Stellate ganglion block reduces symptoms of Long COVID: A case series (2021) Liu et al

[Milo]

Highlights

Long COVID symptoms include fatigue, brain fog, anosmia, dysgeusia, orthostatic intolerance

Long COVId symptoms overlap with those of chronic fatigue syndrome (ME/CFS) and POTS.

Reduced cerebral blood flow is a feature of dysautonomia in ME/CFS and POTS.

Stellate ganglion block increases cerebral blood flow and alleviates Long COVID symptoms.

The interaction between nervous and immune systems is involved in Long COVID.


Abstract
After recovering from COVID-19, a significant proportion of symptomatic and asymptomatic individuals develop Long COVID.

Fatigue, orthostatic intolerance, brain fog, anosmia, and ageusia/dysgeusia in Long COVID resemble “sickness behavior,” the autonomic nervous system response to pro-inflammatory cytokines (Dantzer et al., 2008).

Aberrant network adaptation to sympathetic/parasympathetic imbalance is expected to produce long-standing dysautonomia.

Cervical sympathetic chain activity can be blocked with local anesthetic, allowing the regional autonomic nervous system to “reboot.”

In this case series, we successfully treated two Long COVID patients using stellate ganglion block, implicating dysautonomia in the pathophysiology of Long COVID and suggesting a novel treatment

link to article here

 

[Hoopoe]

Cervical sympathetic chain activity can be blocked with local anesthetic, allowing the regional autonomic nervous system to “reboot.”

Could anesthesia during neck surgery have this effect as well?

 

[5vforest]

I had one recently. Didn’t do anything. Seems like a big fad tbqh

 

[Hutan]

There are a couple of things just in the introduction of the paper that could be warning signs that this idea isn't very solid:

develop a distinct proinflammatory cytokine/chemokine profile (Patterson et al., 2021)

1. taking Bruce Patterson's reports at face value

Injection of local anesthetic near the stellate ganglion can block activity of the entire cervical sympathetic chain, as evidenced by the physiological signs of a successful block stellate ganglion block (SGB) collectively known as “Horner's Syndrome” which includes ipsilateral ptosis, meiosis, anhidrosis, and facial flushing.

Horner syndrome is a combination of signs and symptoms caused by the disruption of a nerve pathway from the brain to the face and eye on one side of the body. Typically, Horner syndrome results in a decreased pupil size, a drooping eyelid and decreased sweating on the affected side of your face

2. Decreased pupil size is called 'miosis'. Meiosis of course is what cells do during sexual reproduction and so is very unlikely to be a sign of Horner's Syndrome.

Of course, neither small issues mean that the treatment doesn't work. It does make me want to look into the background of the authors though...

Luke Liu - 'Neuroversion Inc., Anchorage, AK, USA' This seems to be the only paper he has ever published.
I have to say that increases my doubts - no academic affiliation or relevant track record, just a company based in Alaska.

Deborah Duricka - 'Neuroversion Inc., Anchorage, AK, USA'
Yeah, that's looking even more worrying, both authors affiliated to the same Alaskan company.

And yep, the company offers the treatment:
https://www.neuroversion.com
Luke Liu is the owner and Chief Medical Officer of Neuroversion.
Deborah Duricka is the Patient Care & Clinical Research Coordinator of Neuroversion

It has all the markers of a scam/'alternative medicine'. Might not be, but I'm not booking a flight to Alaska at this point.

 

[Hutan]

Mechanisms for the durable central nervous system effects of the SGB in these conditions are unclear, delaying its broad acceptance as a valid treatment.

If only that were true.

It seems I don't need to travel to Alaska, you can get this treatment anywhere
Stella Centres across Australia offer the treatment for PTSD

Built by Trailblazers, Led by Innovators
Considered the pioneer of the Stellate Ganglion Block treatment for PTSD, Dr. Lipov was the first to use the procedure for PTSD back in 2006. Because of his development of Stella’s SGB procedure, the Dual Sympathetic Reset, Dr. Lipov has been called the “Einstein of modern anesthesiology” for his work developing the SGB treatment for PTSD. As one of the world's leading experts, Dr. Lipov ensures that the latest protocols are being followed by every Stella physician, to meet our highest standards of care.

