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Peer-reviewedCC BY-NCMedicine

Repetitive transcranial magnetic stimulation for the treatment of restless legs syndrome: A meta-analysis.

  • Zhenchao Dong1
  • Xiaojun Zhang1
  • Jiaqin Zhang1
  • JinTao Yuan1
  • Hanbo Li2
  • Weigang Tang3,4
  • Wei Jiang3,4
  • Wei Xu3,4
4 affiliations
  1. 1Department of Emergency Medicine, The People's Hospital of Danyang & Affiliated Danyang Hospital of Nantong University, Danyang, Jiangsu, China.
  2. 2Department of Psychiatry, Changzhou Dean Hospital, Changzhou, Jiangsu, China.
  3. 3Department of Nephrology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China.
  4. 4Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu, China.
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Abstract

Background

The benefit of repetitive transcranial magnetic stimulation (rTMS) in patients with Restless Legs Syndrome (RLS) is uncertain. This study was performed to explore the therapeutic effect of rTMS in treating RLS.Methods

Databases including PubMed, EMbase, the Cochrane Library, China National Knowledge Infrastructure, and Wanfang database were searched from their inception to May 1, 2026. Eligible studies comparing rTMS with sham stimulation were included. Data were analyzed using Review Manager Version 5.3.Results

Four studies were included in the meta-analysis. The overall pooled analysis confirmed that rTMS could effectively reduce International RLS-Rating Scale (IRLS-RS) scores (mean difference [MD] = 6.46, 95% confidence interval [CI]: 4.44 -8.48, P < .00001) and Pittsburgh sleep quality index (PSQI) scores (MD = 4.80, 95% CI: 3.51-6.08, P < .00001) at different follow-up periods. Meanwhile, the overall pooled analysis confirmed that rTMS could effectively reduce IRLS-RS scores (MD = 7.79, 95% CI: 3.90-11.68, P < .0001) and PSQI scores (MD = 5.58, 95% CI: 3.81-7.35, P < .00001) in the subgroup analysis by RLS subtype. However, rTMS showed no significant effect on PSQI scores in primary RLS (MD = 1.86, 95% CI: -2.65-6.37, P = .42). In addition, the overall pooled analysis confirmed that both low-frequency and high-frequency rTMS could effectively reduce IRLS-RS scores (MD = 7.79, 95% CI: 3.90-11.68, P < .0001) and PSQI scores (MD = 5.58, 95% CI: 3.81-7.35, P < .00001). Finally, the overall pooled analysis confirmed that rTMS could not significantly reduce Hamilton anxiety scale and Hamilton depression scale scores in subgroup analyses of follow-up period, RLS subtype, or rTMS frequency (P > .05).Conclusion

rTMS might alleviate core limb discomfort symptoms measured by IRLS-RS and improve sleep quality assessed by PSQI in patients with RLS. However, rTMS might not be effective in improving symptoms of anxiety and depression. To further confirm the conclusion, more large randomized controlled trials are necessary.

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Cite

BibTeXRIS
BibTeX
@article{dong2026repetitive,
  title = {{Repetitive transcranial magnetic stimulation for the treatment of restless legs syndrome: A meta-analysis.}},
  author = {Zhenchao Dong and Xiaojun Zhang and Jiaqin Zhang and JinTao Yuan and Hanbo Li and Weigang Tang and Wei Jiang and Wei Xu},
  journal = {Medicine},
  year = {2026},
  month = oct,
  doi = {10.1097/md.0000000000051088},
  url = {https://europepmc.org/article/MED/42888613},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Repetitive transcranial magnetic stimulation for the treatment of restless legs syndrome: A meta-analysis.
AU  - Zhenchao Dong
AU  - Xiaojun Zhang
AU  - Jiaqin Zhang
AU  - JinTao Yuan
AU  - Hanbo Li
AU  - Weigang Tang
AU  - Wei Jiang
AU  - Wei Xu
PY  - 2026
DA  - 2026/10/01
JO  - Medicine
DO  - 10.1097/md.0000000000051088
UR  - https://europepmc.org/article/MED/42888613
AB  - Background  The benefit of repetitive transcranial magnetic stimulation (rTMS) in patients with Restless Legs Syndrome (RLS) is uncertain. This study was performed to explore the therapeutic effect of rTMS in treating RLS.Methods  Databases including PubMed, EMbase, the Cochrane Library, China National Knowledge Infrastructure, and Wanfang database were searched from their inception to May 1, 2026. Eligible studies comparing rTMS with sham stimulation were included. Data were analyzed using Review Manager Version 5.3.Results  Four studies were included in the meta-analysis. The overall pooled analysis confirmed that rTMS could effectively reduce International RLS-Rating Scale (IRLS-RS) scores (mean difference [MD] = 6.46, 95% confidence interval [CI]: 4.44 -8.48, P < .00001) and Pittsburgh sleep quality index (PSQI) scores (MD = 4.80, 95% CI: 3.51-6.08, P < .00001) at different follow-up periods. Meanwhile, the overall pooled analysis confirmed that rTMS could effectively reduce IRLS-RS scores (MD = 7.79, 95% CI: 3.90-11.68, P < .0001) and PSQI scores (MD = 5.58, 95% CI: 3.81-7.35, P < .00001) in the subgroup analysis by RLS subtype. However, rTMS showed no significant effect on PSQI scores in primary RLS (MD = 1.86, 95% CI: -2.65-6.37, P = .42). In addition, the overall pooled analysis confirmed that both low-frequency and high-frequency rTMS could effectively reduce IRLS-RS scores (MD = 7.79, 95% CI: 3.90-11.68, P < .0001) and PSQI scores (MD = 5.58, 95% CI: 3.81-7.35, P < .00001). Finally, the overall pooled analysis confirmed that rTMS could not significantly reduce Hamilton anxiety scale and Hamilton depression scale scores in subgroup analyses of follow-up period, RLS subtype, or rTMS frequency (P > .05).Conclusion  rTMS might alleviate core limb discomfort symptoms measured by IRLS-RS and improve sleep quality assessed by PSQI in patients with RLS. However, rTMS might not be effective in improving symptoms of anxiety and depression. To further confirm the conclusion, more large randomized controlled trials are necessary.
SN  - 0304-5412
SN  - 1536-5964
ER  -