Skip to main content
Top

18-12-2024 | Capsaicin | Review Article

Sphenopalatine ganglion stimulation for the treatment of cerebrovascular ischemia

Authors: Juan Manuel Marquez-Romero, Karen Itzel Sánchez-Ramírez

Published in: Clinical Autonomic Research

Login to get access

Abstract

Purpose

The parasympathetic effects of the sphenopalatine ganglion (SPG) on the cerebral vasculature provide a compelling rationale for its therapeutic application in cerebrovascular ischemia. In recent years, attempts have been made to stimulate the SPG to achieve beneficial effects on cerebral circulation.

Methods

This review synthesizes the available publications on SPG stimulation. It critically evaluates the evidence from preclinical studies and clinical trials to assess its potential as a treatment for acute cerebrovascular disorders and outlines aspects that still require more study.

Results

The medical literature provides consistent evidence of the significant effects of stimulating the SPG on cerebrovascular circulation. In addition, considerable evidence supports the therapeutic role of SPG stimulation in patients with cerebral ischemia.

Conclusion

Given the current understanding, future research could explore the potential of SPG stimulation as a non-reperfusion intervention to improve long-term outcomes for individuals with ischemic cerebrovascular conditions.
Literature
7.
8.
go back to reference Jesser J, Awounvo S, Vey JA, Vollherbst DF, Hilgenfeld T, Chen M et al (2023) Prediction and outcomes of cerebral vasospasm in ischemic stroke patients receiving anterior circulation endovascular stroke treatment. Eur Stroke J 8(3):684–691CrossRefPubMedPubMedCentral Jesser J, Awounvo S, Vey JA, Vollherbst DF, Hilgenfeld T, Chen M et al (2023) Prediction and outcomes of cerebral vasospasm in ischemic stroke patients receiving anterior circulation endovascular stroke treatment. Eur Stroke J 8(3):684–691CrossRefPubMedPubMedCentral
9.
go back to reference Pilato F, Distefano M, Calandrelli R (2020) Posterior reversible encephalopathy syndrome and reversible cerebral vasoconstriction syndrome: clinical and radiological considerations. Front Neurol 11:34CrossRefPubMedPubMedCentral Pilato F, Distefano M, Calandrelli R (2020) Posterior reversible encephalopathy syndrome and reversible cerebral vasoconstriction syndrome: clinical and radiological considerations. Front Neurol 11:34CrossRefPubMedPubMedCentral
10.
go back to reference Romenskaya T, Longhitano Y, Piccolella F, Berger JM, Artico M, Taurone S et al (2023) Cerebral vasospasm: practical review of diagnosis and management. Rev Recent Clin Trials 18(1):12–18CrossRefPubMed Romenskaya T, Longhitano Y, Piccolella F, Berger JM, Artico M, Taurone S et al (2023) Cerebral vasospasm: practical review of diagnosis and management. Rev Recent Clin Trials 18(1):12–18CrossRefPubMed
16.
go back to reference Yamamoto M, Ho Cho K, Murakami G, Abe S, Rodriguez-Vazquez JF (2018) Early fetal development of the otic and pterygopalatine ganglia with special reference to the topographical relationship with the developing sphenoid bone. Anat Rec (Hoboken) 301(8):1442–1453. https://doi.org/10.1002/ar.23833CrossRefPubMed Yamamoto M, Ho Cho K, Murakami G, Abe S, Rodriguez-Vazquez JF (2018) Early fetal development of the otic and pterygopalatine ganglia with special reference to the topographical relationship with the developing sphenoid bone. Anat Rec (Hoboken) 301(8):1442–1453. https://​doi.​org/​10.​1002/​ar.​23833CrossRefPubMed
17.
