Manipulating facial musculature with functional electrical stimulation as an intervention for major depressive disorder: a focused search of literature for a proposal.
Ilya Demchenko, Naaz Desai, Stephanie N Iwasa and 8 others
PMID 37193985WHAT IT FOUND
Facial electrical stimulation targeting smile muscles reduced depression scores in a small pilot study of 10 patients.
While safe and feasible, this is a narrative review of preliminary data, not proof of efficacy. Larger trials comparing it to sham treatment are required before clinical use.
Key findings
01In an open-label pilot study of 10 participants with moderate-to-severe major depressive disorder, 10 sessions of functional electrical stimulation (FES) to facial 'smile' muscles resulted in significant reductions in depression scores.
02The review identifies FES as a novel experimental treatment requiring thorough investigation, noting that current evidence is limited to two preliminary studies and lacks comparison to placebo or existing therapies.
03Adverse events were minimal, typically consisting of transient skin irritation or muscle soreness, suggesting the intervention is well-tolerated.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The evidence reviewed consists of a small pilot study (n=10) and a healthy volunteer study (n=12), neither of which were randomized controlled trials. The pilot study was open-label with no control group or sham stimulation, meaning placebo effects cannot be ruled out. The review itself does not present new data but summarizes existing preliminary findings. Optimal dosing, stimulation parameters, and long-term effects remain unknown.
Declared interests
The authors declare no conflicts of interest. The work was supported by grants from the National Institutes of Health (NIH) and the Canadian Institutes of Health Research (CIHR).
The easy way to misread this
Do not interpret the significant reduction in depression scores in the 10-patient pilot as proof that facial electrical stimulation effectively treats major depressive disorder. The study lacked a control group and blinding, so the improvements could be due to placebo effects, natural variation, or the attention received during the study. This is an experimental intervention not yet validated for clinical use.