Evidence for Stellate Ganglion Block (Sgb) as a Novel Management Strategy for Anxiety Disorder
Abstract
Background: Post-Traumatic Stress Disorder (PTSD) is a disabling psychiatric disorder associated with functional and cognitive impairments that results following exposure to either real or perceived physical or mental injury or threat. Generalized Anxiety Disorder (GAD) is a category of anxiety disorders in which excessive, persistent, and unrealistic fear, worry, and feeling of being overwhelmed is accompanied by nonspecific physiological symptoms. GAD and PTSD are common comorbid conditions with an estimated 50% comorbidity rate in civilian populations and up to 91% in veterans. GAD and PTSD pathogenesis have been associated with hyperactivity or dysregulation of the sympathetic nervous system and evidence suggests a significant functional overlap in the neurocircuitry responsible for executing the stress and fear/anxiety responses in these conditions.
Methods: We highlight results from case studies and applicable randomized controlled trial secondary outcomes when these were available.
Results: Stellate Ganglion Blocks (SGB) modulate sympathetic signaling and have been shown to provide significant and long-lasting symptom relief for patients with PTSD and trauma-related anxiety. Assuming GAD and PTSD are in some measure driven by abnormal sympathetic signaling, then SGB may have an impact on GAD symptoms.
Limitations: Additional clinical studies are required to accurately describe the clinical symptom-relieving benefits observed following SGB in PTSD management prior to contingent clinical applications of SGB in anxiety disorder treatment plans.
Conclusions: Considering the overlapping pathophysiology and high comorbidity of PTSD and GAD, therapeutic applications of SGB for GAD may be feasible.
