SynthesisDevelopmental medicine and child neurology2021
Pharmacological and neurosurgical interventions for individuals with cerebral palsy and dystonia: a systematic review update and meta-analysis.
Synthesis in Developmental medicine and child neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06606574 (PREDICT-ITB), which is not on this map. Cited by 45 papers, 6 of them syntheses that pooled 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.
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.
PREDICT-ITB: Predicting Response in Children With Dystonic Cerebral Palsy to Intrathecal Baclofen
Who cites it
45 citing papers in PubMed, 6 syntheses or guidelines pooled it, 91 citations in OpenAlex.
- Clinical Presentations and Treatment of Baclofen Toxicity and Withdrawal: A Systematic Review.CNS drugs · 2026Pooled it
- Deep brain stimulation for dystonia treatment in cerebral palsy: efficacy exploration.Experimental biology and medicine (Maywood, N.J.) · 2025Pooled it
- Pharmacological and neurosurgical management of cerebral palsy and dystonia: Clinical practice guideline update.Developmental medicine and child neurology · 2024Guideline
- Intrathecal baclofen efficacy for managing motor function and spasticity severity in patients with cerebral palsy: a systematic review and meta-analysis.BMC neurology · 2024Pooled it
- Which gait training intervention can most effectively improve gait ability in patients with cerebral palsy? A systematic review and network meta-analysis.Frontiers in neurology · 2022Pooled it
- Movement disorders in patients with Rett syndrome: A systematic review of evidence and associated clinical considerations.Psychiatry and clinical neurosciences · 2021Pooled it
- Trial
- Article
- Botulinum Toxin in Children and Adolescents-A Comprehensive Review of Clinical Applications.Toxins · 2026Review
- Stepwise surgical management of spasticity and dystonia in severe pediatric cerebral palsy: a case report involving selective dorsal rhizotomy, intrathecal baclofen therapy, and deep brain stimulation.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
- Putamen Atrophy as a Predictive Factor of Efficacy of GPi-DBS in Dystonia-Dyskinesia Syndrome Secondary to Perinatal Anoxic Encephalopathy.Movement disorders : official journal of the Movement Disorder Society · 2026Article
- Preventing Parkinson's disease in the context of movement disorders: a narrative review of current evidence and future directions.Neurological research and practice · 2026Review
- Improving Measurement and Priorities for Assessment in Clinical Trials of childhood-onset Dystonia International Core Outcome Set (Dystonia IMPACT-COS): A protocol.NIHR open research · 2026Article
- Tasks for assessing dystonia in young people with cerebral palsy.medRxiv : the preprint server for health sciences · 2025Article
- Impact of Bilateral GPi Deep Brain Stimulation on Dystonia, Functional Outcomes, and Caregiver Burden in Patients with Dystonic Cerebral Palsy.Journal of clinical medicine · 2025Article
- Exploring the efficacy of deep brain stimulation in pediatric neurological disorders: a comprehensive review.Acta epileptologica · 2025Review
- Multicenter Improvement in Screening for Dystonia in Young People With Cerebral Palsy.Neurology. Clinical practice · 2025Article
- Preterm birth is associated with dystonic features and reduced cortical parvalbumin immunoreactivity in mice.Pediatric research · 2025Article
- Botulinum Toxin Therapy: A Comprehensive Review on Clinical and Pharmacological Insights.Journal of clinical medicine · 2025Review
- National Prescribing Practices for Pediatric Dystonia Among Providers in the United States.Clinical and translational science · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimTo update a systematic review of evidence published up to December 2015 for pharmacological/neurosurgical interventions among individuals with cerebral palsy (CP) and dystonia.
methodSearches were updated (January 2016 to May 2020) for oral baclofen, trihexyphenidyl, benzodiazepines, clonidine, gabapentin, levodopa, botulinum neurotoxin (BoNT), intrathecal baclofen (ITB), and deep brain stimulation (DBS), and from database inception for medical cannabis. Eligible studies included at least five individuals with CP and dystonia and reported on dystonia, goal achievement, motor function, pain/comfort, ease of caregiving, quality of life (QoL), or adverse events. Evidence certainty was evaluated using GRADE.
resultsNineteen new studies met inclusion criteria (two trihexyphenidyl, one clonidine, two BoNT, nine ITB, six DBS), giving a total of 46 studies (four randomized, 42 non-randomized) comprising 915 participants when combined with those from the original systematic review. Very low certainty evidence supported improved dystonia (clonidine, ITB, DBS) and goal achievement (clonidine, BoNT, ITB, DBS). Low to very low certainty evidence supported improved motor function (DBS), pain/comfort (clonidine, BoNT, ITB, DBS), ease of caregiving (clonidine, BoNT, ITB), and QoL (ITB, DBS). Trihexyphenidyl, clonidine, BoNT, ITB, and DBS may increase adverse events. No studies were identified for benzodiazepines, gabapentin, oral baclofen, and medical cannabis.
interpretationEvidence evaluating the use of pharmacological and neurosurgical management options for individuals with CP and dystonia is limited to between low and very low certainty. What this paper adds Meta-analysis suggests that intrathecal baclofen (ITB) and deep brain stimulation (DBS) may improve dystonia and pain. Meta-analysis suggests that DBS may improve motor function. Clonidine, botulinum neurotoxin, ITB, and DBS may improve achievement of individualized goals. ITB and DBS may improve quality of life. No direct evidence is available for oral baclofen, benzodiazepines, gabapentin, or medical cannabis.
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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.