go back to reference Chyi T, Wang SD, Gong CL, Lin SZ, Cheng V, Kuo JS (2005) Preganglionic neurons of the sphenopalatine ganglia reside in the dorsal facial area of the medulla in cats. Chin J Physiol 48(1):31–40PubMed Chyi T, Wang SD, Gong CL, Lin SZ, Cheng V, Kuo JS (2005) Preganglionic neurons of the sphenopalatine ganglia reside in the dorsal facial area of the medulla in cats. Chin J Physiol 48(1):31–40PubMed
28.
go back to reference Iliff JJ, Wang R, Zeldin DC, Alkayed NJ (2009) Epoxyeicosanoids as mediators of neurogenic vasodilation in cerebral vessels. Am J Physiol-Heart Circul Physiol 296(5):H1352–H1363CrossRef Iliff JJ, Wang R, Zeldin DC, Alkayed NJ (2009) Epoxyeicosanoids as mediators of neurogenic vasodilation in cerebral vessels. Am J Physiol-Heart Circul Physiol 296(5):H1352–H1363CrossRef
31.
go back to reference Suzuki N (2012) Roles of cerebrovascular innervations and their neurotransmitters in various pathological conditions of central nervous system. Rinsho Shinkeigaku Clin Neurol 52(11):819–824CrossRef Suzuki N (2012) Roles of cerebrovascular innervations and their neurotransmitters in various pathological conditions of central nervous system. Rinsho Shinkeigaku Clin Neurol 52(11):819–824CrossRef
46.
51.
go back to reference Bornstein NM, Saver JL, Diener HC, Gorelick PB, Shuaib A, Solberg Y et al (2019) An injectable implant to stimulate the sphenopalatine ganglion for treatment of acute ischaemic stroke up to 24 h from onset (ImpACT-24B): an international, randomised, double-blind, sham-controlled, pivotal trial. Lancet 394(10194):219–229. https://doi.org/10.1016/S0140-6736(19)31192-4CrossRefPubMed Bornstein NM, Saver JL, Diener HC, Gorelick PB, Shuaib A, Solberg Y et al (2019) An injectable implant to stimulate the sphenopalatine ganglion for treatment of acute ischaemic stroke up to 24 h from onset (ImpACT-24B): an international, randomised, double-blind, sham-controlled, pivotal trial. Lancet 394(10194):219–229. https://​doi.​org/​10.​1016/​S0140-6736(19)31192-4CrossRefPubMed
65.
go back to reference Buxton RB, Frank LR (1997) A model for the coupling between cerebral blood flow and oxygen metabolism during neural stimulation. J Cereb Blood Flow Metab 17(1):64–72CrossRefPubMed Buxton RB, Frank LR (1997) A model for the coupling between cerebral blood flow and oxygen metabolism during neural stimulation. J Cereb Blood Flow Metab 17(1):64–72CrossRefPubMed
76.
go back to reference Wang YC, Kuo JS, Lin SZ (1998) The effect of sphenopalatine postganglionic neurotomy on the alteration of local cerebral blood flow of normotensive and hypertensive rats in acute cold stress. Proc Natl Sci Counc Repub China B 22(3):122–128PubMed Wang YC, Kuo JS, Lin SZ (1998) The effect of sphenopalatine postganglionic neurotomy on the alteration of local cerebral blood flow of normotensive and hypertensive rats in acute cold stress. Proc Natl Sci Counc Repub China B 22(3):122–128PubMed
77.
go back to reference Fukuyama H, Ouchi Y, Matsuzaki S, Ogawa M, Yamauchi H, Nagahama Y et al (1996) Focal cortical blood flow activation is regulated by intrinsic cortical cholinergic neurons. Neuroimage 3(3):195–201CrossRefPubMed Fukuyama H, Ouchi Y, Matsuzaki S, Ogawa M, Yamauchi H, Nagahama Y et al (1996) Focal cortical blood flow activation is regulated by intrinsic cortical cholinergic neurons. Neuroimage 3(3):195–201CrossRefPubMed
Metadata
Title
Sphenopalatine ganglion stimulation for the treatment of cerebrovascular ischemia
Authors
Juan Manuel Marquez-Romero
Karen Itzel Sánchez-Ramírez
Publication date
18-12-2024
Publisher
Springer Berlin Heidelberg
Published in
Clinical Autonomic Research
Print ISSN: 0959-9851
Electronic ISSN: 1619-1560
DOI
https://doi.org/10.1007/s10286-024-01085-6