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The Stellate Institute in 2023

The year 2023 marks the second full year in operation for The Stellate Institute.  How did we do last year?  We take this time now to assess our four-part mission: 1) Serve as the international experts in SGB, 2) Provide world-class care, 3) Publish research, and 4) Advocate on a national level for our patients.  Here are some highlights below:

1) Serve as the world expert in applying new variants of the stellate ganglion block procedure to treat the injury of trauma

In addition to our patients from the USA, we are always willing to care for anyone suffering around the world who may benefit from our care.  We have had patients travel from ten different countries to seek expert SGB care here in Annapolis, Maryland.  Our care also involves collaborating with our patients’ therapists after they return home to resume therapy.  The behavioral health community at large seems more familiar with SGB.  Some of this increased awareness of stellate ganglion block is also the direct result of outreach and education from The Stellate Institute physicians presenting their research and experiences in official forums throughout 2023.

In April, we presented our latest research at the American Academy of Orthopedic Medicine National Symposium in Fort Lauderdale.  And in May, we presented at the American College of Sports Medicine (ACSM) Annual Meeting in Denver on our work with PTSD in elite athletes.  In October, we spoke at the Integrative Warrior Health Summit at the Military Women’s Memorial in Arlington which was sponsored by HunterSeven Foundation and Task Force Dagger Special Operations Foundation.  In December, we presented on SGB in Amsterdam to an international audience of physicians who routinely treat PTSD.  Throughout the year, we advised the SEAL Future Foundation—a leader in innovative care of our nation’s elite military forces and their families.  Online, we participated as guests on several podcasts and produced three new educational videos which have accumulated over 6,000 views on YouTube thus far.

As pioneers in the use of SGB, we feel strongly that high quality clinical care and growing evidence are absolutely essential to keep momentum going towards wider accessibility to SGB worldwide.  To this end, we frequently field inquiries from numerous clinicians regarding specific patients, techniques and indications.  Last year, this also included advising a new center in The Netherlands on establishing their SGB practice as well as educating several other European specialists.

2) Provide compassionate world-class care to our patients:

In 2023, Dr. Lynch and Dr. Mulvaney combined to perform over 1100 ultrasound-guided stellate ganglion block procedures—doubling what we performed in 2021.  Our patients have traveled to Annapolis from the District of Columbia and 48 of the 50 states (Wyoming and Iowa are the holdouts!).  Our patients have also traveled from 10 different countries, from as far away as New Zealand, the Philippines, and Denmark.  Many make the “short” drive from Canada.

This reach has been due, in part, to a growing network of referring clinicians.  Our colleagues range from pediatricians and family physicians to social workers, psychiatrists, and psychologists.  Many of these teammates were not familiar with SGB before hearing of our work.  Quite a few were surprised they had overlooked the published evidence supporting SGB in the medical literature.  Others learn about the value of adding SGB to their patient’s treatment only after experiencing it firsthand.  Last year, we had hundreds of referrals from therapists many miles away including California, Texas, Florida, New York, and Canada.  Yet, we have many neighbors around Delaware/Maryland/Virginia who are still suffering and could likely benefit from SGB, but they have not been introduced to this treatment by their treating clinicians.  We hope to improve collaboration and cooperation across disciplines in 2024. Medicine is a team sport!

In April 2023, The Stellate Institute/ROSM opened a new clinic in Easton, Maryland to better serve those from Delaware and the Eastern Shore.

3) Continue to publish research as well as educate both our patients and other clinicians on the benefits of SGB

The year 2023 marked a very important discovery where The Stellate Institute research showed that SGB cuts anxiety symptoms in half.  We published the first study demonstrating that SGB can be extremely helpful to those suffering from Anxiety who do not necessarily have a diagnosis of PTSD.*  This was also the first study to demonstrate the benefit of a bilateral SGB over treating just a single side.  The full article is available on our Evidence page.  Briefly, anxiety symptoms are scored on a 21-point scale called the GAD-7.  Our research showed that if we treat the stellate ganglion on one side followed by the other side the following day, GAD-7 scores decreased by about 10 points at 1 week and remained 9.5 points lower than baseline still at 1 month.  This is over twice the change that is considered clinically important on the GAD-7.  This is a big deal, since 50% of anxiety sufferers do not respond well to psychotherapy and/or pharmacotherapy.  So, adding stellate ganglion block to standard anxiety treatments now may provide hope for all who suffer with anxiety.

We completed several other research projects last year which are being submitted for publication now.  And our randomized controlled trial (RCT) studying SGB plus Cognitive Processing Therapy (CPT) is nearly complete through our collaboration with The Ohio State University’s STRIVE Program.    

4) Advocate on a national level for those struggling with PTSD

We had several influential engagements with key leaders in 2023 to raise awareness of SGB and to influence policy and access across the diverse groups of trauma survivors.  We hosted the Maryland Secretary of Veterans Affairs, Anthony Woods, at The Stellate Institute for a discussion on improving access to SGB for Maryland’s veterans with PTSD.  Senator Sarah Elfreth also visited The Stellate Institute in July, expressing her dedication to helping access cutting-edge trauma treatments for all Marylanders including survivors of sexual assault.  Other public official support came from a meeting with Senator Dawn Gile who expressed support for increasing access to SGB across the state.  We served as guest speaker at For the Love of a Veteran annual charity gala in Pennsylvania and partnered with this same organization to raise awareness among community leaders at the Veterans Fair in Delaware in September.

We met with local leaders and peer counselors in the fire fighter community and conducted a site visit to the International Association of Fire Fighters (IAFF) Center of Excellence in Upper Marlboro to coordinate SGB treatment for fire fighters from the US and Canada who are suffering from their traumatic first responder experiences.

Throughout 2023, we fought for advancing access to SGB for survivors of sexual assault through many local and national organizations.  In August, we met with the leaders of RAINN (Rape, Abuse & Incest National Network), which is the nation’s largest anti-sexual violence organization.  We will continue to engage with leaders and charitable organizations in the sexual assault space to bring wider understanding of the value of adding stellate ganglion block to help survivors of rape, intimate partner violence (IPV), childhood abuse, and neglect.  There is no shortage of work to do in this space and we are absolutely committed to doing our part to help survivors from all trauma backgrounds!

In summary, 2023 was a busy year, but we have only just begun scratching the surface of treating those suffering from the injuries of trauma.  If you’d like to join us in this endeavor, you are welcome to climb aboard and row alongside us!  LOTS of work to do!

*Lynch JH, Mulvaney SW, Bryan CJ, Hernandez D. Stellate Ganglion Block Reduces Anxiety Symptoms by Half: A Case Series of 285 Patients. Journal of Personalized Medicine. 2023; 13(6):958.

Full Text Article Available Here

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About the author: Dr. James (Jim) Lynch is the co-founder of The Stellate Institute in Annapolis, Maryland. He is a veteran of 31 years in the US Army. His passion is treating anxiety and trauma survivors from all backgrounds.

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