EPV1187 - Combined Therapy of Posttraumatic Stress Disorder with Stellate GanglionBlock and Radiofrequency Ablation in Military Patients

EPV1187

Combined Therapy of Posttraumatic Stress Disorder with Stellate Ganglion

Block and Radiofrequency Ablation in Military Patients

S. Moroz ^1,*, V. Semenikhina ¹

¹MUNICIPAL ENTERPRISE DNIPROPETROVSK MULTIPROFILE CLINICAL HOSPITAL FOR PROVISION OF PSYCHIATRIC CARE » DNIPROPETROVSK REGIONAL COUNCIL, Dnipro, Ukraine

 

Introduction: Post-traumatic stress disorder (PTSD) is one of the most prevalent and disabling
mental health consequences among military personnel exposed to combat.
Traditional therapeutic strategies, including psychotherapy and
pharmacotherapy, often provide delayed or incomplete relief, with up to 40% of
patients remaining symptomatic. Novel interventional approaches such as
stellate ganglion block (SGB) and radiofrequency ablation (RFA) of the stellate
ganglion have shown promise in reducing sympathetic hyperactivity and
alleviating PTSD symptoms.

Objectives: This pilot study aimed to evaluate the clinical efficacy and safety of combined
therapy using stellate ganglion block and radiofrequency ablation as an adjunct
to standard multimodal care in military patients with severe PTSD.

Methods: From May to July 2025, 61 male military patients (mean age 42.4±9.8 years)
with clinically confirmed PTSD (Mississippi Scale score >100) were enrolled.
Exclusion criteria included structural brain lesions on CT/MRI. Twenty-four
patients consented to interventional treatment (SGB and/or RFA) in addition to
standard therapy (psychotherapy, supportive physiotherapy, and nutrition).
Thirty-seven patients served as controls, receiving only standard treatment.
Procedures were performed under fluoroscopic guidance with intraoperative
stimulation for accurate localization. Clinical outcomes were assessed using the
Mississippi PTSD Scale and quantitative EEG (dominant alpha/beta rhythm
ratio) before intervention and at day 14. Safety outcomes included intra- and
postoperative complications.

Results: In the intervention group, PTSD severity decreased by 41 points on the
Mississippi Scale compared to 22 points in controls (p<0.001). EEG analysis
revealed a 41% restoration of alpha rhythm in the intervention group versus 9%

in controls (p<0.001), with a parallel reduction in beta rhythm (−38% vs −13%).
Vegetative symptoms (hyperhidrosis, blood pressure fluctuations) markedly
improved in the intervention group by days 14–21. Clinical response rate to
SGB/RFA reached 94.6%. The most frequent expected side effect was transient
Horner’s syndrome; one case of self-limited generalized seizure (4.1%) was
reported.

Conclusions: Stellate ganglion block and radiofrequency ablation represent effective and
relatively safe adjunctive interventions for severe PTSD in military patients.
These techniques offer rapid symptom reduction (1–2 days), sustained benefit
(up to 3 weeks), and objective neurophysiological improvement, making them
valuable options in multidisciplinary hospital settings. Further large-scale,
controlled studies are warranted to confirm long-term efficacy and broaden
applications to psychosomatic disorders.

 

Disclosure of Interest: None Declared