Effect of Stellate Ganglion Block on Dysphagia and Cognitive Impairment in Cerebral Small Vessel Disease: A Randomized Controlled Study.

Abstract

BACKGROUNDS Cerebral small vessel disease (CSVD) can potentially and frequently lead to dysphagia and cognitive impairment. Stellate ganglion block (SGB) can alleviate the symptoms by regulating neural pathways and improving cerebral blood circulation. OBJECTIVES This study aimed to explore the clinical effect of SGB on airway protection, dysphagia, cognitive impairment, and activities of daily living (ADL) in CSVD patients. METHOD This was a randomized controlled study conducted from February 2021 to May 2023, including 84 CSVD patients with dysphagia and cognitive impairment. The participants were randomly divided into the SGB group (n = 42) and the untreated group (n = 42). All received standard-of-care rehabilitation for 20 days. The SGB group received SGB once a day additionally. Assessments were conducted on Day 1 and Day 20, respectively. The Penetration-Aspiration Scale (PAS) was primary outcome. Modified Barium Swallow Impairment (MBSImp), Mini-Mental State Examination (MMSE), Modified Barthel Index (MBI) and adverse events were secondary outcomes. This study was registered at ClinicalTrials.gov, Identifier: NCT06176404. RESULTS There were two dropout cases in the untreated group. Time effect with statistical significance was observed in all assessments (p < .05). Group effect with statistical significance was observed in the PAS (z = -17.283, p < .001), MBSImp-Oral (z = -3.382, p = .001), MBSImp-Pharyngeal (z = -2.639, p = .008), MMSE (F = 7.450, p = .008), and MBI (F = 6.408, p = .013). During the treatment, there were no severe adverse events. CONCLUSION SGB can significantly and safely improve airway protection, dysphagia, cognitive function, and ADL in CSVD patients with dysphagia and cognitive impairment who received standard-of-care rehabilitation.