the salience and default mode network. Clinically, after 4 weeks both groups showed a reduction of borderline symptoms. However, the anterior cingulate cortex (ACC) and the face area in the primary motor cortex (M1) displayed aberrant rsFC after BTX compared to ACU treatment. The M1 showed higher rsFC to the ACC after BTX treatment compared to ACU treatment. In addition, the ACC displayed an increased connectivity to the M1 as well as a decrease to the right cerebellum. This study shows first evidence for BTX-specific effects in the motor face region and the ACC. The observed effects of BTX on rsFC to areas are related to motor behavior. Since symptom improvement did not differ between the two groups, a BTX-specific effect seems plausible rather than a general therapeutic effect.

Sundaram H, Signorini M, Liew S et al (2016) Global aesthetics consensus: Botulinum toxin type A—evidence-based review, emerging concepts, and consensus recommendations for aesthetic use, including updates on complications. Plast Reconstruct Surg 137:518e–529e. https://doi.org/10.1097/01.prs.0000475758.63709.23CrossRef

Guo Y, Lu Y, Liu T et al (2015) Efficacy and safety of botulinum toxin type A in the treatment of glabellar lines: a meta-analysis of randomized, placebo-controlled, double-blind trials. Plastic Reconstruct Surg 136:310e–318e. https://doi.org/10.1097/PRS.0000000000001544CrossRef

Tremaine AM, McCullough JL (2010) Botulinum toxin type A for the management of glabellar rhytids. Clin Cosmet Investig Dermatol 3:15–23. https://doi.org/10.2147/ccid.s6492CrossRefPubMedPubMedCentral

Rijntjes M, Tegenthoff M, Liepert J et al (1997) Cortical reorganization in patients with facial palsy. Ann Neurol 41:621–630. https://doi.org/10.1002/ana.410410511CrossRefPubMed

Yildiz S, Bademkiran F, Yildiz N et al (2007) Facial motor cortex plasticity in patients with unilateral peripheral facial paralysis. NRE 22:133–140. https://doi.org/10.3233/NRE-2007-22209CrossRef

Weise D, Weise CM, Naumann M (2019) Central effects of botulinum neurotoxin-evidence from human studies. Toxins (Basel). https://doi.org/10.3390/toxins11010021CrossRefPubMed

Sommer B, Zschocke I, Bergfeld D et al (2003) Satisfaction of patients after treatment with botulinum toxin for dynamic facial lines. Dermatol Surg 29:456–460. https://doi.org/10.1046/j.1524-4725.2003.29113.xCrossRefPubMed

Baumeister J-C, Papa G, Foroni F (2016) Deeper than skin deep – The effect of botulinum toxin-A on emotion processing. Toxicon 118:86–90. https://doi.org/10.1016/j.toxicon.2016.04.044CrossRefPubMed

Lewis MB (2018) The interactions between botulinum-toxin-based facial treatments and embodied emotions. Sci Rep. https://doi.org/10.1038/s41598-018-33119-1CrossRefPubMedPubMedCentral

10.

Davis JI, Senghas A, Brandt F, Ochsner KN (2010) The effects of BOTOX injections on emotional experience. Emotion 10:433–440. https://doi.org/10.1037/a0018690CrossRefPubMedPubMedCentral

11.

Hennenlotter A, Dresel C, Castrop F et al (2009) The link between facial feedback and neural activity within central circuitries of emotion—new insights from botulinum toxin–induced denervation of frown muscles. Cereb Cortex 19:537–542. https://doi.org/10.1093/cercor/bhn104CrossRefPubMed

12.

Kim M, Neta M, Davis F et al (2014) Botulinum toxin-induced facial muscle paralysis affects amygdala responses to the perception of emotional expressions: preliminary findings from an A-B-A design. Biol Mood Anxiety Disord 4:11. https://doi.org/10.1186/2045-5380-4-11CrossRefPubMedPubMedCentral

13.

Strack F, Martin LL, Stepper S (1988) Inhibiting and facilitating conditions of the human smile: a nonobtrusive test of the facial feedback hypothesis. J Person Soc Psychol 54:768–777. https://doi.org/10.1037/0022-3514.54.5.768CrossRef

14.

Adelmann PK, Zajonc RB (1989) Facial efference and the experience of emotion. Annu Rev Psychol 40:249–280. https://doi.org/10.1146/annurev.ps.40.020189.001341CrossRefPubMed

15.

Al Abdulmohsen T, Kruger THC (2011) The contribution of muscular and auditory pathologies to the symptomatology of autism. Med Hypoth 77:1038–1047. https://doi.org/10.1016/j.mehy.2011.08.044CrossRef

16.

