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ORIGINAL RESEARCH article
Front. Neurol.
Sec. Sleep Disorders
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1554841
This article is part of the Research TopicNew insights into stellate ganglion blockade in basic and clinical studiesView all articles
Efficacy and Exploratory Analysis of Potential Mechanisms of Stellate Ganglion Block in Alleviating Sleep Disturbance in Generalized Anxiety Disorder: A Randomized Controlled Trial Excluding Comorbid Depression
Provisionally accepted- The First hospital of Hebei Medical University, Shijiazhuang, China
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Objective: To investigate the efficacy and mechanisms of stellate ganglion block (SGB) in treating generalized anxiety disorder (GAD) with sleep disturbance, excluding patients with comorbid depression.Methods: This double-blind randomized controlled trial (RCT) enrolled 128 patients with GAD (Hamilton Anxiety Scale [HAMA] >14, Generalized Anxiety Disorder 7-item Scale [GAD-7] ≥5) and sleep disturbance (Pittsburgh Sleep Quality Index [PSQI] ≥15), randomized to receive SGB (n=64, 4 ultrasound-guided 1% lidocaine injections) or conventional treatment (n=64, cognitive behavioral therapy [CBT] + estazolam 1–2 mg/day). Outcomes included anxiety (HAMA), depression (Hamilton Depression Scale [HAMD]), sleep quality (PSQI), polysomnography (PSG), and neurotransmitter levels (norepinephrine [NE], serotonin [5-HT], neuropeptide Y [NPY]).Results: After 4 weeks, SGB demonstrated higher efficacy (98.4% vs. 89.1%, P=0.028) and greater reductions in HAMA (9.36±2.34 vs. 11.87±2.71, P<0.001) and HAMD scores (6.87±2.01 vs. 8.09±2.04, P<0.001). PSQI improved significantly in the SGB group (5.74±1.64 vs. 8.03±1.86, P<0.001), with increased total sleep time (TST) (429.76±33.22 vs. 391.13±30.76 min, P<0.001) and efficiency (90.23±13.29% vs. 86.34±12.84%, P<0.001). Neurotransmitter analysis showed reduced NE (289.43±51.68 vs. 253.78±57.12 pg/mL, P<0.05) and increased 5-HT (138.56±19.73 vs. 124.93±18.44 ng/mL, P<0.05) and NPY (453.21±73.41 vs. 402.34±68.12 pg/mL, P<0.05). Adverse events were comparable (6.25% vs. 3.13%, P=0.403).Conclusion: SGB effectively improves GAD symptoms and sleep quality in patients without comorbid depression, potentially via modulation of NE, 5-HT, and NPY pathways. The exclusion of psychiatric comorbidities enhances the specificity of these findings.
Keywords: Stellate ganglion block, generalized anxiety disorder, Sleep disturbance, efficacy, Mechanism
Received: 03 Jan 2025; Accepted: 11 Apr 2025.
Copyright: © 2025 Liu, Ma #, Zhou, Yang, Wang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yanyong Wang, The First hospital of Hebei Medical University, Shijiazhuang, China
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