Evidence map›Paper›PMID 39173210›Full record

SynthesisSleep medicine2024

Efficacy and safety of TOMAC for treatment of medication-naïve and medication-refractory restless legs syndrome: A randomized clinical trial and meta-analysis.

Haramandeep Singh, Fiona C Baker, Joseph Ojile, Bahman Adlou, Viktoriia Kolotovska, Stephanie K Rigot, Jonathan D Charlesworth

Abstract readMeta-AnalysisRandomized Controlled Trial
In one paragraph

Synthesis in Sleep medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Observational
  3. The evolving treatment landscape of restless legs syndrome.Therapeutic advances in neurological disorders · 2026
    Review
  4. Article
  5. Pharmacological Strategies for the Treatment of Restless Legs Syndrome.Current neurology and neuroscience reports · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Haramandeep SinghSleep Medicine Specialists of California, 5201 Norris Canyon Rd, Suite 120, San Ramon, CA 94583, USA. Electronic address: hsingh@sleepmds.com.
Fiona C BakerCenter for Health Sciences, SRI International, 333 Ravenswood Ave, Menlo Park, CA 94025, USA. Electronic address: fiona.baker@sri.com.
Joseph OjileClayton Sleep Institute, LLC, 11188 Tesson Ferry Road, Suite 100, St. Louis, MO 63123 USA. Electronic address: OjileJ@claytonsleep.com.
Bahman AdlouNoctrix Health, Inc., 6700 Koll Center Pkwy, Suite 310, Pleasanton, CA, USA.
Viktoriia KolotovskaNoctrix Health, Inc., 6700 Koll Center Pkwy, Suite 310, Pleasanton, CA, USA.
Stephanie K RigotNoctrix Health, Inc., 6700 Koll Center Pkwy, Suite 310, Pleasanton, CA, USA.
Jonathan D CharlesworthNoctrix Health, Inc., 6700 Koll Center Pkwy, Suite 310, Pleasanton, CA, USA. Electronic address: jcharlesworth@noctrixhealth.com.

Funding

Treatment of Restless Legs Syndrome through non-invasive peripheral nerve stimulationR44NS117294 · NINDS · NOCTRIX HEALTH, INC · PI Jonathan David Charlesworth · 2020 to 2026
$4.6M
NINDS NIH HHS R44 NS117294
6 · The paper itself

Abstract

OBJECTIVE/

backgroundThere is a significant unmet need for safe and effective nonpharmacological therapies for restless legs syndrome (RLS). The objective was to evaluate the efficacy and safety of tonic motor activation (TOMAC) in patients with RLS. PATIENTS/

methodsA multicenter, randomized, participant-blinded, sham-controlled trial enrolled 45 adults with primary moderate-to-severe RLS who were either medication-naïve (n = 20) or medication-refractory (n = 25). Participants were 1:1 randomized to TOMAC (n = 22) or sham (n = 23) for two weeks and instructed to self-administer 30-min TOMAC sessions when they experienced RLS symptoms. The primary outcome was mean change in International RLS Study Group Rating Scale (IRLS) total score. A subsequent meta-analysis included the present trial and a previous randomized clinical trial that enrolled medication-naïve RLS patients.

resultsIRLS reduction was significantly greater for TOMAC than sham (TOMAC -6.59 vs. sham -2.17; mean difference (MD) = -4.42; 95 % confidence interval [CI] -1.57 to -7.26; p = 0.0040). Subgroup analysis showed similar IRLS mean difference for medication-refractory (MD = -4.50; p = 0.02) and medication-naïve (MD = -4.40; p = 0.08) cohorts, which was significantly different from sham only for the medication-refractory cohort. Meta-analysis of combined data from 33 medication-naïve RLS patients showed a significant reduction in mean IRLS score after two weeks for TOMAC compared to sham (MD = -4.30; 95 % CI -1.36 to -7.24; p = 0.004).

conclusionsThe present trial confirmed previous reports documenting efficacy and safety of TOMAC in refractory RLS and indicated similar effect sizes in refractory versus naïve subgroups. The meta-analysis demonstrated that TOMAC significantly improves RLS symptoms in naïve participants.

Indexed as

Restless Legs SyndromeAdultAgedFemaleHumansMaleMiddle AgedTreatment OutcomeBioelectronicNeurological disorderNeuromodulationPeripheral nerve stimulationRestless legs syndromeSleep disorder

Identifiers

PMID39173210
PMCPMC11414842

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.