Hwang K, Kim YJ, Chung IH (2004) Innervation of the corrugator supercilii muscle. Ann Plast Surg 52:140–143. https://doi.org/10.1097/01.sap.0000095440.20407.0bCrossRefPubMed

17.

Brown TM, Drake TM, Krishnamurthy K (2022) Anatomy, head and neck, procerus muscle. In: StatPearls. StatPearls Publishing, Treasure Island (FL)

18.

Brin MF, Durgam S, Lum A et al (2020) OnabotulinumtoxinA for the treatment of major depressive disorder: a phase 2 randomized, double-blind, placebo-controlled trial in adult females. Int Clin Psychopharmacol 35:19–28. https://doi.org/10.1097/YIC.0000000000000290CrossRefPubMed

19.

Finzi E, Rosenthal NE (2014) Treatment of depression with onabotulinumtoxin A: a randomized, double-blind, placebo controlled trial. J Psychiat Res 52:1–6. https://doi.org/10.1016/j.jpsychires.2013.11.006CrossRefPubMed

20.

Magid M, Reichenberg JS, Poth PE et al (2014) Treatment of major depressive disorder using botulinum toxin a: a 24-week randomized, double-blind, placebo-controlled study. J Clin Psychiatry 75:837–844. https://doi.org/10.4088/JCP.13m08845CrossRefPubMed

21.

Wollmer MA, de Boer C, Kalak N et al (2012) Facing depression with botulinum toxin: a randomized controlled trial. J Psychiat Res 46:574–581. https://doi.org/10.1016/j.jpsychires.2012.01.027CrossRefPubMed

22.

Zamanian A, Ghanbari Jolfaei A, Mehran G, Azizian Z (2017) Efficacy of botox versus placebo for treatment of patients with major depression. Iran J Public Health 46:982–984PubMedPubMedCentral

23.

Matzke B, Herpertz SC, Berger C et al (2014) Facial reactions during emotion recognition in borderline personality disorder: a facial electromyography study. Psychopathology 47:101–110. https://doi.org/10.1159/000351122CrossRefPubMed

24.

Kruger THC, Magid M, Wollmer MA (2016) Can botulinum toxin help patients with borderline personality disorder? Am J Psychiat 173:940–941. https://doi.org/10.1176/appi.ajp.2016.16020174CrossRefPubMed

25.

Lenzenweger MF (2010) Current status of the scientific study of the personality disorders: an overview of epidemiological, longitudinal, experimental psychopathology, and neurobehavioral perspectives. J Am Psychoan Assoc 58:741–778. https://doi.org/10.1177/0003065110386111CrossRef

26.

Ten Have M, Verheul R, Kaasenbrood A et al (2016) Prevalence rates of borderline personality disorder symptoms: a study based on the Netherlands Mental Health Survey and Incidence Study-2. BMC Psychiatry 16:249. https://doi.org/10.1186/s12888-016-0939-xCrossRefPubMedPubMedCentral

27.

American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th ed.

28.

Bohus M (2018) Borderline-Störung. In: Margraf J, Schneider S (eds) Lehrbuch der Verhaltenstherapie, vol 2. Springer, Berlin, Heidelberg, pp 471–505CrossRef

29.

Domes G, Czieschnek D, Weidler F et al (2008) Recognition of facial affect in borderline personality disorder. J Person Disord 22:135–147. https://doi.org/10.1521/pedi.2008.22.2.135CrossRef

30.

Lynch TR, Rosenthal MZ, Kosson DS et al (2006) Heightened sensitivity to facial expressions of emotion in borderline personality disorder. Emotion 6:647–655. https://doi.org/10.1037/1528-3542.6.4.647CrossRefPubMed

31.

Sinke C, Wollmer MA, Kneer J et al (2017) Interaction between behavioral inhibition and emotional processing in borderline personality disorder using a pictorial emotional go/no-go paradigm. Psychiatry Res 256:286–289. https://doi.org/10.1016/j.psychres.2017.06.046CrossRefPubMed

32.

van Zutphen L, Siep N, Jacob GA et al (2015) Emotional sensitivity, emotion regulation and impulsivity in borderline personality disorder: a critical review of fMRI studies. Neurosci Biobehav Rev 51:64–76. https://doi.org/10.1016/j.neubiorev.2015.01.001CrossRefPubMed

33.

