ReviewMovement disorders : official journal of the Movement Disorder Society2025
Update on Treatments for Parkinson's Disease Motor Fluctuations - An International Parkinson and Movement Disorder Society Evidence-Based Medicine Review.
Review in Movement disorders : official journal of the Movement Disorder Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 2 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Update on Medical Treatments for Essential Tremor: An International Parkinson and Movement Disorder Society Evidence-Based Medicine Review.Movement disorders : official journal of the Movement Disorder Society · 2026Pooled it
- Parkinson's disease in the United Arab Emirates (UAE): Emirates Neurology Society consensus guidelines.Frontiers in neurology · 2026Guideline
- Outcomes of rehabilitation following device-aided therapy start in parkinson's disease: a randomized controlled trial.Journal of rehabilitation medicine · 2026Trial
- Research advances in the microbiota‑gut‑brain axis and Parkinson's disease (Review).Molecular medicine reports · 2026Review
- Consensus-based perspectives on integrating IPX203 into Parkinson's disease management.Journal of neurology · 2026Review
- Short-term Classification of Neurodegenerative Diseases using Time-series Features Based on Analysis of Gait Dynamics.Journal of biomedical physics & engineering · 2026Article
- On-demand therapies-emergency medication or daily routine?Journal of neural transmission (Vienna, Austria : 1996) · 2026Review
- Clinical trials in late-stage Parkinson's disease.Journal of Parkinson's disease · 2026Review
- German Delphi consensus: COMT inhibitors in the management of wearing-off fluctuations in Parkinson's disease.Journal of neural transmission (Vienna, Austria : 1996) · 2026Article
- Do We Need to Monitor B-Vitamins and Homocysteine During Initiation of Foslevodopa/Foscarbidopa Therapy?Movement disorders : official journal of the Movement Disorder Society · 2026Article
- Symptom prevalence and pharmacological management of late-stage Parkinson's disease (LSPD): a cross-sectional, multinational survey.Journal of neural transmission (Vienna, Austria : 1996) · 2026Article
- Exercise and Motor Complications in Parkinson's Disease: A Systematic Review and Meta-Analysis.Movement disorders clinical practice · 2026Review
- What's in a name? reframing advanced Parkinson's disease as a multidimensional state.Journal of neural transmission (Vienna, Austria : 1996) · 2026Review
- Review
- Breaking barriers and fighting inequality in Parkinson's disease care: Personal reflections of movement disorders clinicians.Journal of Parkinson's disease · 2026Article
- Refractory Motor Complications: Towards a Pragmatic Definition.Movement disorders clinical practice · 2026Article
- Advancing the Treatment of Motor Fluctuations in Parkinson's Disease with a Next-Generation Levodopa/Carbidopa Formulation.Neurology and therapy · 2026Review
- From continuous to adaptive deep brain stimulation: Personalized modulation improves motor complications and sleep in Parkinson's Disease.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Patient-reported outcomes and experiences with COMT inhibitors in the management of motor fluctuations in Parkinson's disease: a UK-based nested cross-sectional study.Journal of neurology · 2026Article
- Drug repurposing for disease-modifying effects in multiple system atrophy.Translational neurodegeneration · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
22 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo update evidence-based medicine recommendations for treating motor fluctuations of Parkinson's disease (PD).
backgroundThe International Parkinson and Movement Disorder Society (MDS) Evidence Based Medicine in Movement Disorders Committee recommendations for the treatments of PD were first published in 2002 and regularly updated. The current review uses a new methodology, including the Cochrane Risk of Bias tool and a modified version of GRADE (Grading of Recommendations, Assessment, Development, and Evaluations).
methodsOn January 1, 2023, a literature search was conducted without date limit in the MEDLINE, Embase, and Cochrane databases using the following search terms: Parkinson disease, levodopa and, for the Embase database, randomized controlled trial (RCT). The inclusion criteria for studies were: patients with PD, on oral levodopa therapy, experiencing motor fluctuations, investigating an intervention that was (commercially) available in at least one country, study design RCT, and with a follow-up duration of at least 3 months.
resultsA total of 102 studies were included. Levodopa extended release, pramipexole immediate release and extended release, ropinirole immediate release, rotigotine, opicapone, safinamide, and bilateral subthalamic nucleus deep brain stimulation (DBS) were assessed as efficacious, and continuous intestinal levodopa infusion, continuous subcutaneous levodopa, continuous subcutaneous apomorphine, ropinirole prolonged release, ropinirole patch, entacapone, rasagiline, istradefylline, amantadine extended release, zonisamide, bilateral globus pallidus DBS, and pallidotomy were assessed as likely efficacious for the treatment of motor fluctuations in people with PD who are already being treated with levodopa.
conclusionsThere are several treatment options that can improve motor fluctuations in PD. These recommendations will assist physicians and patients in determining which intervention to use. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Indexed as
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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.