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Augmenting Massed Prolonged Exposure With a Stellate Ganglion Block to Treat PTSD

Early Phase 1
Completed
Conditions
Stress Disorders, Post-Traumatic
Interventions
Registration Number
NCT04302181
Lead Sponsor
The University of Texas Health Science Center at San Antonio
Brief Summary

This is a small, open-label treatment study that tests the potential safety and treatment effectiveness of a stellate ganglion block combined with Massed Prolonged Exposure (PE). Each of the 12 participants will receive ten 90-minute sessions of Massed Prolonged Exposure and an injection of a stellate ganglion block between the first and second PE sessions.

Detailed Description

Massed PE will be conducted by doctoral-level therapists. Participants will meet with their providers for individual, 90-minute sessions. They will then be asked to complete out-of-session treatment assignments throughout the rest of the day. Between the individual therapy session and out-of-session treatment assignments, participants will engage in approximately four to six hours of treatment per day, Monday through Friday, for two weeks. The stellate ganglion block injection will be administered between the first and second massed PE session by qualified medical personnel as per standard operating procedure for the placement of a stellate ganglion block. A research nurse will be in attendance during the procedure and for an hour recovery period following the block administration.

During PE treatment, participants will complete interim assessments of their PTSD symptoms, mood symptoms, trauma-related cognitions, and suicidal ideation proceeding sessions 6 and 10.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
12
Inclusion Criteria
  1. Active duty or retired military service member (age 18- 65 years)
  2. PTSD diagnosis as assessed by Clinician-Administered Posttraumatic Stress Scale (CAPS-5)
  3. Able to speak and read English (due to standardization of outcome measures)
  4. Defense Enrollment Eligibility Reporting System (DEERS)-eligible to receive care at Brooke Army Medical Center for the stellate ganglion block.
Exclusion Criteria
  1. Classification as high risk for suicide
  2. Current serious mental health diagnosis (e.g., bipolar or psychosis)
  3. Symptoms of moderate to severe substance (to include alcohol) use within the last 30 days
  4. Pregnancy (i.e. positive pregnancy test at screening) or breastfeeding
  5. Current anticoagulant use
  6. History of bleeding disorder
  7. Infection or mass at injection site
  8. Myocardial infarction within 6 months of procedure
  9. Pathologic bradycardia or irregularities of heart rate or rhythm;
  10. Symptomatic hypotension
  11. Phrenic or laryngeal nerve palsy
  12. History of glaucoma
  13. Uncontrolled seizure disorder
  14. History of allergy to local anesthetics

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Stellate Ganglion BlockRopivacaine injectionOne time administration of a stellate ganglion block
Primary Outcome Measures
NameTimeMethod
Change in PCL-5 (Posttraumatic Stress Disorder Checklist)Baseline, 1 month and 3 months

A 20-item self-report measure that assesses the presence and severity of PTSD symptoms using the Diagnostic and Statistical Manual of mental disorders (DSM-5).

Change in CAPS-5 (Clinician-Administered PTSD Scale)Baseline, 1 month and 3 months

A 30-item structured interview used to assess symptoms of PTSD. Questions target the onset and duration of symptoms, subjective distress, impact on social and occupational functioning.

Secondary Outcome Measures
NameTimeMethod
Change in PHQ-9 (Patient Health Questionnaire-9)Baseline, 1 month and 3 months

A 9-item self-report measure that assesses the presence and severity of depressive symptoms.

Change in Brief Inventory of Psychosocial FunctioningBaseline, 1 month and 3 months

A 7-item self-report measure assessing respondents' level of functioning in seven life domains: romantic relationship, relationship with children, family relationships, friendships and socializing, work, training and education, and activities of daily living.

Change in GAD-7 (General Anxiety Disorder Screener)Baseline, 1 month and 3 months

A 9-item self-report measure that assesses the presence and severity of general anxiety symptoms.

Change in PTCI (Posttraumatic Cognitions Inventory)Baseline, 1 month and 3 months

A 36-item self-report measure that assesses self-blame, negative cognitions about self, and negative cognitions about the world following trauma exposure.

Trial Locations

Locations (2)

Brooke Army Medical Center

🇺🇸

Fort Sam Houston, Texas, United States

University of Texas Health Science Center at San Antonio

🇺🇸

San Antonio, Texas, United States

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