Frankenburg FR, Zanarini MC (2004) The association between borderline personality disorder and chronic medical illnesses, poor health-related lifestyle choices, and costly forms of health care utilization. J Clin Psychiat 65:1660–1665. https://doi.org/10.4088/JCP.v65n1211CrossRef

34.

Soeteman DI, Verheul R, Busschbach JJV (2008) The burden of disease in personality disorders: diagnosis-specific quality of life. J Person Disord 22:259–268. https://doi.org/10.1521/pedi.2008.22.3.259CrossRef

35.

Lee MH, Smyser CD, Shimony JS (2013) Resting-state fMRI: a review of methods and clinical applications. Am J Neuroradiol 34:1866–1872. https://doi.org/10.3174/ajnr.A3263CrossRefPubMedPubMedCentral

36.

Warren SM, Chou Y, Steklis HD (2020) Potential for resting-state fMRI of the amygdala in elucidating neural mechanisms of adaptive self-regulatory strategies: a systematic review. Brain Connect 10:3–17. https://doi.org/10.1089/brain.2019.0700CrossRefPubMed

37.

Lissek S, Wilimzig C, Stude P et al (2009) Immobilization impairs tactile perception and shrinks somatosensory cortical maps. Curr Biol 19:837–842. https://doi.org/10.1016/j.cub.2009.03.065CrossRefPubMed

38.

Franchi G (2002) Time course of motor cortex reorganization following botulinum toxin injection into the vibrissal pad of the adult rat: cortical reorganization after BTX injection in the rat vibrissal pad. Eur J Neurosci 16:1333–1348. https://doi.org/10.1046/j.1460-9568.2002.02195.xCrossRefPubMed

39.

Delnooz CCS, Pasman JW, Beckmann CF, van de Warrenburg BPC (2013) Task-free functional MRI in cervical dystonia reveals multi-network changes that partially normalize with botulinum toxin. PLoS ONE 8:e62877. https://doi.org/10.1371/journal.pone.0062877CrossRefPubMedPubMedCentral

40.

Barnow S, Völker KA, Möller B et al (2009) Neurophysiological correlates of borderline personality disorder: a transcranial magnetic stimulation study. Biol Psychiatry 65:313–318. https://doi.org/10.1016/j.biopsych.2008.08.016CrossRefPubMed

41.

Krause-Utz A, Veer IM, Sarb R et al (2014) Amygdala and anterior cingulate resting-state functional connectivity in borderline personality disorder patients with a history of interpersonal trauma. Psychol Med 13:1–13. https://doi.org/10.1017/S0033291714000324CrossRef

42.

Das P, Calhoun V, Malhi GS (2014) Bipolar and borderline patients display differential patterns of functional connectivity among resting state networks. Neuroimage 98:73–81. https://doi.org/10.1016/j.neuroimage.2014.04.062CrossRefPubMed

43.

Doll A, Sorg C, Manoliu A et al (2013) Shifted intrinsic connectivity of central executive and salience network in borderline personality disorder. Front Hum Neurosci 7:727. https://doi.org/10.3389/fnhum.2013.00727CrossRefPubMedPubMedCentral

44.

Kluetsch RC, Schmahl C, Niedtfeld I et al (2012) Alterations in default mode network connectivity during pain processing in borderline personality disorder. Arch Gen Psychiatry 69:993–1002. https://doi.org/10.1001/archgenpsychiatry.2012.476CrossRefPubMedPubMedCentral

45.

Visintin E, De Panfilis C, Amore M et al (2016) Mapping the brain correlates of borderline personality disorder: a functional neuroimaging meta-analysis of resting state studies. J Affect Disord 204:262–269. https://doi.org/10.1016/j.jad.2016.07.025CrossRefPubMed

46.

Wolf RC, Sambataro F, Vasic N et al (2011) Aberrant connectivity of resting-state networks in borderline personality disorder. J Psychiatry Neurosci 36:402–411. https://doi.org/10.1503/jpn.100150CrossRefPubMedPubMedCentral

47.

Wollmer MA, Neumann I, Jung S et al (2022) Clinical effects of glabellar botulinum toxin injections on borderline personality disorder: a randomized controlled trial. J Psychopharmacol 36:159–169. https://doi.org/10.1177/02698811211069108CrossRefPubMed

48.

Armour M, Smith CA, Wang L-Q et al (2019) Acupuncture for depression: a systematic review and meta-analysis. J Clin Med 8:E1140. https://doi.org/10.3390/jcm8081140CrossRef

49.

