Evidence map›Paper›PMID 41701756›Full record

Trial reportEuropean stroke journal2026

The impact of levodopa on post-stroke depression: the ESTREL-depression-study.

Mirjam I Sauter, Josefin E Kaufmann, Lukas Boos, Annaelle Zietz, Simon Trüssel, Andreas R Luft, Alexandros Polymeris, Valerian L Altersberger, Karin Wiesner, Martina Wiegert and 46 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European stroke journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03735901 (Enhancement of Stroke Rehabilitation With Levodopa), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

NCT03735901 phase3active not recruitingnot on this map

Enhancement of Stroke Rehabilitation With Levodopa (ESTREL): a Randomized Placebo-controlled Trial

TypeinterventionalSponsorUniversity Hospital, Basel, SwitzerlandRan2019 to 2029Enrolled610ConditionsAcute Stroke, Stroke RehabilitationArmsIMP Levodopa 100mg/Carbidopa 25mg, Matching placebo
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

56 authors.

Mirjam I SauterDepartment of Rehabilitation and Neurology, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland.ORCID 0009-0004-5598-6249
Josefin E KaufmannDepartment of Rehabilitation and Neurology, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland.ORCID 0000-0001-7744-2796
Lukas BoosDepartment of Rehabilitation and Neurology, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland.ORCID 0009-0006-2383-881X
Annaelle ZietzDepartment of Rehabilitation and Neurology, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland.ORCID 0000-0002-4362-2497
Simon TrüsselDepartment of Rehabilitation and Neurology, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland.ORCID 0009-0004-2537-855X
Andreas R LuftDivision of Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital of Zurich and University of Zurich, Zurich, Switzerland.ORCID 0000-0001-9865-7382
Alexandros PolymerisDepartment of Neurology and Stroke Center, Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.ORCID 0000-0002-9475-2208
Valerian L AltersbergerDepartment of Neurology and Stroke Center, Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.ORCID 0000-0002-0610-9328
Karin WiesnerDepartment of Rehabilitation and Neurology, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland.
Martina WiegertDepartment of Rehabilitation and Neurology, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland.
Jeremia P O HeldDivision of Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital of Zurich and University of Zurich, Zurich, Switzerland.ORCID 0000-0001-5373-2000
Yannik RottenbergerDivision of Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital of Zurich and University of Zurich, Zurich, Switzerland.
Anne SchwarzDivision of Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital of Zurich and University of Zurich, Zurich, Switzerland.ORCID 0000-0001-8943-5673
Friedrich MedlinService of Neurology and Stroke Unit, HFR Fribourg-Cantonal Hospital, Fribourg, Switzerland.ORCID 0000-0002-8477-899X
Ettore A AccollaService of Neurology and Stroke Unit, HFR Fribourg-Cantonal Hospital, Fribourg, Switzerland.ORCID 0000-0003-1234-8808
Sandrine FoucrasService of Neurology and Stroke Unit, HFR Fribourg-Cantonal Hospital, Fribourg, Switzerland.
Georg KägiUniversity Teaching and Research Hospital, Neurology Department & Stroke Center, HOCH Health Ostschweiz, Kantonsspital St Gallen, St Gallen, Switzerland.ORCID 0000-0001-7749-8060
Gian Marco De MarchisUniversity Teaching and Research Hospital, Neurology Department & Stroke Center, HOCH Health Ostschweiz, Kantonsspital St Gallen, St Gallen, Switzerland.ORCID 0000-0002-0342-9780
Svetlana PolitzKantonsspital Münsterlingen, Münsterlingen, Switzerland.ORCID 0000-0002-8237-5011
Matthias GreulichKantonsspital Winterthur, Winterthur, Switzerland.
Alexander A TarnutzerNeurology, Cantonal Hospital of Baden, Baden, Switzerland.ORCID 0000-0002-6984-6958
Rolf SturzeneggerDepartement Innere Medizin, Neurologie, Kantonsspital Graubünden, Chur, Switzerland.
Mira KatanDepartment of Neurology and Stroke Center, Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.ORCID 0000-0002-9265-8066
Marcel ArnoldDepartment of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland.ORCID 0000-0002-4274-4644
Krassen NedeltchevCantonal Hospital of Aarau and Department of Neurology, University of Bern, Bern, Switzerland.ORCID 0000-0002-7614-1227
Janine SchärDepartment of Neurology and Stroke Center, Klinik Hirslanden, Zurich, Switzerland.
Katrien Van Den Keybus DeglonAcute Neurorehabilitation Unit, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.ORCID 0009-0001-6614-9444
Pierre-André RapinLavigny Rehabilitation Institution, Lavigny, Switzerland.ORCID 0009-0008-0210-0378
Alexander SalernoStroke Center, Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.ORCID 0000-0001-8494-5527
David J SeiffgeDepartment of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland.ORCID 0000-0003-3890-3849
Elias AuerDepartment of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland.ORCID 0009-0000-8172-0648
Julian LippertDepartment of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland.ORCID 0000-0002-9951-4807
Leo H BonatiDepartment of Neurology and Stroke Center, Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.ORCID 0000-0003-1163-8133
Corina Schuster-AmftResearch Department, Reha Rheinfelden, Rheinfelden, Switzerland.ORCID 0000-0003-1120-4423
Szabina GäumannResearch Department, Reha Rheinfelden, Rheinfelden, Switzerland.ORCID 0000-0002-1535-2063
Joelle N ChabwineDivision of Neurorehabilitation, Fribourg Hospital, Meyriez-Murten, Switzerland.ORCID 0000-0002-5470-9272
Andrea HummService of Neurology and Stroke Unit, HFR Fribourg-Cantonal Hospital, Fribourg, Switzerland.ORCID 0000-0002-1435-7903
J Carsten MöllerDivision of Neurorehabilitation, Fribourg Hospital, Meyriez-Murten, Switzerland.ORCID 0000-0003-1718-4486
Raoul SchweinfurtherRehaklinik Zihlschlacht AG, Zihlschlacht-Sittendorf, Switzerland.
Bartosz BujanNeurorehabilitation, Klinik Lengg Zurich, Zurich, Switzerland.
Piotr JedrysiakNeurorehabilitation, Klinik Lengg Zurich, Zurich, Switzerland.
Peter S SandorResearch Department, Rehaklinik Bad Zurzach, ZURZACH Care Group, Bad Zurzach, Switzerland.ORCID 0000-0002-4373-5555
Roman GonzenbachKliniken Valens, St. Gallen, Switzerland.ORCID 0009-0004-1917-0613
Veit MyliusKliniken Valens, St. Gallen, Switzerland.ORCID 0000-0002-0900-0491
Dietmar LutzKliniken Valens, St. Gallen, Switzerland.
Carmen LienertKliniken Valens, St. Gallen, Switzerland.ORCID 0000-0002-4069-7573
Nils PetersDepartment of Neurology and Stroke Center, Klinik Hirslanden, Zurich, Switzerland.ORCID 0000-0001-8451-7389
Patrik MichelStroke Center, Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.ORCID 0000-0003-4954-7579
René M MüriDepartment of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.ORCID 0000-0001-6990-4188
Sabine SchädelinDepartment of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.ORCID 0000-0002-1150-0962
Lars G HemkensDepartment of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.ORCID 0000-0002-3444-1432
Gary A FordRadcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom.ORCID 0000-0001-8719-4968
Philippe A LyrerDepartment of Neurology and Stroke Center, Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.ORCID 0000-0002-1435-1114
Henrik GensickeDepartment of Rehabilitation and Neurology, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland.ORCID 0000-0002-0949-2422
Christopher TraenkaDepartment of Rehabilitation and Neurology, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland.ORCID 0000-0002-7600-1005
Stefan T EngelterDepartment of Rehabilitation and Neurology, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland.ORCID 0000-0003-3855-6234

