Evidence map›Paper›PMID 42525438›Full record

Trial reportEuropean stroke journal2026

Time course of motor recovery after stroke with and without levodopa: a post hoc 6-month longitudinal analysis of the ESTREL trial.

Simon Trüssel, Christopher K Traenka, Alexandros Polymeris, Lukas Enz, Annaelle Zietz, Valerian L Altersberger, Karin Wiesner, Mira Katan, Philippe A Lyrer, Irina Goga and 29 more

Registry-linked trialAbstract readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
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

39 authors.

Simon TrüsselDepartement of Rehabilitation and Neurology, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland.ORCID 0009-0004-2537-855X
Christopher K TraenkaDepartement of Rehabilitation and Neurology, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland.ORCID 0000-0002-7600-1005
Alexandros PolymerisDepartment of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland.ORCID 0000-0002-9475-2208
Lukas EnzDepartment of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.ORCID 0000-0002-6588-2142
Annaelle ZietzDepartment of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland.ORCID 0000-0002-4362-2497
Valerian L AltersbergerDepartment of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland.ORCID 0000-0002-0610-9328
Karin WiesnerDepartement of Rehabilitation and Neurology, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland.ORCID 0009-0000-2620-013X
Mira KatanDepartment of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland.ORCID 0000-0002-9265-8066
Philippe A LyrerDepartment of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland.ORCID 0000-0002-1435-1114
Irina GogaDepartement of Rehabilitation and Neurology, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland.ORCID 0009-0007-1362-8656
Sophia EngelterDepartement of Rehabilitation and Neurology, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland.ORCID 0009-0003-2257-8997
Andreas R LuftLake Lucerne Institute, Vitznau, Switzerland.ORCID 0000-0001-9865-7382
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
René M MüriDepartment of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland.ORCID 0000-0001-6990-4188
David SeiffgeDepartment of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland.ORCID 0000-0003-3890-3849
Urs FischerDepartment of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland.ORCID 0000-0003-0521-4051
Patrik MichelStroke Center, Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.ORCID 0000-0003-4954-7579
Nils PetersDepartement of Rehabilitation and Neurology, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland.ORCID 0000-0001-8451-7389
Georg KägiDepartment of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland.ORCID 0000-0001-7749-8060
Svetlana PolitzKantonsspital Münsterlingen, Münsterlingen, Switzerland.ORCID 0000-0002-8237-5011
Alexander TarnutzerDepartment of Neurology, Cantonal Hospital of Baden, Baden, Switzerland.ORCID 0000-0002-6984-6958
Krassen NedeltchevDepartment of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland.ORCID 0000-0002-7614-1227
Leo BonatiDepartment of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland.ORCID 0000-0003-1163-8133
Corina Schuster-AmftResearch Department, Reha Rheinfelden, Rheinfelden, Switzerland.ORCID 0000-0003-1120-4423
J Carsten MöllerDivision of Neurorehabilitation, Fribourg Hospital, Meyriez-Murten, Switzerland.ORCID 0000-0003-1718-4486
Bartosz BujanNeurorehabilitation, 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
Carmen LienertKliniken Valens, St. Gallen, Switzerland.ORCID 0000-0002-4069-7573
Jeremia HeldDivision of Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital of Zurich and University of Zurich, Zurich, Switzerland.ORCID 0000-0001-5373-2000
Sabine SchaedelinDepartment of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.ORCID 0000-0002-1150-0962
Lars G HemkensDepartment of Clinical Research, University of Bern, Bern, Switzerland.ORCID 0000-0002-3444-1432
Gary A FordRadcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom.ORCID 0000-0001-8719-4968
Josefin E KaufmannDepartement of Rehabilitation and Neurology, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland.ORCID 0000-0001-7744-2796
Henrik GensickeDepartement of Rehabilitation and Neurology, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland.ORCID 0000-0002-0949-2422
Stefan T EngelterDepartement of Rehabilitation and Neurology, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland.ORCID 0000-0003-3855-6234

Funding

Swiss National Science Foundation
6 · The paper itself

Abstract

introductionLevodopa did not enhance early motor recovery at 3 months after stroke in the Enhancement of Stroke Rehabilitation with Levodopa (ESTREL) trial. However, whether levodopa modifies the time course of recovery, leading to a delayed benefit remains unclear. Here, we examined levodopa's effects on the trajectories of motor recovery up to 6 months after stroke. PATIENTS AND

methodsThe ESTREL trial, a double-blind, randomised controlled clinical trial, compared a 39-day regimen of levodopa/carbidopa (100 mg/25 mg, 3×/day) to placebo alongside standardised task-oriented training. We longitudinally analysed Fugl-Meyer Motor Assessment (FMA) total scores (primary outcome), mRS and NIHSS (secondary outcomes) at baseline (0-7 days post stroke), 5 weeks, 3 and 6 months using linear mixed-effects models including timepoint, treatment allocation and their interaction.

resultsIn total, 576 of 610 (94%) participants (median age 73 years; 40% female) were analysed. FMA scores improved over time in both groups (P < .001), with no overall levodopa effect across visits (estimate 0.65 points, 95% CI, -3.3 to 4.6; P = .75). There was no indication that levodopa modified the recovery trajectory (χ2 = 0.52, df = 3, P = .91), and estimated levodopa-placebo differences in FMA changes across visit intervals were small, ranging from -0.7 to +0.8 points, with confidence intervals crossing zero. Secondary outcomes showed similar longitudinal improvement, without evidence of a treatment effect.

conclusionIn this post hoc analysis of ESTREL participants with repeated FMA assessments, motor impairment improved from the first days after stroke up to 6 months. Levodopa added to task-oriented inpatient rehabilitation did not improve motor recovery or alter its trajectory over this period. CLINICAL

trial registrationNCT03735901, available at ClinicalTrials.gov: https://clinicaltrials.gov/study/NCT03735901?cond=NCT03735901&rank=1.

Indexed as

CarbidopaLevodopaRecovery of FunctionStrokeStroke RehabilitationAgedAged, 80 and overDouble-Blind MethodFemaleHumansLongitudinal StudiesMaleMiddle AgedTime FactorsTreatment OutcomeCarbidopaLevodopadopamine agentsenhancementFugl-Meyer Motor Assessmentlevodoparecovery of functionrehabilitation

Identifiers

PMID42525438
PMCPMC13418197

What Socratic holds

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LicenceCC BY-NC
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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 Socratic graph.