Hollifield M, Sinclair-Lian N, Warner TD, Hammerschlag R (2007) Acupuncture for posttraumatic stress disorder: a randomized controlled pilot trial. J Nerv Ment Dis 195:504–513. https://doi.org/10.1097/NMD.0b013e31803044f8CrossRefPubMed

50.

Pilkington K, Kirkwood G, Rampes H et al (2007) Acupuncture for anxiety and anxiety disorders—a systematic literature review. Acupunct Med 25:1–10. https://doi.org/10.1136/aim.25.1-2.1CrossRefPubMed

51.

Shen X, Xia J, Adams CE (2014) Acupuncture for schizophrenia. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD005475.pub2

52.

Smith CA, Armour M, Lee MS, et al (2018) Acupuncture for depression. Cochrane Database Syst Rev 3:CD004046. https://doi.org/10.1002/14651858.CD004046.pub4

53.

Dilling H, Mombour W, Schmidt MH, et al (2015) Internationale Klassifikation psychischer Störungen : ICD-10 Kapitel V (F) klinisch-diagnostische Leitlinien, 10. In: Auflage, unter Berücksichtigung der Änderungen entsprechend ICD-10-GM 2015. Hogrefe Verlag, Bern

54.

Fydrich T, Renneberg B, Schmitz B, Wittchen H-U (1997) SKID II. Strukturiertes Klinisches Interview für DSM-IV, Achse II: Persönlichkeitsstörungen. Hogrefe, Göttingen

55.

Zanarini MC (2003) Zanarini rating scale for borderline personality disorder (ZAN-BPD): a continuous measure of DSM-IV borderline psychopathology. J Person Disord 17:233–242. https://doi.org/10.1521/pedi.17.3.233.22147CrossRef

56.

Wolf M, Limberger MF, Kleindienst N et al (2009) Kurzversion der Borderline-Symptom-Liste (BSL-23): entwicklung und Überprüfung der psychometrischen Eigenschaften. PPmP-Psychotherapie Psychosomatik Medizinische Psychologie 59:321–324. https://doi.org/10.1055/s-0028-1104598CrossRef

57.

Song X-W, Dong Z-Y, Long X-Y et al (2011) REST: a toolkit for resting-state functional magnetic resonance imaging data processing. PLoS ONE 6:e25031. https://doi.org/10.1371/journal.pone.0025031CrossRefPubMedPubMedCentral

58.

Yan C-G, Wang X-D, Zuo X-N, Zang Y-F (2016) DPABI: data processing and analysis for (resting-state) brain imaging. Neuroinformatics 14:339–351. https://doi.org/10.1007/s12021-016-9299-4CrossRefPubMed

59.

Liepert J, Tegenthoff M, Malin J-P (1995) Changes of cortical motor area size during immobilization. Electroencephalogr Clin Neurophysiol Electromyogr Motor Control 97:382–386. https://doi.org/10.1016/0924-980X(95)00194-PCrossRef

60.

Raffin E, Siebner HR (2019) Use-dependent plasticity in human primary motor hand area: synergistic interplay between training and immobilization. Cereb Cortex 29:356–371. https://doi.org/10.1093/cercor/bhy226CrossRefPubMed

61.

Krippl M, Karim AA, Brechmann A (2015) Neuronal correlates of voluntary facial movements. Front Hum Neurosci. https://doi.org/10.3389/fnhum.2015.00598CrossRefPubMedPubMedCentral

62.

Tzourio-Mazoyer N, Landeau B, Papathanassiou D et al (2002) Automated anatomical labeling of activations in SPM using a macroscopic anatomical parcellation of the MNI MRI single-subject brain. Neuroimage 15:273–289. https://doi.org/10.1006/nimg.2001.0978CrossRefPubMed

63.

Paxinos G, Xu-Feng H, Sengul G, Watson C (2012) Organization of brainstem nuclei. In: The Human Nervous System. Elsevier, pp 260–327

64.

Singh K, Indovina I, Augustinack JC et al (2020) Probabilistic template of the lateral parabrachial nucleus, medial parabrachial nucleus, vestibular nuclei complex, and medullary viscero-sensory-motor nuclei complex in living humans from 7 Tesla MRI. Front Neurosci 13:1425. https://doi.org/10.3389/fnins.2019.01425CrossRefPubMedPubMedCentral

65.

Singh K, García-Gomar MG, Bianciardi M (2021) Probabilistic atlas of the mesencephalic reticular formation, isthmic reticular formation, microcellular tegmental nucleus, ventral tegmental area nucleus complex, and caudal–rostral linear raphe nucleus complex in living humans from 7 Tesla magnetic resonance imaging. Brain Connect 11:613–623. https://doi.org/10.1089/brain.2020.0975CrossRefPubMedPubMedCentral

66.

