Manipulating facial musculature with functional electrical stimulation as an intervention for major depressive disorder: a focused search of literature for a proposal

Major Depressive Disorder (MDD) is associated with interoceptive deficits expressed throughout the body, particularly the facial musculature. Manipulating the facial muscles could provide a new “mind-body” intervention for MDD. Functional electrical stimulation (FES) is a novel neuromodulation-based treatment modality that can be potentially used in the treatment of disorders of disrupted brain connectivity, such as MDD. Manipulating facial muscles may represent a mechanistically novel treatment strategy for MDD and other disorders of disrupted brain connectivity that is worthy of investigation in phase II/III trials.

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  FES may attenuate the negative interoceptive bias associated with MDD by enhancing positive facial feedback.
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  The amygdala and nodes of the emotion-to-motor transformation loop may serve as potential neural targets for facial FES in MDD.
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  Recent pilot data on repetitive FES applied to the facial muscles in healthy participants and patients with MDD show early promise.