Evidence map›Paper›PMID 40153030›Full record

ArticleJournal of neurology2025

The effects of dopaminergic medication and task load on trembling and akinetic freezing of gait in Parkinson's disease.

Demi Zoetewei, Pieter Ginis, Talia Herman, Moran Gilat, Nicholas D'Cruz, Luca Palmerini, Eran Gazit, Jeffrey M Hausdorff, Alice Nieuwboer

Abstract read
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In one paragraph

Article 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 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 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

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. An updated definition of freezing of gait.Nature reviews. Neurology · 2026
    Review
  4. Review
  5. Article
  6. Article
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

9 authors.

Demi ZoeteweiDepartment of Rehabilitation Sciences, Neurorehabilitation Research Group (eNRGy), KU Leuven, Leuven, Belgium.ORCID http://orcid.org/0000-0001-5175-6762
Pieter GinisDepartment of Rehabilitation Sciences, Neurorehabilitation Research Group (eNRGy), KU Leuven, Leuven, Belgium.ORCID http://orcid.org/0000-0002-6762-3347
Talia HermanCenter for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Moran GilatDepartment of Rehabilitation Sciences, Neurorehabilitation Research Group (eNRGy), KU Leuven, Leuven, Belgium.ORCID http://orcid.org/0000-0002-0072-4637
Nicholas D'CruzDepartment of Rehabilitation Sciences, Neurorehabilitation Research Group (eNRGy), KU Leuven, Leuven, Belgium.ORCID http://orcid.org/0000-0002-5306-5903
Luca PalmeriniDepartment of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, 40136, Bologna, Italy.ORCID http://orcid.org/0000-0003-4758-662X
Eran GazitCenter for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.ORCID http://orcid.org/0009-0009-1085-9664
Jeffrey M HausdorffCenter for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.ORCID http://orcid.org/0000-0002-1608-0776
Alice NieuwboerDepartment of Rehabilitation Sciences, Neurorehabilitation Research Group (eNRGy), KU Leuven, Leuven, Belgium. alice.nieuwboer@kuleuven.be.ORCID http://orcid.org/0000-0003-1193-6229

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn people with Parkinson's disease (PD), freezing of gait (FOG) can manifest as an absence of leg movement (akinetic) or a presence of high-frequency leg trembling. FOG is triggered most often during turning or dual-tasking when OFF-medication, but it is unclear whether the same holds true for akinetic and trembling FOG.

objectivesTo investigate the effects of dopaminergic medication and cognitive and motor tasks on trembling and akinetic FOG.

methodSixty-three PD patients with daily FOG performed a home-based FOG-provoking protocol OFF and ON-dopaminergic medication. FOG was video-annotated based on pre-specified definitions. We compared the % time in trembling and in akinetic FOG between OFF and ON. We also analyzed these outcomes during various motor tasks and with- and without a cognitive dual task. To identify subgroups, an exploratory k-means cluster analysis was performed.

resultsTrembling and akinetic FOG co-occurred in most patients (82.5%), although trembling was observed most frequently. Both manifestations were ameliorated by medication, but we identified four different patterns: a responsive mild group (n = 32), an unresponsive akinetic-dominant group (n = 8), and two trembling-dominant groups with (n = 12) and without (n = 11) a response to medication. Task load also affected the manifestations differentially, as dual-tasking and gait initiation induced more akinetic FOG compared to other conditions.

conclusionsTrembling and akinetic FOG respond similarly to dopaminergic medication (except for a specific trembling subgroup), yet they are differentially influenced by FOG triggers. Altogether, we suggest that "trembling" may represent a milder form of FOG, although "trembling" as a distinct FOG-variant cannot be rule out.

Indexed as

Antiparkinson AgentsDopamine AgentsGait Disorders, NeurologicParkinson DiseasePsychomotor PerformanceAgedFemaleHumansMaleMiddle AgedAntiparkinson AgentsDopamine AgentsAkinetic freezingDopaminergic medicationFreezing of gaitParkinson’s diseaseTrembling freezingTriggers

Identifiers

PMID40153030

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.