{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T10:03:29Z","timestamp":1783677809821,"version":"3.55.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T00:00:00Z","timestamp":1751500800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Facial Plastic Surgery &amp; Aesthetic Medicine"],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Facial synkinesis is associated with increased anxiety\/depression and decreased quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate changes in anxiety and depression among patients with synkinesis before and after chemodenervation as measured by validated scales.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A retrospective review of botulinum toxin na\u00efve adults treated with chemodenervation for synkinesis was performed. Validated outcome metrics were compared before the first treatment and &gt;3 months after the final treatment. Clinician-graded assessment used the Sunnybrook Facial Grading System (SB). Patient-reported assessments included the Synkinesis Assessment Questionnaire (SAQ) and Facial Clinimetric Evaluation (FaCE). Patient Health Questionnaire-2 (PHQ-2) and Generalized Anxiety Disorder-2 (GAD-2) questionnaires assessed depression and anxiety. Paired\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -tests compared scores before and after treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Sixty-eight patients aged 54 years (standard deviation \u00b113.5) were included. Most patients were female, 53\/68 (78%). Bell\u2019s palsy was the most common cause, 34\/68 (50%), with a median duration of 42 months (ranging from 4 to 730). Twelve participants (17.6%) initially screened positive for depression, and 11 (16.2%) for anxiety. Chemodenervation demonstrated significant improvements in SB (\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      = \u22127.14,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.0001), FaCE (\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      = \u22122.15,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.041), GAD-2 (\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      = 2.18,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.03), and PHQ-2 scores (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.016). There was no significant change in SAQ (standardized mean difference = \u22120.9,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.71).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Chemodenervation for synkinesis demonstrated improved patient quality of life and reduced symptoms of anxiety and depression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/fpsam.2024.0262","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T12:53:02Z","timestamp":1751547182000},"page":"278-283","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Botulinum Toxin for Treatment of Synkinesis: Effects on Anxiety and Depression"],"prefix":"10.1177","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4029-1140","authenticated-orcid":false,"given":"Feyisayo O.","family":"Adegboye","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3495-9231","authenticated-orcid":false,"given":"Osama A.","family":"Hamdi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelson","family":"Gruszczynski","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3631-5624","authenticated-orcid":false,"given":"Neil P.","family":"Monaghan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4547-5192","authenticated-orcid":false,"given":"Samuel L.","family":"Oyer","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Facial Plastic and Reconstructive Surgery, University of Virginia Medical Center, Charlottesville, Virginia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,3]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1098\/RSTB.2009.0142"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/LARY.28751"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1089\/FPSAM.2024.0119"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/JAMAFACIAL.2016.1462"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0B013E3181AB31AF"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/COA.13322"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/FPSAM.2022.0037"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1089\/FPSAM.2020.0082"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000001908"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/FPSAM.2023.0351"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0B013E318230E758"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S181820"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/LARY.20868"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-59989670206-1"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200103000-00005"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0B013E3180412460"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/J.JPSYCHORES.2004.09.006"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/J.GENHOSPPSYCH.2015.11.005"},{"issue":"8","key":"e_1_3_2_20_2","first-page":"508","article-title":"Depression: Screening and diagnosis","volume":"98","author":"Maurer DM","year":"2018","unstructured":"Maurer DM, , Raymond TJ, , Davis BN. 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