Repetitive transcranial magnetic stimulation in restless legs syndrome: preliminary results

Abstract

Our aim was to compare the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) over supplementary motor area with that of sham stimulation in restless legs syndrome (RLS). In this prospective study, patients were randomly assigned to either real stimulation group (11 patients), or sham stimulation group (8 patients) in a double-blinded fashion. Five patients, who were initially in the sham stimulation group, received real stimulation 1 month after the sham stimulation. One session of intervention was performed once every 3 days and total of ten sessions were done in each group. The International RLS-Rating Scale (IRLS-RS) was assessed at baseline and after 5th and 10th sessions in both groups and also in five patients in whom both sham and real stimulation were performed. A statistically significant difference was seen in the IRLS scores between real (n = 11) and sham stimulation (n = 8) after 5th and 10th sessions. The real stimulation significantly improved the IRLS-RS scores although they were unaffected by the sham stimulation. In five patients, in whom both sham and real stimulation were performed, a statistically significant improvement was seen in the IRLS-RS scores with the real stimulation and a statistically significant difference was seen in the IRLS scores between real and sham stimulation after 10th session. In conclusion, this method is safe and non-invasive, and the results of this pilot study may support that rTMS has the potential to be used in the treatment of RLS, which should be verified in larger series.

Novel Exercises for Restless Legs Syndrome: A Randomized, Controlled Trial

“…Not only are the specific effects of interest in supporting people with this condition, but the impact of group interaction needs to be partitioned in outcomes analysis in future trials of therapies. None of the eleven randomized controlled trials investigating nonpharmacological therapies for RLS [12][13][14][15][16][17][18][19][20][21][22] have provided insight into the potential effects of group therapy on symptoms, so this seems to be an important target for future attention.…”

“…However, high-quality guidelines published by Aurora et al 10 (AGREE assessment "recommended" 11 ) concluded that there was insufficient evidence for nonpharmacological therapy. A recent review by the authors of eleven randomized trials [12][13][14][15][16][17][18][19][20][21][22] concluded that some nonpharmacological interventions including exercise and acupuncture seem beneficial for RLS symptoms; however, few studies were identified and the level of evidence was often not high. Given common unwanted side effects associated with pharmacological management, nonpharmacological treatment options may be valuable for symptom reduction.…”

Repetitive Transcranial Magnetic Stimulation for the Treatment of Restless Legs Syndrome

“…A study independently examining the treatment of RLS with rTMS has been published. [ 20 ] Burcu et al . found that high-frequency rTMS over the supplementary motor area (SMA) improved IRLS-RS scores significantly after 5 and 10 sessions of stimulation.…”

Nonpharmacological therapies for central poststroke pain

“…It has been used in a range of neurological disorders. [ 22 , 23 ] To date, 3 sham-controlled studies have examined the analgesic effects of rTMS on neuropathic pain; [ 4 , 24 , 25 ] however, the data in 2 of these trials were unable to be separately extracted for CPSP, and were thus excluded. [ 24 , 25 ] In the 1 included trial, [ 4 ] patients randomly received 10 daily sessions of active rTMS (n = 11) or sham rTMS (n = 10) over the premotor cortex/dorsolateral prefrontal cortex (PMC/DLPFC) (10 Hz, 1250 pulses/d).…”