Funding

SNSF 33IC30_179667
6 · The paper itself

Abstract

introductionPost-stroke depression (PSD) frequently occurs after acute stroke and negatively affects rehabilitation. Dopamine has beneficial effects on motivation and emotional stability. In stroke patients, low dopamine levels are linked to PSD. This study investigated whether levodopa treatment during in-hospital rehabilitation impacts PSD compared to placebo. PATIENTS AND

methodsESTREL-Depression was a pre-planned analysis of the multicenter, randomized, double-blind, placebo-controlled ESTREL trial. Participants with an acute ischemic or hemorrhagic stroke were randomly assigned to receive either levodopa/carbidopa (100/25 mg) or placebo three times daily for 39 days. All ESTREL participants with (1) information about the presence or absence of depression at three months and (2) who took at least 80% of the study medication were eligible for the study. Participants with a history of depression were excluded. For the primary outcome, the presence of PSD was defined as having a T-score of ≥55 in the Patient-Reported Outcomes Measurement Information System short-form depression-4a 3 months after randomization. Binary logistic regression was performed to assess the effect of levodopa on PSD.

resultsThe study included 407 ESTREL participants (median age 72, 60% male), 209 receiving levodopa, and 198 receiving placebo. At 3 months, the frequency and odds of PSD did not differ between the levodopa group (26%) and the placebo group (28%) (OR = 0.93, 95% CI, 0.60-1.43).

conclusionIn the ESTREL-Depression study, treatment with levodopa had no impact on the occurrence of PSD. CLINICAL

trial registrationClinicalTrials.gov: NCT03735901 (https://clinicaltrials.gov/study/NCT03735901).

Indexed as

CarbidopaDepressionLevodopaStrokeAgedDouble-Blind MethodDrug CombinationsFemaleHumansMaleMiddle AgedStroke RehabilitationTreatment OutcomeCarbidopaDrug CombinationsLevodopadepressiondopaminelevodopapost-stroke depressionrehabilitationstroke

Identifiers

PMID41701756
PMCPMC12911922

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Registered trials

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