{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:38:17Z","timestamp":1792791497273,"version":"4.5.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T00:00:00Z","timestamp":1746576000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This double-blind randomized controlled trial (RCT) enrolled 128 patients with GAD (Hamilton Anxiety Scale [HAMA]\u202f&amp;gt;\u202f14, Generalized Anxiety Disorder 7-item Scale [GAD-7]\u202f\u2265\u202f5) and sleep disturbance (Pittsburgh Sleep Quality Index [PSQI]\u202f\u2265\u202f15), randomized to receive SGB (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f64, 4 ultrasound-guided 1% lidocaine injections) or conventional treatment (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f64, cognitive behavioral therapy [CBT]\u202f+\u202festazolam 1\u20132\u202fmg\/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]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After 4\u202fweeks, SGB demonstrated higher efficacy (98.4% vs. 89.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.028) and greater reductions in HAMA (9.36\u202f\u00b1\u202f2.34 vs. 11.87\u202f\u00b1\u202f2.71,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and HAMD scores (6.87\u202f\u00b1\u202f2.01 vs. 8.09\u202f\u00b1\u202f2.04,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). PSQI improved significantly in the SGB group (5.74\u202f\u00b1\u202f1.64 vs. 8.03\u202f\u00b1\u202f1.86,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), with increased total sleep time (TST) (429.76\u202f\u00b1\u202f33.22 vs. 391.13\u202f\u00b1\u202f30.76\u202fmin,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and efficiency (90.23\u202f\u00b1\u202f13.29% vs. 86.34\u202f\u00b1\u202f12.84%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Neurotransmitter analysis showed reduced NE (289.43\u202f\u00b1\u202f51.68 vs. 253.78\u202f\u00b1\u202f57.12\u202fpg.\/mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05) and increased 5-HT (138.56\u202f\u00b1\u202f19.73 vs. 124.93\u202f\u00b1\u202f18.44\u202fng\/mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05) and NPY (453.21\u202f\u00b1\u202f73.41 vs. 402.34\u202f\u00b1\u202f68.12\u202fpg.\/mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). Adverse events were comparable (6.25% vs. 3.13%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.403).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1554841","type":"journal-article","created":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T01:13:13Z","timestamp":1746580393000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["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"],"prefix":"10.3389","volume":"16","author":[{"given":"Na","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Neurology, The First Hospital of Hebei Medical University","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinying","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Hospital of Hebei Medical University","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moqing","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Hospital of Hebei Medical University","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Hospital of Hebei Medical University","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenyuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Hospital of Hebei Medical University","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Hospital of Hebei Medical University","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1097\/YCO.0000000000000840","article-title":"Interventions for generalized anxiety disorder","volume":"36","author":"Byrne","year":"2023","journal-title":"Curr Opin Psychiatry"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1080\/14737175.2023.2211767","article-title":"Pharmacological treatment of generalised anxiety disorder: current practice and future directions","volume":"23","author":"Fagan","year":"2023","journal-title":"Expert Rev Neurother"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20054431","article-title":"Sleep disturbances in generalized anxiety disorder: the role of calcium homeostasis 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