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To date, no comprehensive analysis of non\u2010lesional therapies to manage tremor in iPD exists to base recommendations upon. We therefore present a systematic literature review and meta\u2010analysis assessing the efficacy\/effectiveness and safety of non\u2010lesional treatments for tremor in iPD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Three electronic databases were searched using a combination of title\/abstract keywords complemented by hand\u2010searching of reference lists. A random\u2010effects meta\u2010analysis of standardized mean change scores was conducted where appropriate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Some 114 studies met inclusion criteria involving 8045 patients. The meta\u2010analysis revealed an overall reduction of standardized mean change scores by (\u22120.93 [CI: \u22121.42; \u22120.43], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) by 14 different dopaminergic and non\u2010dopaminergic classes of agents. No significant differences were identified between direct comparisons. Subgroup analysis comparing dopamine receptor agonists resulted in superior effects of pramipexole and rotigotine compared with ropinirole. There was little cumulative evidence to support the use of individual non\u2010pharmacological interventions for tremor, except for electrical stimulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results of this meta\u2010analysis suggest a large but nonspecific effect of established pharmacological therapies on tremor in iPD. Based on high\u2010quality studies, there is sufficient evidence to support that levodopa, dopamine receptor agonists, and monoamine oxidase inhibitors provide tremor relief in most patients, while evidence supporting other treatments is less well established. Sufficient evidence to draw conclusions on effects of non\u2010lesional treatments in cases with refractory tremor is lacking.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15823","type":"journal-article","created":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T11:00:12Z","timestamp":1683543612000},"page":"2544-2556","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Non\u2010lesional treatments for tremor in Parkinson's disease: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4757-9019","authenticated-orcid":false,"given":"Anna J.","family":"Pedrosa","sequence":"first","affiliation":[{"name":"Research Group Medical Ethics Philipps\u2010University Marburg  Marburg Germany"},{"name":"Department of Neurology University Hospital Gie\u00dfen and Marburg  Marburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6505-9922","authenticated-orcid":false,"given":"Josefine","family":"Waldthaler","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital Gie\u00dfen and Marburg  Marburg Germany"},{"name":"Centre for Mind, Brain and Behaviour Philipps\u2010University Marburg  Marburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felicitas","family":"M\u00fcgge","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital Gie\u00dfen and Marburg  Marburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5301-3580","authenticated-orcid":false,"given":"Lars","family":"Timmermann","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital Gie\u00dfen and Marburg  Marburg Germany"},{"name":"Centre for Mind, Brain and Behaviour Philipps\u2010University Marburg  Marburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5403-1959","authenticated-orcid":false,"given":"David J.","family":"Pedrosa","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital Gie\u00dfen and Marburg  Marburg Germany"},{"name":"Centre for Mind, Brain and Behaviour Philipps\u2010University Marburg  Marburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,5,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26424"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awp234"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2015.04.019"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.23135"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3233\/JPD-140446"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.2165\/00002512-200016040-00003"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp043908"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a008862"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.22361"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.expneurol.2013.06.009"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2017-316302"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-016-0690-1"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31825dcdc1"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-048367"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22340"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.2007.00818.x"},{"key":"e_1_2_10_19_1","article-title":"Dopamine agonist therapy in early Parkinson's disease","volume":"2","author":"Stowe R","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_20_1","article-title":"Monoamine oxidase B inhibitors versus other dopaminergic agents in early Parkinson's disease","volume":"4","author":"Caslake R","year":"2009","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_21_1","article-title":"Evaluation of the efficacy and safety of adjuvant treatment to levodopa therapy in Parkinson s disease patients with motor complications","volume":"7","author":"Stowe R","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12984-021-00811-9"},{"key":"e_1_2_10_23_1","unstructured":"KmetLM CookLS LeeRC.Standard quality assessment criteria for evaluating primary research papers from a variety of fields.2004. 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