Agitation predicts response of depression to botulinum toxin treatment in a randomized controlled trial

M. Axel Wollmer, Nadeem Kalak, Stefanie Jung, Claas de Boer, Michelle Magid, Jason S. Reichenberg, Serge Brand, Edith Holsboer-Trachsler, Tillmann H C Kruger

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

In a randomized, controlled trial (n = 30), we showed that botulinum toxin injection to the glabellar region produces a marked improvement in the symptoms of major depression. We hypothesized that the mood-lifting effect was mediated by facial feedback mechanisms. Here we assessed if agitation, which may be associated with increased dynamic psychomotor activity of the facial musculature, can predict response to the treatment. To test this hypothesis, we re-analyzed the data of the scales from our previous study on a single item basis and compared the baseline scores in the agitation item (item 9) of the Hamilton Depression Rating Scale (HAM-D) between responders (n = 9) and participants who did not attain response (n = 6) among the recipients of onabotulinumtoxinA (n = 15). Responders had significantly higher item 9 scores at baseline [1.56 + 0.88 vs. 0.33 + 0.52, t(13) = 3.04, d = 1.7, p = 0.01], while no other single item of the HAM-D or the Beck Depression Inventory was associated with treatment response. The agitation score had an overall precision of 78% in predicting response in a receiver operating characteristic (ROC) analysis (area under the curve, AUC = 0.87). These data provide a link between response to botulinum toxin treatment with a psychomotor manifestation of depression and thereby indirect support of the proposed facial feedback mechanism of action. Moreover, it suggests that patients with agitated depression may particularly benefit from botulinum toxin treatment.

Original languageEnglish (US)
Article numberArticle 36
JournalFrontiers in Psychiatry
Volume5
Issue numberMAR
DOIs
StatePublished - 2014

Fingerprint

Botulinum Toxins
Randomized Controlled Trials
Depression
Area Under Curve
Therapeutics
ROC Curve
Equipment and Supplies
Injections

Keywords

  • Major depressive disorder
  • Personalized medicine
  • Psychomotor agitation
  • Randomized controlled trial
  • Type a botulinum toxins

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Axel Wollmer, M., Kalak, N., Jung, S., de Boer, C., Magid, M., Reichenberg, J. S., ... Kruger, T. H. C. (2014). Agitation predicts response of depression to botulinum toxin treatment in a randomized controlled trial. Frontiers in Psychiatry, 5(MAR), [Article 36]. https://doi.org/10.3389/fpsyt.2014.00036

Agitation predicts response of depression to botulinum toxin treatment in a randomized controlled trial. / Axel Wollmer, M.; Kalak, Nadeem; Jung, Stefanie; de Boer, Claas; Magid, Michelle; Reichenberg, Jason S.; Brand, Serge; Holsboer-Trachsler, Edith; Kruger, Tillmann H C.

In: Frontiers in Psychiatry, Vol. 5, No. MAR, Article 36, 2014.

Research output: Contribution to journalArticle

Axel Wollmer, M, Kalak, N, Jung, S, de Boer, C, Magid, M, Reichenberg, JS, Brand, S, Holsboer-Trachsler, E & Kruger, THC 2014, 'Agitation predicts response of depression to botulinum toxin treatment in a randomized controlled trial', Frontiers in Psychiatry, vol. 5, no. MAR, Article 36. https://doi.org/10.3389/fpsyt.2014.00036
Axel Wollmer, M. ; Kalak, Nadeem ; Jung, Stefanie ; de Boer, Claas ; Magid, Michelle ; Reichenberg, Jason S. ; Brand, Serge ; Holsboer-Trachsler, Edith ; Kruger, Tillmann H C. / Agitation predicts response of depression to botulinum toxin treatment in a randomized controlled trial. In: Frontiers in Psychiatry. 2014 ; Vol. 5, No. MAR.
@article{02c66b90cfdb44c4bfd1d9f204957ed2,
title = "Agitation predicts response of depression to botulinum toxin treatment in a randomized controlled trial",
abstract = "In a randomized, controlled trial (n = 30), we showed that botulinum toxin injection to the glabellar region produces a marked improvement in the symptoms of major depression. We hypothesized that the mood-lifting effect was mediated by facial feedback mechanisms. Here we assessed if agitation, which may be associated with increased dynamic psychomotor activity of the facial musculature, can predict response to the treatment. To test this hypothesis, we re-analyzed the data of the scales from our previous study on a single item basis and compared the baseline scores in the agitation item (item 9) of the Hamilton Depression Rating Scale (HAM-D) between responders (n = 9) and participants who did not attain response (n = 6) among the recipients of onabotulinumtoxinA (n = 15). Responders had significantly higher item 9 scores at baseline [1.56 + 0.88 vs. 0.33 + 0.52, t(13) = 3.04, d = 1.7, p = 0.01], while no other single item of the HAM-D or the Beck Depression Inventory was associated with treatment response. The agitation score had an overall precision of 78{\%} in predicting response in a receiver operating characteristic (ROC) analysis (area under the curve, AUC = 0.87). These data provide a link between response to botulinum toxin treatment with a psychomotor manifestation of depression and thereby indirect support of the proposed facial feedback mechanism of action. Moreover, it suggests that patients with agitated depression may particularly benefit from botulinum toxin treatment.",
keywords = "Major depressive disorder, Personalized medicine, Psychomotor agitation, Randomized controlled trial, Type a botulinum toxins",
author = "{Axel Wollmer}, M. and Nadeem Kalak and Stefanie Jung and {de Boer}, Claas and Michelle Magid and Reichenberg, {Jason S.} and Serge Brand and Edith Holsboer-Trachsler and Kruger, {Tillmann H C}",
year = "2014",
doi = "10.3389/fpsyt.2014.00036",
language = "English (US)",
volume = "5",
journal = "Frontiers in Psychiatry",
issn = "1664-0640",
publisher = "Frontiers Research Foundation",
number = "MAR",

