Enhancing Cognitive Processing Therapy for Posttraumatic Stress Disorder Via Stellate Ganglion Block Treatment: A Pilot Trial

Cognitive Processing Therapy (CPT) is an effective first-line, evidence-based treatment for posttraumatic stress disorder (PTSD). Despite its well-demonstrated effectiveness, research has shown that approximately two-thirds of individuals continue to meet the diagnostic criteria for PTSD even after successful treatment completion. Stellate Ganglion Block (SGB) treatment, involving a local anesthesia injection to the stellate ganglion (around the lower base of the neck), has been shown to block its pain signal transmissions. Prior case studies and reviews have provided evidence for reducing PTSD symptoms with SGB treatment. However, studies to date have only examined SGB as a standalone intervention. The utility of combining CPT with concurrent SGB treatment remains unknown, although it is plausible that the combination of the two treatments can improve the effectiveness of CPT alone. The present study aims to test this hypothesis by comparing either a combined 1-week massed CPT + SGB treatment and 1-week massed CPT + placebo treatment (saline injection) using a randomized controlled trial design.

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Key information

Conditions

Posttraumatic Stress Disorder Chronic Pain Mental Disorders Neurologic Manifestations Pain Pathological Conditions, Signs and Symptoms Signs and Symptoms Stress Disorders, Post-Traumatic Stress Disorders, Traumatic Trauma and Stressor Related Disorders

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Rush University Medical Center

Chicago, Illinois, 60612, United States

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Are 18 years or older
Are fluent in English
Reside in Illinois
Have safe transportation means other than driving themselves to Rush University Medical Center for two separate procedures (e.g., Uber, family or friend to drive them to study visits, etc.)
Have experienced a Criterion A traumatic event during their lifetime
Have a PTSD diagnosis verified via the Clinician Administered PTSD Scale for DSM-5
Have not previously received stellate ganglion blocks
Are willing and able to participate in daily Cognitive Processing Therapy over the course of one week
Are willing and able to complete self-report measures and clinician-rated assessments at multiple time points over the course of the study

Exclusion criteria

The traumatic event occurred in the past month
They are currently suicidal or homicidal (i.e., plan and intent)
They have unmanaged psychosis or mania
They have not been on a stable dose of psychotropic medication for at least one month by the time of the baseline assessment or are planning to change their medications within 3 months of starting their participation in the study
They have completed an evidence-based cognitive behavioral PTSD treatment (e.g., Cognitive Processing Therapy or Prolonged Exposure) in the past 12 months or are currently receiving an evidence-based PTSD treatment
They have an intellectual disability or significant cognitive impairment that would prevent them from engaging in CPT, as assessed via the Mini-Mental State Exam-Second Edition (MMSE-2)
They are currently on any blood-thinning medications or have a coagulopathy
They have any of the following conditions: a recent myocardial infarction, glaucoma, a pre-existing contralateral nerve palsy, severe emphysema or a cardiac conduction blockade.
They are allergic to any of the medications injected (i.e., ropivacaine, lidocaine, propofol, medications)
They have an active infection
They have a serious or unstable medical illness or instability for which hospitalization may be likely within the next year
They have a visual or auditory impairment that would prevent them from fully participating in study activities
They are involved with current legal actions related to the traumatic event that is anticipated to be targeted during treatment
Subjects who, at the time of consent, appear to have extenuating life circumstances (e.g., unstable housing, no internet access, etc.) which, in the judgement of the Principal Investigator, could affect the ability to deliver the intervention with fidelity

Treatment and study plan

Stellate Ganglion Block Treatment

Procedure

Stellate ganglion block procedure is a treatment that involves injection of local anesthetic around the stellate ganglion (located at the base of the neck) to block its transmission of pain signals.

Placebo

Procedure

Sham

Primary outcomes

Clinician Administered PTSD Scale for DSM-5

Time frame: Through study completion, on average of 3 months

Clinician Administered Assessment of PTSD
PTSD Checklist for DSM-5 Criteria

Time frame: Through study completion, on average of 3 months

Self-report measure for PTSD

Sponsors and collaborators

Lead sponsor

Rush University Medical Center

Other

Registry information

Acronym: SGB

Important dates

Study start: 2022
Primary completion: 2025
Study completion: 2025
First posted: Sep 9, 2022
Registry last updated: Oct 24, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.

Completed