{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T15:09:34Z","timestamp":1785337774220,"version":"3.55.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Levodopa did not enhance early motor recovery at 3\u00a0months 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\u2019s effects on the trajectories of motor recovery up to 6\u00a0months after stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>The ESTREL trial, a double-blind, randomised controlled clinical trial, compared a 39-day regimen of levodopa\/carbidopa (100\u00a0mg\/25\u00a0mg, 3\u00d7\/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\u20137\u00a0days post stroke), 5\u00a0weeks, 3 and 6\u00a0months using linear mixed-effects models including timepoint, treatment allocation and their interaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 576 of 610 (94%) participants (median age 73 years; 40% female) were analysed. FMA scores improved over time in both groups (P\u00a0&amp;lt;\u00a0.001), with no overall levodopa effect across visits (estimate 0.65 points, 95% CI, \u22123.3 to 4.6; P\u00a0=\u00a0.75). There was no indication that levodopa modified the recovery trajectory (\u03c72\u00a0=\u00a00.52, df\u00a0=\u00a03, P\u00a0=\u00a0.91), and estimated levodopa\u2013placebo differences in FMA changes across visit intervals were small, ranging from \u22120.7 to +0.8 points, with confidence intervals crossing zero. Secondary outcomes showed similar longitudinal improvement, without evidence of a treatment effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this post hoc analysis of ESTREL participants with repeated FMA assessments, motor impairment improved from the first days after stroke up to 6\u00a0months. Levodopa added to task-oriented inpatient rehabilitation did not improve motor recovery or alter its trajectory over this period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>NCT03735901, available at ClinicalTrials.gov: https:\/\/clinicaltrials.gov\/study\/NCT03735901?cond=NCT03735901&amp;rank=1<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/esj\/aakag089","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T14:37:48Z","timestamp":1785335868000},"source":"Crossref","is-referenced-by-count":0,"title":["Time course of motor recovery after stroke with and without levodopa: a post hoc 6-month longitudinal analysis of the ESTREL trial"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2537-855X","authenticated-orcid":false,"given":"Simon","family":"Tr\u00fcssel","sequence":"first","affiliation":[{"name":"Departement of Rehabilitation and Neurology, University Department of Geriatric Medicine FELIX PLATTER, University of Basel , Basel ,","place":["Switzerland"]},{"name":"Department of Neurology and Stroke Center, University Hospital Basel , Basel ,","place":["Switzerland"]},{"name":"Department of Clinical Research, University Hospital Basel and University of Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7600-1005","authenticated-orcid":false,"given":"Christopher K","family":"Traenka","sequence":"additional","affiliation":[{"name":"Departement of Rehabilitation and Neurology, University Department of Geriatric Medicine FELIX PLATTER, University of Basel , Basel ,","place":["Switzerland"]},{"name":"Department of Neurology and Stroke Center, University Hospital Basel , Basel ,","place":["Switzerland"]},{"name":"Department of Clinical Research, University Hospital Basel and University of Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9475-2208","authenticated-orcid":false,"given":"Alexandros","family":"Polymeris","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel , Basel ,","place":["Switzerland"]},{"name":"Department of Clinical Research, University Hospital Basel and University of Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6588-2142","authenticated-orcid":false,"given":"Lukas","family":"Enz","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, University Hospital Basel and 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