Evidence map›Paper›PMID 39751950›Full record

GuidelineJournal of neurology2025

Diagnosis and treatment of autonomic failure, pain and sleep disturbances in Parkinson's disease: guideline "Parkinson's disease" of the German Society of Neurology.

Alessandra Fanciulli, Friederike Sixel-Döring, Carsten Buhmann, Florian Krismer, Wiebke Hermann, Christian Winkler, Dirk Woitalla, Wolfgang H Jost, German Parkinson’s Guideline Group, Claudia Trenkwalder and 1 more

Abstract readPractice GuidelineReview
PubMed Full text at PMC Publisher
In one paragraph

Guideline 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 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing 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

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

  1. Pooled it
  2. Review
  3. Review
  4. Review
  5. Article
  6. Article
  7. How to treat cardiovascular autonomic failure in Parkinson's disease.Journal of neural transmission (Vienna, Austria : 1996) · 2026
    Review
  8. Article
  9. Article
  10. Review
  11. Article
  12. Article
  13. The diagnosis comes before therapy, even with non-motor features.Therapeutic advances in neurological disorders · 2025
    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

11 authors.

Alessandra FanciulliDepartment of Neurology, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria. alessandra.fanciulli@i-med.ac.at.ORCID http://orcid.org/0000-0002-2854-4179
Friederike Sixel-DöringParacelsus-Elena-Klinik, Kassel, Germany.
Carsten BuhmannDepartment of Neurology, University Clinic Eppendorf, Hamburg, Germany.
Florian KrismerDepartment of Neurology, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.
Wiebke HermannDepartment of Neurology, Rostock University Medical Center, Rostock, Germany.
Christian WinklerDepartment of Neurology, Lindenbrunn Hospital, Coppenbrügge, Germany.
Dirk WoitallaKathol. Kliniken der Ruhrhalbinsel, Essen, Germany.
Wolfgang H JostParkinson-Klinik Ortenau, Wolfach, Germany.
German Parkinson’s Guideline Group
Claudia TrenkwalderParacelsus-Elena-Klinik, Kassel, Germany.
Günter HöglingerDepartment of Neurology, LMU University Hospital, Ludwig-Maximilians-Universität (LMU) München, Munich, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveNon-motor symptoms frequently develop throughout the disease course of Parkinson's disease (PD), and pose affected individuals at risk of complications, more rapid disease progression and poorer quality of life. Addressing such symptom burden, the 2023 revised "Parkinson's disease" guideline of the German Society of Neurology aimed at providing evidence-based recommendations for managing PD non-motor symptoms, including autonomic failure, pain and sleep disturbances.

methodsKey PICO (Patient, Intervention, Comparison, Outcome) questions were formulated by the steering committee and refined by the assigned authors. Recommendations were drafted based on relevant studies, systematic reviews, meta-analyses and high-quality guidelines identified by the literature search. They were subsequently reviewed, revised, and voted by the Guideline Group in online consensus conferences. Consensus was achieved in case of > 75% agreement among the group members. The consensus was considered strong, if agreement was > 95%.

resultsThe guideline entails: (i) 10 PICOs and 23 recommendations on the diagnosis and treatment of urogenital, cardiovascular and gastrointestinal autonomic failure; (ii) four PICOs and four recommendations on the possible types of pain in PD individuals, their diagnosis and treatment; (iii) 11 PICOs and 11 recommendations on the screening, diagnosis and treatment of sleep disturbances and excessive daytime sleepiness in PD individuals, as well as on their prognostic implications. Thirty-one out of 38 recommendations achieved a strong consensus.

conclusionThe current German PD guideline provides a practice-oriented and etiology-driven stepwise approach to the diagnosis and treatment of autonomic failure, pain and sleep disturbances in PD individuals.

Indexed as

Autonomic Nervous System DiseasesPainParkinson DiseaseSleep Wake DisordersGermanyHumansNeurologySocieties, MedicalConstipationDaytime sleepinessErectile dysfunctionNocturiaOrthostatic hypotensionPainParkinson’s diseaseREM-sleep behavior disorderSleepSupine hypertensionUrinary incontinence

Identifiers

PMID39751950
PMCPMC11698777

What Socratic holds

Textmetadata
LicenceCC BY
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 Socratic graph.