Evidence map›Paper›PMID 41806217›Full record

SynthesisSleep & breathing = Schlaf & Atmung2026

Neuromodulation for Restless Legs Syndrome: A Systematic Review and Mechanistic Considerations for Spinal Cord Stimulation.

Garrett W Thrash, Elijah Wang, David Brockington, Colby Rives, Yifei Sun, Anne C Roberts, Somnath Das, Julie G Pilitsis, Prasad Shirvalkar, Rocio Vazquez do Campo and 3 more

Abstract readSystematic Review
In one paragraph

Synthesis in Sleep & breathing = Schlaf & Atmung, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. The evolving treatment landscape of restless legs syndrome.Therapeutic advances in neurological disorders · 2026
    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

13 authors.

Garrett W ThrashHeersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Elijah WangHeersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. elw2@uab.edu.ORCID 0009-0000-0512-4123
David BrockingtonHeersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Colby RivesHeersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Yifei SunHeersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Anne C RobertsHeersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Somnath DasDepartment of Neurosurgery, University of Alabama at Birmingham, FOT Suite 1060, 1720 2nd Ave S, Birmingham, AL, 35294, USA.
Julie G PilitsisDepartment of Neurosurgery, University of Arizona, Tucson, AZ, USA.
Prasad ShirvalkarDepartments of Neurological Surgery, Anesthesiology and Neurology, University of California San Francisco, San Francisco, CA, USA.
Rocio Vazquez do CampoDepartment of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
Harrison C WalkerDepartment of Neurosurgery, University of Alabama at Birmingham, FOT Suite 1060, 1720 2nd Ave S, Birmingham, AL, 35294, USA.
Christopher J EarleyDepartment of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Marshall T HollandDepartment of Neurosurgery, University of Alabama at Birmingham, FOT Suite 1060, 1720 2nd Ave S, Birmingham, AL, 35294, USA.

Funding

High-Resolution, Spinal Cord Stimulation for Non-Opioid Treatment of Neuropathic PainU44NS115111 · NINDS · MICRO-LEADS, INC. · PI MCLAUGHLIN, BRYAN L · 2019 to 2025
$9.8M
Peripheral Tissue Biomarker for Premorten Diagnosis of Lewy Body DementiaR01NS118760 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CHEN, SHU G., KRAUS, ALLISON L · 2020 to 2025
$7.4M
Multisite adaptive brain stimulation for multidimensional treatment of refractory chronic painUH3NS115631 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SHIRVALKAR, PRASAD · 2019 to 2023
$6.9M
MR-Guided Precision Conformal Ablation Therapy for Brain TumorsR01CA166379 · NCI · WORCESTER POLYTECHNIC INSTITUTE · PI FISCHER, GREGORY S, PILITSIS, JULIE GEORGIA · 2013 to 2022
$6.5M
Corticothalamic network function in chronic painR01NS136739 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Prasad Shirvalkar · 2024 to 2026
$2.3M
Reconfigurable MRI technology for safe and high-resolution imaging of deep brain stimulation at 3TR01EB030324 · NIBIB · NORTHWESTERN UNIVERSITY AT CHICAGO · PI GOLESTANI RAD, LALEH · 2021 to 2024
$2.1M
Biophysical Characterization of Subthalamic Local Field Potentials in Parkinson's DiseaseR01NS119520 · NINDS · DUKE UNIVERSITY · PI MCINTYRE, CAMERON · 2021 to 2024
$1.9M
Stimulus-evoked directional field potentials to guide subthalamic and pallidal DBS for PDUG3NS130202 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI WALKER, HARRISON CARROLL · 2024 to 2024
$1.2M
Abbott Fund Abbott FundBoston Scientific Corporation Boston Scientific CorporationMarcus Innovation Fund Marcus Innovation FundMedtronic MedtronicNational Institute of Health NIH 1R01NS136739National Institute of Health NIH 2R01CA166379National Institute of Health NIH R01EB030324National Institute of Health NIH R01NS118760National Institute of Health NIH R01NS119520National Institute of Health NIH U44NS115111National Institute of Health NIH UG3NS130202National Institute of Health NIH UH3 NS115631NCI NIH HHS R01 CA166379NIBIB NIH HHS R01 EB030324NINDS NIH HHS R01 NS118760NINDS NIH HHS R01 NS119520NINDS NIH HHS R01 NS136739NINDS NIH HHS U44 NS115111NINDS NIH HHS UG3 NS130202NINDS NIH HHS UH3 NS115631Weill Institute for Neurosciences, University of California, San Francisco Weill Institute for Neurosciences, University of California, San Francisco
6 · The paper itself

Abstract

backgroundRestless legs syndrome (RLS) is a common sleep disorder characterized by an irresistible urge to move the legs. Symptoms predominate in the evening and cause significant circadian rhythm interruptions that impact sleep and quality of life, leading to decreased work productivity, anxiety, and depression. Some patients improve with oral medications, but many experience treatment-refractory symptoms, whether from lack of efficacy or intolerable cognitive or behavioral side effects. Emerging evidence suggests that diverse neuromodulation modalities could provide a novel circuit-based therapy option for patients with treatment-refractory RLS. Given its prevalence, most of these reports arise as serendipitous observations of improved RLS symptoms when it is comorbid with an approved indication for neuromodulation, such as chronic neuropathic pain or a movement disorder. More recent work has begun investigating neuromodulation, including spinal cord stimulation, for primary idiopathic RLS.

methodsHere we performed a PRISMA systematic review identifying 120 articles utilizing spinal cord stimulation, deep brain stimulation, transcranial magnetic stimulation, vagal nerve stimulation, and other modalities. Among these, we summarize findings from 54 studies that met our specific inclusion criteria and suggest potential mechanisms, such as spinal cord hyperexcitability, for neuromodulation of RLS symptoms.

resultsInterestingly, the amount and duration of RLS improvement seems to correlate with the invasiveness of the neuromodulation modality. Spinal cord stimulation has demonstrated more consistent, promising results with greater magnitude of IRLS Score improvement compared to the other modalities.

conclusionProspective, multi-institutional trials are needed to evaluate whether various neuromodulation strategies can impact debilitating symptoms from treatment-refractory RLS, and rigorous analysis should be conducted to identify the most effective modalities.

Indexed as

Restless Legs SyndromeSpinal Cord StimulationDeep Brain StimulationHumansTranscranial Magnetic StimulationVagus Nerve StimulationDeep Brain StimulationNeuromodulationRestless Legs SyndromeSpinal Cord StimulationTranscranial Magnetic Stimulation

Identifiers

PMID41806217
PMCPMC12975800

What Socratic holds

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LicenceCC BY
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.