Repetitive transcranial magnetic stimulation for the treatment of restless legs syndrome: A meta-analysis.
Zhenchao Dong, Xiaojun Zhang, Jiaqin Zhang et al.
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In 30 seconds
This meta-analysis examined repetitive transcranial magnetic stimulation (rTMS) versus sham stimulation for restless legs syndrome (RLS), pooling four eligible studies. Across different follow-up periods, rTMS was associated with lower International RLS Rating Scale scores (mean difference [MD] = 6.46, 95% CI: 4.44 -8.48, P < .00001) and Pittsburgh Sleep Quality Index scores (MD = 4.80, 95% CI: 3.51-6.08, P < .00001). The authors concluded that rTMS might improve core RLS symptoms and sleep quality, but not anxiety or depression scores; they called for larger randomized controlled trials.
Key findings
- Across follow-up periods, pooled IRLS-RS scores favored rTMS (MD = 6.46, 95% CI: 4.44 -8.48, P < .00001).
- Pooled PSQI scores favored rTMS (MD = 4.80, 95% CI: 3.51-6.08, P < .00001).
- In primary RLS, rTMS did not significantly affect PSQI scores (MD = 1.86, 95% CI: -2.65-6.37, P = .42).
- The meta-analysis found no significant reduction in Hamilton anxiety or depression scale scores across subgroup analyses (P > .05).
Why it matters
RLS symptoms and impaired sleep are the outcomes for which this synthesis suggests a potential benefit from rTMS. The findings also indicate that improvement in these measures should not be assumed to extend to anxiety or depression. The evidence remains preliminary, so the pooled results are best interpreted as a signal requiring confirmation rather than definitive evidence of benefit.
What to keep in mind
Only four studies were included, and the authors state that larger randomized controlled trials are needed to confirm the findings.