A unifying theory linking the prolonged efficacy of the stellate ganglion block for the treatment of chronic regional pain syndrome (CRPS), hot flashes, and posttraumatic stress disorder (PTSD)

Modulation of NGF by cortisol and the Stellate Ganglion Block – Is this the missing link between memory consolidation and PTSD?

“…The working hypothesis was that the autonomic nervous system modulates PTSD via a complex neurological pathway beginning with NGF and culminating in excess concentration of norepinephrine. This was described in Medical Hypothesis publication in 2009 [22].…”

Effects of stellate ganglion block on cardiovascular reaction and heart rate variability in elderly patients during anesthesia induction and endotracheal intubation

“…The postganglionic fibers are widely distributed in the blood vessels; smooth muscles; and glands of the head, neck, face, upper limbs, lungs, trachea, and heart [11]. Stellate ganglion block (SGB) has been used to manage pain [12,13] and treat various diseases caused by sympathetic overexcitation through increased blood flow; improved hemodynamics; and regulation of the central nervous, immune, and endocrine systems [14,15]. The effects of SGB on the cardiovascular system remain controversial.…”

Letter to the Editor

“…Although it is true that SGB changes cerebral blood flow, it is unlikely to lead to a persistent effect across 6 months. 3 The explanation of a prolonged effect of SGB on HFs and posttraumatic stress disorder has led my team to publish BA unifying theory linking the prolonged efficacy of the stellate ganglion block for the treatment of chronic regional pain syndrome (CRPS), hot flashes, and posttraumatic stress disorder (PTSD)[ in 2009. 3 The theory rests on previous reports of HFs and posttraumatic stress disorder being associated with increased nerve growth factor (NGF), 3 which is known to promote sympathetic neurite growth (increased density of aberrant sympathetic nerve fibers) 4 that leads to increased intracerebral norepinephrine, eventually leading to HFs and posttraumatic stress disorder symptoms.…”

“…3 The explanation of a prolonged effect of SGB on HFs and posttraumatic stress disorder has led my team to publish BA unifying theory linking the prolonged efficacy of the stellate ganglion block for the treatment of chronic regional pain syndrome (CRPS), hot flashes, and posttraumatic stress disorder (PTSD)[ in 2009. 3 The theory rests on previous reports of HFs and posttraumatic stress disorder being associated with increased nerve growth factor (NGF), 3 which is known to promote sympathetic neurite growth (increased density of aberrant sympathetic nerve fibers) 4 that leads to increased intracerebral norepinephrine, eventually leading to HFs and posttraumatic stress disorder symptoms. 3 My team's article did not state that Bnerve growth factor and norepinephrine, which increases centrally before and during a hot flash,[ as stated by Walega et al 1 The 2009 unified theory states that BNGF level increase is an effect of estrogen decrease, that eventually leads to NOR EPI [norepinephrine] increase leading to HF.…”

“…3 The theory rests on previous reports of HFs and posttraumatic stress disorder being associated with increased nerve growth factor (NGF), 3 which is known to promote sympathetic neurite growth (increased density of aberrant sympathetic nerve fibers) 4 that leads to increased intracerebral norepinephrine, eventually leading to HFs and posttraumatic stress disorder symptoms. 3 My team's article did not state that Bnerve growth factor and norepinephrine, which increases centrally before and during a hot flash,[ as stated by Walega et al 1 The 2009 unified theory states that BNGF level increase is an effect of estrogen decrease, that eventually leads to NOR EPI [norepinephrine] increase leading to HF. [ To the best of my knowledge, there is no evidence to support the reported NGF increase during HFs, as noted by Walega et al 1 in their article.…”