{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T01:13:46Z","timestamp":1777770826185,"version":"3.51.4"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and purpose<\/jats:title>\n                    <jats:p>Parkinson's disease (PD), a prevalent neurodegenerative disorder characterized by motor impairments, frequently accompanied by neuropsychiatric symptoms that significantly impair daily functioning and quality of life. The present study aimed to assess the efficacy of botulinum toxin A (BTX\u2010A) in alleviating neuropsychiatric symptoms among PD patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This is an open\u2010label, nonrandomized controlled trial. The subscales of the Cornell Medical Index, including somatization, anxiety, depression, maladjustment, sensitivity, anger, and tension, were used to evaluate neuropsychiatric symptoms. The study compared neuropsychiatric health status among 97 PD patients with neuropsychiatric symptoms, divided into two groups: BTX\u2010A (\n                      <jats:italic>n<\/jats:italic>\n                      = 58) and citalopram hydrobromide (CH;\n                      <jats:italic>n<\/jats:italic>\n                      = 39). The BTX\u2010A group received local injections targeting the bilateral glabella, orbicularis oculi muscle, forehead, bilateral lateral canthus, and temporal area. Patients in the CH group received daily doses ranging from 10 to 40\u00a0mg. The efficacy of BTX\u2010A was assessed before and eight weeks after treatment, with outcomes compared to those of the CH group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The BTX\u2010A group showed significant reductions in somatization (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.028), tension (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), anxiety (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001), depression (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002), sensitivity (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.006), and total scores (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.009) at 8 weeks after treatment. Both the BTX\u2010A and CH groups demonstrated significant reductions in neuropsychiatric symptoms, with BTX\u2010A showing comparable efficacy to CH (\n                      <jats:italic>p<\/jats:italic>\n                      &gt; 0.05 for all parameters). Additionally, both groups showed comparable neuropsychiatric symptom improvement rates (64.3%\u00a0vs. 73.7%,\n                      <jats:italic>p<\/jats:italic>\n                      &gt; 0.05). These rates were calculated based on reductions in overall neuropsychiatric symptom severity scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In summary, BTX\u2010A demonstrates efficacy in reducing multiple neuropsychiatric symptoms (such as tension, anxiety, depression, sensitivity, etc.) in PD, with comparable effectiveness to CH, supporting its consideration as an alternative therapeutic option.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.70806","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T06:46:29Z","timestamp":1757400389000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of Facial Botulinum Toxin A Injections in Alleviating Neuropsychiatric Symptoms in Parkinson's Disease Patients: An Open\u2010Label, Nonrandomized Controlled Trial"],"prefix":"10.1002","volume":"15","author":[{"given":"Huimin","family":"Li","sequence":"first","affiliation":[{"name":"Department of Neurology Huai'an First People's Hospital, the Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University  Huai'an Jiangsu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Neurology Huai'an First People's Hospital, the Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University  Huai'an Jiangsu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaofeng","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Neurology Huai'an First People's Hospital, the Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University  Huai'an Jiangsu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiu","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology Huai'an First People's Hospital, the Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University  Huai'an Jiangsu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiang","family":"Tong","sequence":"additional","affiliation":[{"name":"Department of Neurology Huai'an First People's Hospital, the Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University  Huai'an Jiangsu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0070-1870","authenticated-orcid":false,"given":"Qiu","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Neurology Huai'an First People's Hospital, the Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University  Huai'an Jiangsu China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3233\/JPD-150604"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12967-021-02801-w"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.22360"},{"key":"e_1_2_8_5_1","first-page":"70","article-title":"The Progress on the Use of Botulinum Toxin Type A Therapy in Parkinson\u2032s Disease","volume":"55","author":"Bai R.","year":"2022","journal-title":"Chinese Journal of Neurology"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00218-X"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/YIC.0000000000000290"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3999(62)90005-3"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2022.104749"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000801"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S181820"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2016.200"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2013.11.006"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2016.06.009"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.17.5.427"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2022.101834"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12264-019-00367-8"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2022.08.097"},{"key":"e_1_2_8_19_1","first-page":"745","article-title":"Clinical Study on the Efficacy and Safety of Botulinum Toxin A in the Treatment of Parkinson\u2032s Disease With Depression","volume":"52","author":"Lyu A.","year":"2019","journal-title":"Chinese Journal of Neurology"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.13m08845"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.10473"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1159\/000314478"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13760-021-01601-9"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2021-068718"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(21)00330-6"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26170"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2012.01.027"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/164_2019_272"},{"key":"e_1_2_8_29_1","first-page":"982","article-title":"Efficacy of Botox versus Placebo for Treatment of Patients With Major Depression","volume":"46","author":"Zamanian A.","year":"2017","journal-title":"Iran Journal of Public Health"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1080\/00207454.2016.1196687"},{"key":"e_1_2_8_31_1","first-page":"2717","article-title":"Effects of Botulinum Toxin Type A On Mood and Cognitive Function in Patients With parkinson's Disease and Depression","volume":"13","author":"Zhu C.","year":"2021","journal-title":"American Journal of Translational Research"}],"container-title":["Brain and Behavior"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/brb3.70806","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/brb3.70806","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/brb3.70806","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T16:40:54Z","timestamp":1777480854000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/brb3.70806"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":30,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1002\/brb3.70806"],"URL":"https:\/\/doi.org\/10.1002\/brb3.70806","archive":["Portico"],"relation":{},"ISSN":["2162-3279","2162-3279"],"issn-type":[{"value":"2162-3279","type":"print"},{"value":"2162-3279","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"2024-09-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70806"}}