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Updated: Jan 21, 2026

Ultrasound-guided Botulinum Toxin-A Injections: A Method of Treating Sialorrhea
Published on: November 9, 2016
The effects of Botulinum toxin on the detection of gradual changes in facial emotion
L C Bulnes1,2, P Mariën3,4, M Vandekerckhove5
1Université libre de Bruxelles (ULB), Consciousness, Cognition and Computation Group (CO3), Center for Research in Cognition & Neurosciences, ULB Neuroscience Institute, Brussels, Belgium. lbulnesf@ulb.ac.be.
Abstract:
When we feel sad or depressed, our face invariably "drops". Conversely, when we try to cheer someone up, we might tell them "keep your smile up", so presupposing that modifying the configuration of their facial muscles will enhance their mood. A crucial assumption that underpins this hypothesis is that mental states are shaped by information originating from the peripheral neuromotor system - a view operationalised as the Facial Feedback Hypothesis. We used botulinum toxin (BoNT-A) injected over the frown area to temporarily paralyse muscles necessary to express anger. Using a pre-post treatment design, we presented participants with gradually changing videos of a face morphing from neutral to full-blown expressions of either anger or happiness and asked them to press a button as soon as they had detected any change in the display. Results indicate that while all participants (control and BoNT-A) improved their reaction times from pre-test to post-test, the BoNT-A group did not when detecting anger in the post-test. We surmise that frown paralysis disadvantaged participants in their ability to improve the detection of anger. Our finding suggests that facial feedback causally affects perceptual awareness of changes in emotion, as well as people's ability to use perceptual information to learn.
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