Evidence map›Paper›PMID 27461783›Full record

ReviewParkinsonism & related disorders2016

Pharmacological treatment in Parkinson's disease: Effects on gait.

Katrijn Smulders, Marian L Dale, Patricia Carlson-Kuhta, John G Nutt, Fay B Horak

Registry-linked trialOpen access · greenAbstract readReview
In one paragraph

Review in Parkinsonism & related disorders, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07226284 (The Effects of Vagus Nerve Stimulation on Intrinsic Lower Leg Spinal Motoneuron Excitability in Parkinson's Disease.), which is not on this map. Cited by 98 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
98citing papers in PubMed, 1 pooled it
10.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07226284 narecruitingnot on this mapstarted 2026, after this paper: background citation

The Effects of Vagus Nerve Stimulation on Intrinsic Lower Leg Spinal Motoneuron Excitability in Parkinson's Disease.

TypeinterventionalSponsorUniversity of MinnesotaRan2026 to 2029Enrolled75ConditionsPARKINSON DISEASE (Disorder), Parkinson's Disease (PD)ArmsVagal nerve stimulation, No intervention
3 · Its place in the literature

Who cites it

98 citing papers in PubMed, 1 synthesis or guideline pooled it, 182 citations in OpenAlex.

  1. Pooled it
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  9. Is levodopa induced freezing of gait a paradox or an expected phenomenon?: a clinico-pathophysiological hypothesis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Review
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38 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Katrijn SmuldersOregon Health & Science University, Department of Neurology, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, United States. Electronic address: katrijn.smulders@gmail.com.
Marian L DaleOregon Health & Science University, Department of Neurology, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, United States.
Patricia Carlson-KuhtaOregon Health & Science University, Department of Neurology, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, United States.
John G NuttOregon Health & Science University, Department of Neurology, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, United States.
Fay B HorakOregon Health & Science University, Department of Neurology, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, United States; VA Portland Health Care Systems, Department of Research, 3710 SW US Veteran Hospital Road, Portland, OR, 97230, United States.
Oregon Health & Science University · US

Funding

Udall Center Director's meeting poster awardP50NS062684 · NINDS · UNIVERSITY OF WASHINGTON · PI MONTINE, THOMAS J · 2009 to 2020
$18.3M
PERIPHERAL AND CENTRAL POSTURAL DISORDERS IN THE ELDERLYR01AG006457 · NIA · OREGON HEALTH & SCIENCE UNIVERSITY · PI HORAK, FAY BAHLING · 1986 to 2018
$5.2M
Peripheral and central Postural Disorders in the ElderlyR37AG006457 · NIA · OREGON HEALTH & SCIENCE UNIVERSITY · PI HORAK, FAY BAHLING · 2004 to 2013
$4.5M
Frontal Cortex and Gait Freezing in Parkinson's Disease: Rehabilitation ImpactI01RX001075 · VA · PORTLAND VA MEDICAL CENTER · PI HORAK, FAY BAHLING · 2015 to 2017
–
NIA NIH HHS R01 AG006457NIA NIH HHS R37 AG006457NINDS NIH HHS P50 NS062684RRD VA I01 RX001075
6 · The paper itself

Abstract

Gait impairments are a hallmark of Parkinson's disease (PD), both as early symptom and an important cause of disability later in the disease course. Although levodopa has been shown to improve gait speed and step length, the effect of dopamine replacement therapy on other aspects of gait is less well understood. In fact, falls are not reduced and some aspects of postural instability during gait are unresponsive to dopaminergic treatment. Moreover, many medications other than dopaminergic agents, can benefit or impair gait in people with PD. We review the effects of pharmacological interventions used in PD on gait, discriminating, whenever possible, among effects on four components of everyday mobility: straight walking, gait initiation, turning, gait adaptability. Additionally, we summarize the effects on freezing of gait. There is substantial evidence for improvement of spatial characteristics of simple, straight-ahead gait with levodopa and levodopa-enhancing drugs. Recent work suggests that drugs aiming to enhance the acetylcholine system might improve gait stability measures. There is a lack of well-designed studies to evaluate effects on more complex, but highly relevant walking abilities such as turning and making flexible adjustments to gait. Finally, paucity in the literature exists on detrimental effects of drugs used in PD that are known to worsen gait and postural stability in the elderly population.

Indexed as

Accidental FallsAcetylcholineAntiparkinson AgentsDopamine AgentsGait Disorders, NeurologicHumansParkinson DiseasePostural BalanceAcetylcholineAntiparkinson AgentsDopamine AgentsAcetylcholineDopamineFallsGaitTurning

Identifiers

PMID27461783
PMCPMC5048566
OpenAlexW2500704598

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.