Evidence map›Paper›PMID 41131044›Full record

ArticleNPJ Parkinson's disease2025

Bradykinesia induced by pallidal neurostimulation in dystonia: clinical risk factors and anatomical mapping.

Florian Lange, Diego L Guarin, Stella Mosert, Berenike Karrasch, Jonas Roothans, Benedikt Weigl, Pavel Navratil, Christine Daniels, Thorsten Odorfer, Gregor Brandt and 8 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in NPJ Parkinson's disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Probabilistic mapping of tremor control and gait ataxia risk in deep brain stimulation.Journal of neural transmission (Vienna, Austria : 1996) · 2026
    Article
  2. Observational
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

18 authors.

Florian LangeDepartment of Neurology, University of Würzburg, Würzburg, Germany. flrnlng0@gmail.com.
Diego L GuarinMovement Estimation and Analysis Laboratory, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA.
Stella MosertDepartment of Neurology, University of Würzburg, Würzburg, Germany.
Berenike KarraschDepartment of Neurology, University of Würzburg, Würzburg, Germany.
Jonas RoothansDepartment of Neurology, University of Würzburg, Würzburg, Germany.
Benedikt WeiglDepartment of Neurology, University of Würzburg, Würzburg, Germany.
Pavel NavratilDepartment of Neurology, University of Würzburg, Würzburg, Germany.
Christine DanielsDepartment of Neurology, University of Würzburg, Würzburg, Germany.
Thorsten OdorferDepartment of Neurology, University of Würzburg, Würzburg, Germany.
Gregor BrandtMovement Disorders and Neuromodulation Unit, Department of Neurology, Charite-Universitätsmedizin Berlin, Berlin, Germany.
Philipp MahlknechtDepartment of Neurology, Innsbruck Medical University, Innsbruck, Austria.
Joachim K KraussDepartment of Neurosurgery, Hannover Medical School, Hannover, Germany.
Joachim RungeDepartment of Neurosurgery, Hannover Medical School, Hannover, Germany.
Andrea A KühnMovement Disorders and Neuromodulation Unit, Department of Neurology, Charite-Universitätsmedizin Berlin, Berlin, Germany.
Günther DeuschlDepartment of Neurology, University Kiel, Kiel, Germany.
Jens VolkmannDepartment of Neurology, University of Würzburg, Würzburg, Germany.
Robert Peach *Department of Neurology, University of Würzburg, Würzburg, Germany.
Martin M Reich *Department of Neurology, University of Würzburg, Würzburg, Germany.

Funding

Deutsche Forschungsgemeinschaft 424778381, TRR 295Interdisziplinäres Zentrum für Klinische Forschung, Universitätsklinikum Würzburg Z-3BC/19
6 · The paper itself

Abstract

Pallidal deep brain stimulation (DBS) for dystonia can induce bradykinesia. We analyzed retrospective (n = 55) and prospective (n = 11) cohorts to identify risks and anatomical substrates for this side effect. Bradykinesia was prevalent (60-72%), with female sex, older dystonia onset, shorter disease duration, and crucially, stimulation pulse width identified as key predictive factors. Probabilistic mapping isolated a posterolateral globus pallidus internus "sour spot" for bradykinesia, which was spatially distinct from therapeutic "sweet spots" and demonstrated patient-level predictive power in cross-validation (R² = 0.16, p = 0.0013). Kinematic analysis showed reducing stimulation selectively improved movement frequency without altering amplitude. The effect appears mediated by local grey-matter modulation, not major white matter tracts. These findings suggest programming strategies using shorter pulse widths while avoiding the identified sour spot can mitigate bradykinesia without sacrificing antidystonic benefit.

Identifiers

PMID41131044
PMCPMC12550046

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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.