"The Einstein of modern anesthesiology". wow

The Stellate Ganglion Block (SGB) treatment is a widely used procedure shown to provide relief from symptoms like continual sleep disturbance, surges of anxiety and irritability, hypervigilance, difficulties concentrating and jumpiness.

What's the bet the evidence base for SGB treatment is studies of open label treatment with subjective outcomes?

 

[Hutan]

Stellate Ganglion Block treatment is discussed in more general terms on this thread:
Stellate Ganglion Block treatment

 

[Wyva]

"The Einstein of modern anesthesiology". wow

Once I saw a website where the doc with his dubious therapy was said to have been nominated for the Nobel Prize for his work and it even gave a specific year when this happened.

Fun fact: the names of the Nobel Prize nominees are sealed for 50 years, so no one knows who was really nominated. Anyone can walk around claiming to be a nominee, even you or me and no one can disprove it.

 

[rvallee]

Moved from the long covid in the media thread

Says nothing about a study, trial, or any evidence. Not sure if they really are going to just offer this treatment without any evidence, but it sure looks like it.


Stella and RTHM Partner to Treat Long COVID
https://www.prnewswire.com/news-releases/stella-and-rthm-partner-to-treat-long-covid-301561432.html

Stella ( www.stellacenter.com ), the leader in Stellate Ganglion Block (SGB) treatment for emotional trauma and mental health management, and RTHM ( www.rthm.com ), a Long COVID clinic with expert clinicians, a research arm, and a patented treatment and diagnosis algorithm, have partnered to provide RTHM's Long COVID patients with access to Stella's Stellate Ganglion Block (SGB) treatment.​

Or that's the evidence they're citing anyway, a case study:

SGB has been shown to help return the sympathetic nervous system to a healthier state after a biological trigger alters its function. Recently, Stella partners published a case study in the Journal of Neuroimmunology that showed how SGB treatment reduced symptoms of Long COVID.​

Yup, they're straight up offering it:

The SGB treatment offers promising results and will be administered by a board-certified anesthesiologist trained by Stella at locations convenient to patients. "Stella's SGB is one of the options within our individualized treatment plans, but it's an important one," says RTHM's co-founder, Dr. Jennifer Curtin. "The collaboration between RTHM and Stella provides our patients with a unique and potentially helpful treatment."​

About the company:

Long COVID affects up to 30% of those who have contracted COVID-19. Yet few clinicians have the background in post-viral disease or can access all the tools required to treat these challenging conditions. RTHM is unpacking the knowledge gained from other, often post-viral diseases like ME/CFS and leveraging that wisdom for those suffering with Long COVID. "Where others see Long COVID as 'uncharted waters'," Dr. Curtin says, "we already have a partial map from navigating other post-viral diseases."
...
MORE ABOUT STELLA: Stella's team of medical doctors, psychologists, patient care coordinators, and tireless advocates are on a mission to create a world where no person needlessly suffers from symptoms following trauma. Stella offers effective, peer-reviewed, breakthrough trauma and PTSD treatments. Stella innovates like lives depend on it – because they do. www.stellacenter.com
​

 

[Jonathan Edwards]

SGB has been shown to help return the sympathetic nervous system to a healthier state after a biological trigger alters its function.

Not sure how you return something to a healthier state by stopping it working with a block?

 

[Forbin]

Once I saw a website where the doc with his dubious therapy was said to have been nominated for the Nobel Prize for his work and it even gave a specific year when this happened.

The qualifications to be a nominator for the Nobel Peace Prize include:

• University professors, professors emeriti and associate professors of history, social sciences, law, philosophy, theology, and religion; university rectors and university directors (or their equivalents); directors of peace research institutes and foreign policy institutes.

So, if you happen to have a friend who's an associate history professor at a university, you can ask them to nominate you for the Nobel Peace Prize. Then you can more vaguely claim that you've been "nominated" for a "Nobel Prize." I once saw a news report on someone who had done this just for fun.