Evidence map›Paper›PMID 39891751›Full record

SynthesisJournal of neurology2025

Dopaminergic responsiveness and dopaminergic challenge tests of Parkinson's disease: a systematic review and meta-analysis.

Wenyi Kou, Huihui Cai, Yusha Cui, Jinqiao Zhu, Siming Li, Chen Yang, Haibo Chen, Tao Feng

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Review
  6. Article
  7. Review
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

8 authors.

Wenyi Kou *Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Huihui Cai *Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yusha CuiCenter for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Jinqiao ZhuCenter for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Siming LiCenter for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Chen YangCenter for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Haibo ChenDepartment of Neurology, Beijing Hospital; National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China. dr_chenhaibo@126.com.
Tao FengCenter for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. bxbkyjs@sina.com.

Funding

National Natural Science Foundation of China 82071422National Natural Science Foundation of China 82271459Natural Science Foundation of Beijing Municipality 7212031
6 · The paper itself

Abstract

BACKGROUND AND

objectiveThe assessment and quantification of dopaminergic responsiveness are crucial for the diagnosis and management of Parkinson's disease (PD). This study aimed to summarize and compare motor improvements in patients with PD and atypical parkinsonian syndromes (APS) across three types of dopaminergic challenge tests, as well as evaluate their diagnostic performance.

methodsPubMed, Embase, Cochrane Library, and Web of Science were searched to identify eligible studies reporting the improvement rate of the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) or MDS-UPDRS-III in dopaminergic challenge tests for PD or APS, or diagnostic outcomes in differential diagnosis between PD and APS. A random-effects model was conducted to pool improvement rates and standardized mean differences (SMDs) in patients with PD or APS during dopaminergic challenge tests. Subgroup analysis and meta-regression were used to investigate the sources of heterogeneity. A bivariate mixed-effects model was employed to evaluate the diagnostic performance of these tests.

resultsA total of 58 studies (3641 PD and 711 APS) were included. In the acute levodopa challenge test, patients with PD, APS, and multiple system atrophy (MSA) demonstrated pooled UPDRS-III improvement rates of 41.5% [95% confidence interval (CI) 38.5%-44.5%; I

conclusionsThe overall dopaminergic responsiveness is greater in PD patients compared to those with APS. However, there is significant heterogeneity in the pooled motor improvement of dopaminergic responsiveness within PD or APS, with overlap between de novo PD and early-stage APS. All three types of dopaminergic challenge tests demonstrate moderate diagnostic performance in differentiating PD from APS.

Indexed as

Dopamine AgentsLevodopaParkinson DiseaseParkinsonian DisordersHumansDopamine AgentsLevodopaAcute levodopa challenge testDiagnostic performanceDopaminergic responsivenessParkinson's disease

Identifiers

PMID39891751

What OpenQuestion holds

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Registered trials

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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.