Repetitive Transcranial Magnetic Stimulation For The Treatment Of Restless Legs Syndrome

Objective Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive and a valuable method to investigate the human brain function. Additionally, rTMS is able to induce changes in brain activity by stimulating different brain regions. The aim of this study was to investigate whether high-frequency rTMS could have any beneficial effects in the patients with Restless legs syndrome (RLS).Methods Eighteen patients with primary RLS were randomly divided into the rTMS group (n=14) or the control group (n=4). The patients in the rTMS group were given high-frequency rTMS (15Hz,100%motor threshold) to their prefrontal cortices for14days, and the control patients were given sham stimulations with same region, intensity, frequency and interval. Duration of effects was assessed at14days,1month and2months posttreatment. All the patients were evaluated using the2003RLS symptom criteria outlined by the International Restless Legs Syndrome Study Groups (IRLSSG). International RLS severity rating scale, Pittsburgh sleep quality index (PSQI), Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA) were used to evaluate the severity of RLS, quality of sleep, depression severity and anxiety severity, respectively. The scores of the scales were assessed at four time points (baseline, end of treatment, end1month, and2months follow-up). Statistical analyses were performed using SPSS13.0statistical software packet.Results The rTMS group showed a statistically significant reductions in the IRLS, PSQI and HAMA scale scores by the end of Week2after treatment (IRLS scores decreased from23.86±5.88at baseline to11.21±7.23after treatment, P=0.000; PSQI scores decreased from15.00±4.88at baseline to9.29±3.91after treatment, P=0.000; HAMA scores decreased from17.93±7.11at baseline to10.36±7.13after treatment, P=0.001), and the effects were last for2months. However, the scores of HAMD24were not changed in the patients until1month after rTMS treatment. In addition, the scores of these scales in the sham-treatment group were not significant decreased when compared with the baseline at all the time points. Moreover, the severity of anxiety and severity of depression significantly positively correlated with poor sleep quality (r=0.695, P=0.000and r=0.635, P=0.000, respectively). The quality of sleep, severity of anxiety and severity of depression were directly correlated with the severity of RLS (r=0.671, P=0.000and r=0.733, P=0.000and r=0.690, P=0.000, respectively).Conclusions High-frequency rTMS may alleviate the motor symptom and sleep disturbances, anxiety and depressive emotion in the RLS patients. Therefore, rTMS treatment may be used to improve a life quality of RLS patients.