Stinear CM, Coxon JP, Byblow WD (2009) Primary motor cortex and movement prevention: where stop meets go. Neurosci Biobehav Rev 33:662–673. https://doi.org/10.1016/j.neubiorev.2008.08.013CrossRefPubMed

67.

Stevens FL, Hurley RA, Taber KH et al (2011) Anterior cingulate cortex: unique role in cognition and emotion. JNP 23:121–125. https://doi.org/10.1176/jnp.23.2.jnp121CrossRef

68.

Etkin A, Egner T, Kalisch R (2011) Emotional processing in anterior cingulate and medial prefrontal cortex. Trends Cogn Sci 15:85–93. https://doi.org/10.1016/j.tics.2010.11.004CrossRefPubMed

69.

Saxe R (2006) Uniquely human social cognition. Curr Opin Neurobiol 16:235–239. https://doi.org/10.1016/j.conb.2006.03.001CrossRefPubMed

70.

Van Overwalle F (2009) Social cognition and the brain: a meta-analysis. Hum Brain Mapp 30:829–858. https://doi.org/10.1002/hbm.20547CrossRefPubMed

71.

Seidler RD, Kwak Y, Fling BW, Bernard JA (2013) Neurocognitive mechanisms of error-based motor learning. Adv Exp Med Biol. https://doi.org/10.1007/978-1-4614-5465-6_3CrossRefPubMedPubMedCentral

72.

Paus T (2001) Primate anterior cingulate cortex: where motor control, drive and cognition interface. Nat Rev Neurosci 2:417–424. https://doi.org/10.1038/35077500CrossRefPubMed

73.

Chouinard PA, Paus T (2006) The primary motor and premotor areas of the human cerebral cortex. Neuroscientist 12:143–152. https://doi.org/10.1177/1073858405284255CrossRefPubMed

74.

Friston K (2010) The free-energy principle: a unified brain theory? Nat Rev Neurosci 11:127–138. https://doi.org/10.1038/nrn2787CrossRefPubMed

75.

Alexander WH, Brown JW (2019) The role of the anterior cingulate cortex in prediction error and signaling surprise. Top Cogn Sci 11:119–135. https://doi.org/10.1111/tops.12307CrossRefPubMed

76.

Doya K (2000) Complementary roles of basal ganglia and cerebellum in learning and motor control. Curr Opin Neurobiol 10:732–739. https://doi.org/10.1016/S0959-4388(00)00153-7CrossRefPubMed

77.

Ito M (2008) Control of mental activities by internal models in the cerebellum. Nat Rev Neurosci 9:304–313. https://doi.org/10.1038/nrn2332CrossRefPubMed

78.

Popa LS, Ebner TJ (2018) Cerebellum, predictions and errors. Front Cell Neurosci 12:524. https://doi.org/10.3389/fncel.2018.00524CrossRefPubMed

79.

Wolpert DM, Miall RC, Kawato M (1998) Internal models in the cerebellum. Trends Cogn Sci 2:338–347. https://doi.org/10.1016/s1364-6613(98)01221-2CrossRefPubMed

80.

Cullen KR, Vizueta N, Thomas KM et al (2011) Amygdala functional connectivity in young women with borderline personality disorder. Brain Connect 1:61–71. https://doi.org/10.1089/brain.2010.0001CrossRefPubMedPubMedCentral

81.

Cai R, Shen G, Wang H, Guan Y (2018) Brain functional connectivity network studies of acupuncture: a systematic review on resting-state fMRI. J Integrat Med 16:26–33. https://doi.org/10.1016/j.joim.2017.12.002CrossRef

82.

Shah R, Zanarini MC (2018) Comorbidity of borderline personality disorder: current status and future directions. Psychiatr Clin North Am 41:583–593. https://doi.org/10.1016/j.psc.2018.07.009CrossRefPubMed

Titel: Effects of glabellar botulinum toxin injections on resting-state functional connectivity in borderline personality disorder
verfasst von: Jara Schulze
Christopher Sinke
Insa Neumann
M. Axel Wollmer
Tillmann H. C. Kruger
Publikationsdatum: 29.03.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: European Archives of Psychiatry and Clinical Neuroscience / Ausgabe 1/2024
Print ISSN: 0940-1334
Elektronische ISSN: 1433-8491
DOI: https://doi.org/10.1007/s00406-023-01563-4

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Effects of glabellar botulinum toxin injections on resting-state functional connectivity in borderline personality disorder

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