“Effect of Stellate Ganglion Block on ME/CFS Symptoms and Plasma Metabolites”
Principal Investigator: Deborah Duricka, PhD
Co-Investigator: Luke Liu, MD
“Effect of Stellate Ganglion Block on ME/CFS Symptoms and Plasma Metabolites”
Principal Investigator: Deborah Duricka, PhD
Co-Investigator: Luke Liu, MD
Dr. Deborah Duricka, PhD (Neuroscience), is the clinical research scientist at Neuroversion Inc., an interventional pain clinic in Anchorage, Alaska. She has conducted research projects at the Salk Institute for Biological Studies, the Huntsman Cancer Institute, Amgen, Proctor and Gamble, and Novartis. Topics of research have included molecular genetics/genomics, heart disease and metabolic balance, the neuroscience of sleep, and the pathophysiology (genetic damage) of congenital cytomegalovirus infection. Her range of knowledge is extraordinarily broad as a result. Dr. Duricka has published in prestigious scientific journals including Genetics, Journal of Biological Chemistry, Biochemical Journal, Journal of Virology, and Journal of Neuroimmunology.
Dr. Luke Liu, MD, is the Chief Medical Officer and Owner of Neuroversion, Inc. He is board certified in Anesthesiology and Pain Medicine. Dr. Liu strongly believes in the value of investigating serendipitous discoveries in the clinic, including the utility of the stellate ganglion block for alleviating symptoms of a variety of illnesses with autonomic underpinnings, including ME/CFS and Long Covid.
Study Summary
Recruitment information for this study can be found on ClinicalTrials.gov.
The autonomic nervous system (ANS), which controls all involuntary functions of the body, has been implicated in both Long COVID and ME/CFS. Notably, the sympathetic nervous system (SNS, the ‘fight or flight’ arm of the ANS) modulates the immune system, vascular resistance and regional blood flow, level of alertness/drowsiness, blood pressure and heart rate, baroreceptor reflex responsiveness (orthostatic tolerance), mitochondrial function (substrate utilization, fragmentation, biogenesis), and gut motility, among other things. The parasympathetic nervous system (PNS, ‘rest and digest’) works in conjunction with the SNS to maintain homeostasis, a dynamic balance that allows the organism to respond appropriately to internal and external conditions. When this balance is disrupted, dysautonomia results. Because the ANS has a broad range of responsibilities, the symptoms and consequences of dysautonomia vary greatly.
The stellate ganglion (SG) is a waystation for sympathetic signals descending from the brainstem to the head and upper thoracic organs, including the thymus (origin of autoimmunity). Signals routed through the SG modulate cerebral blood flow, which is associated with the severity of brain fog and fatigue in ME/CFS and POTS. Due to its effect on the heart and brain, the SG plays a large part in setting the balance of the ANS.
We serendipitously discovered that blocking the stellate ganglion with regional anesthesia (a ‘stellate ganglion block’ or SGB) reduces the symptom of Long COVID. The purpose of this study is to investigate the effect of SGB on ME/CFS symptoms and physiology. We will measure orthostatic tolerance, cognitive function, subjective rating of symptoms, and plasma markers before and after treatment. Non-longitudinal studies are hampered by the large overlap in the ranges of potential biomarkers in healthy controls and ME/CFS patients. The advantage of our study is that each patient serves as their own control, which may allow us to find a biomarker that correlates with changes in symptom severity. The SGB procedure has the potential to illuminate the pathophysiology of ME/CFS symptoms, and alleviate the suffering of individual patients.
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