Post-Traumatic Stress Disorder and the Stellate Ganglion Block
Post-traumatic stress disorder is an era-defining affliction. A majority of 21st-century combat veterans and countless victims of abuse find themselves in the terrifying grip of this disease. Though historically misunderstood, PTSD’s underlying mechanisms are beginning to reveal themselves to the scientific community.
Our increasing knowledge directly corresponds to our growing power to fight the disease. There is work being done with VRET, or virtual-reality exposure therapy. The FDA recently affirmed the efficacy of MDMA-assisted psychotherapy. Evidence for the efficacy of stellate-ganglion block (SGB) procedures for those who suffer PTSD is accumulating quicker than ever.
The stellate ganglion is a bundle of nerves in the human neck. It coordinates various neurological signals, but plays a critical part in the escalation and de-escalation of our “fight or flight” response. It is a connector from our sympathetic to parasympathetic nervous system.
Individuals suffering from PTSD have overactive stress responses. With an SGB, local anesthetic is injected into the stellate ganglion. This procedure is thought to reduce connectivity between the peripheral parasympathetic nervous system and the parts of the brain most intricately connected to anxiety and stress. Additionally, it may inhibit parasympathetic nerve growth and ultimately reduce norepinephrine levels in the brain (the neurotransmitter norepinephrine is the precursor to adrenaline and thus, the fight or flight stress).
Just last year JAMA Psychiatry published a study showing that the SGB procedure was twice as effective as a placebo for curing symptoms of PTSD. Which confirms, anecdotally what we knew to be true: augmented with traditional therapy, the SGB procedure is a particularly sharp arrow in our quiver in the fight against PTSD.