}

TY - JOUR

T1 - Agitation predicts response of depression to botulinum toxin treatment in a randomized controlled trial

AU - Axel Wollmer, M.

AU - Kalak, Nadeem

AU - Jung, Stefanie

AU - de Boer, Claas

AU - Magid, Michelle

AU - Reichenberg, Jason S.

AU - Brand, Serge

AU - Holsboer-Trachsler, Edith

AU - Kruger, Tillmann H C

PY - 2014

Y1 - 2014

N2 - In a randomized, controlled trial (n = 30), we showed that botulinum toxin injection to the glabellar region produces a marked improvement in the symptoms of major depression. We hypothesized that the mood-lifting effect was mediated by facial feedback mechanisms. Here we assessed if agitation, which may be associated with increased dynamic psychomotor activity of the facial musculature, can predict response to the treatment. To test this hypothesis, we re-analyzed the data of the scales from our previous study on a single item basis and compared the baseline scores in the agitation item (item 9) of the Hamilton Depression Rating Scale (HAM-D) between responders (n = 9) and participants who did not attain response (n = 6) among the recipients of onabotulinumtoxinA (n = 15). Responders had significantly higher item 9 scores at baseline [1.56 + 0.88 vs. 0.33 + 0.52, t(13) = 3.04, d = 1.7, p = 0.01], while no other single item of the HAM-D or the Beck Depression Inventory was associated with treatment response. The agitation score had an overall precision of 78% in predicting response in a receiver operating characteristic (ROC) analysis (area under the curve, AUC = 0.87). These data provide a link between response to botulinum toxin treatment with a psychomotor manifestation of depression and thereby indirect support of the proposed facial feedback mechanism of action. Moreover, it suggests that patients with agitated depression may particularly benefit from botulinum toxin treatment.

AB - In a randomized, controlled trial (n = 30), we showed that botulinum toxin injection to the glabellar region produces a marked improvement in the symptoms of major depression. We hypothesized that the mood-lifting effect was mediated by facial feedback mechanisms. Here we assessed if agitation, which may be associated with increased dynamic psychomotor activity of the facial musculature, can predict response to the treatment. To test this hypothesis, we re-analyzed the data of the scales from our previous study on a single item basis and compared the baseline scores in the agitation item (item 9) of the Hamilton Depression Rating Scale (HAM-D) between responders (n = 9) and participants who did not attain response (n = 6) among the recipients of onabotulinumtoxinA (n = 15). Responders had significantly higher item 9 scores at baseline [1.56 + 0.88 vs. 0.33 + 0.52, t(13) = 3.04, d = 1.7, p = 0.01], while no other single item of the HAM-D or the Beck Depression Inventory was associated with treatment response. The agitation score had an overall precision of 78% in predicting response in a receiver operating characteristic (ROC) analysis (area under the curve, AUC = 0.87). These data provide a link between response to botulinum toxin treatment with a psychomotor manifestation of depression and thereby indirect support of the proposed facial feedback mechanism of action. Moreover, it suggests that patients with agitated depression may particularly benefit from botulinum toxin treatment.

KW - Major depressive disorder

KW - Personalized medicine

KW - Psychomotor agitation

KW - Randomized controlled trial

KW - Type a botulinum toxins

UR - http://www.scopus.com/inward/record.url?scp=84897977889&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84897977889&partnerID=8YFLogxK

U2 - 10.3389/fpsyt.2014.00036

DO - 10.3389/fpsyt.2014.00036

M3 - Article

VL - 5

JO - Frontiers in Psychiatry

JF - Frontiers in Psychiatry

SN - 1664-0640

IS - MAR

M1 - Article 36

ER -