Wang YM, Liu X, Sun XJ, Li N, Yang ZL, Feng TC. Continuous stellate ganglion block for neurovascular headache and associated anxiety and depression. World J Psychiatry 2026; 16(7): 117484 [DOI: 10.5498/wjp.117484]
Corresponding Author of This Article
Ye-Ming Wang, Department of Anesthesiology, The First Affiliated Hospital of Hebei North University, No. 12 Changqing Road, Qianxi District, Zhangjiakou 075000, Hebei Province, China. wangyeming8011@163.com
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Psychology
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research-article
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Wang YM, Liu X, Sun XJ, Li N, Yang ZL, Feng TC. Continuous stellate ganglion block for neurovascular headache and associated anxiety and depression. World J Psychiatry 2026; 16(7): 117484 [DOI: 10.5498/wjp.117484]
World J Psychiatry. Jul 19, 2026; 16(7): 117484 Published online Jul 19, 2026. doi: 10.5498/wjp.117484
Continuous stellate ganglion block for neurovascular headache and associated anxiety and depression
Ye-Ming Wang, Xuan Liu, Xiao-Jia Sun, Ning Li, Zhan-Long Yang, Teng-Chen Feng
Ye-Ming Wang, Xuan Liu, Xiao-Jia Sun, Teng-Chen Feng, Department of Anesthesiology, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, Hebei Province, China
Ning Li, Zhan-Long Yang, Department of Operating Rooms, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, Hebei Province, China
Author contributions: Wang YM contributed to conceptualization, project administration, writing - original draft; Wang YM and Feng TC contributed to methodology, writing - review and editing; Liu X contributed to formal analysis; Liu X, Sun XJ, Li N, and Yang ZL contributed to investigation; Liu X and Yang ZL contributed to data curation; Sun XJ contributed to validation; Sun XJ and Li N contributed to resources; Feng TC contributed to formal analysis; and all authors have read and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of the First Affiliated Hospital of Hebei North University (Approval No. K2021151).
Informed consent statement: The requirement for written informed consent was waived by the Medical Ethics Committee of the First Affiliated Hospital of Hebei North University because this was a retrospective study using previously collected clinical data, with no patient identifiers and no additional risk to participants.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.
Corresponding author: Ye-Ming Wang, Department of Anesthesiology, The First Affiliated Hospital of Hebei North University, No. 12 Changqing Road, Qianxi District, Zhangjiakou 075000, Hebei Province, China. wangyeming8011@163.com
Received: January 6, 2026 Revised: February 1, 2026 Accepted: April 2, 2026 Published online: July 19, 2026 Processing time: 172 Days and 13.5 Hours
Abstract
BACKGROUND
Neurovascular headache is a prevalent chronic pain syndrome (10%-15%) worldwide. 50%-80% of patients have comorbid anxiety or depression which triggers and perpetuates a pain-emotion vicious cycle with limited success in treatment. The sympathatic modulatory role of the stellate ganglion block (SGB) may produce pain relief and psychological symptom improvement, but few studies systematically evaluate dual effects and prognosis predictive factors for continuous SGB. This study aims to evaluate the 3-month efficacy of continuous SGB on pain and psychological symptoms, investigate the relationship between pain/emotion and provide predictors for treatment effects in order to optimize further clinical strategies.
AIM
To determine the effectiveness of ongoing SGB in improving pain severity and associated with anxiety and depression states in neurovascular headache patients and to define prognostic factors influencing treatment outcomes.
METHODS
A retrospective study enrolled 126 patients with neurovascular headache who received continuous SGB treatment from January 2020 to June 2024. Under ultrasound guidance, catheters were placed on the longus colli muscle surface with continuous infusion of 0.2% lidocaine (1 mL/hour) for 5 consecutive days on the left stellate ganglion, followed by 5 consecutive days on the right stellate ganglion, for a total treatment duration of 10 days. Visual Analog Scale scores, headache frequency, Self-Rating Anxiety Scale (SAS) scores, Self-Rating Depression Scale (SDS) scores, and quality of life were assessed at baseline, 1 week, 1 month, and 3 months post-treatment.
RESULTS
All 126 patients completed the full treatment course (5 consecutive days on the left stellate ganglion followed by 5 consecutive days on the right stellate ganglion, totaling 10 days). Follow-up assessments were completed by 126 patients (100%) at 1 week, 122 patients (96.8%) at 1 month, and 116 patients (92.1%) at 3 months post-treatment. At 3 months post-treatment, Visual Analog Scale scores decreased 54.4% (from 6.8 ± 1.2 to 3.1 ± 1.6, P < 0.001), headache frequency reduced 54.5% (from 12.3 ± 4.5 times/month to 5.6 ± 3.1 times/month, P < 0.001), and episode duration shortened 55.2% (P < 0.001). SAS scores decreased 15.6% with anxiety incidence dropping from 48.4% to 25.4% (P < 0.001). SDS scores declined 14.5% with depression incidence decreasing from 57.9% to 35.7% (P < 0.001). Total effective rate reached 86.5%. Pain relief correlated positively with anxiety improvement (r = 0.687, P < 0.001) and depression improvement (r = 0.652, P < 0.001). Shorter disease duration, absence of medication overuse, and lower baseline anxiety were independent favorable prognostic factors. No serious complications occurred.
CONCLUSION
Further, the treatment of neurovascular headache patients with continuous SGB results in safe and effective relief of pain symptoms and reductions in anxiety and depression, with efficacy sustained for up to 3 months. The association of pain relief and improvement in psychology is important and mutually reinforcing. We recommend for early intervention and baseline psychological assessment.
Core Tip: Continuous stellate ganglion block (SGB) are effective and continuous in patients with neurovascular headache. SGB significantly decreased headache intensity, frequency, and duration as well as improved anxiety and depression scores in this study, highlighting its dual effect on pain and psychological comorbidities. Pain reduction was closely associated with the improvement in emotional functioning and may represent common neurobiological mechanisms. Better outcomes were predicted by shorter disease duration, no medication overuse and lower levels of baseline anxiety. In summary, these findings establish SGB as a safe, feasible and clinically beneficial therapeutic option, providing further evidence to favor early intervention along with regular psychological evaluation in the management of headache.
