Refined Sphenopalatine Ganglion Stimulator Placement and Intensity Setting to Augment Blood Flow and Neurologic...

Area of Science:

• Neurology
• Neurosurgery
• Medical Devices

Background:

• Previous trials show sphenopalatine ganglion (SPG) stimulation benefits acute anterior circulation ischemic stroke patients with cortical involvement.
• Refinements in SPG stimulation technique are crucial for optimizing treatment efficacy and patient tolerance.

Purpose of the Study:

• To evaluate SPG electrode placement using real-time optical tracking guidance.
• To assess stimulation intensity selection based on comfortable, non-noxious facial physiological markers.
• To determine the impact of these refined techniques on blood flow and motor function in stroke patients.

Main Methods:

• A single-arm trial enrolled 50 patients with acute anterior circulation ischemic stroke within 24 hours of onset.
• SPG electrodes were placed using real-time optical tracking.
• Stimulation intensity was determined by ipsilateral facial tingling or lacrimation; effects measured via carotid artery blood flow, hand strength, and National Institutes of Health Stroke Scale (NIHSS) changes.

Main Results:

• SPG implantation was rapid (median 4 minutes) and accurate in all patients.
• Comfortable stimulation levels were achieved in 96% of patients using physiological markers.
• SPG stimulation significantly increased carotid artery blood flow (44-52%) and improved hand strength (26-42%). NIHSS scores showed greater improvement compared to historical controls (75% vs. 50% recovery).

Conclusions:

• Real-time optical tracking enables fast and accurate SPG stimulator placement.
• Feasible selection of stimulation intensity using non-noxious facial markers enhances patient tolerance.
• Refined SPG stimulation effectively augments cervico-cranial blood flow and improves motor function in acute ischemic stroke.