Restless Leg Syndrome, neuromodulation..

[House2]

Treatment was well tolerated, and no adverse events were reported. Our case series shows a potential role for self-administered taVNS in patients with severe pharmacoresistant RLS.

Hartley S, Bao G, Russo A, Zagdoun M, Chevallier S, Lofaso F, Leotard A, Azabou E. Self-administered non-invasive vagus nerve stimulation therapy for severe pharmacoresistant restless legs syndrome: outcomes at 6 months. J Sleep Res. 2023 Oct 17:e14066. doi: 10.1111/jsr.14066. Epub ahead of print. PMID: 37846650.

2. Spinal Cord Stimulation remains a promising investigational therapy in RLS on the basis of its potential mitigatory effects in the central hyperexcitability of the sensorimotor cortex through neuromodulation of spinal, subcortical, and cortical areas.

Pagani-Estévez GL, Holland MT, Tippmann-Peikert M, Benarroch EE, Silber MH, Carvalho DZ. Potential therapeutic benefit of spinal cord stimulation in restless legs syndrome: scoping review and mechanistic considerations. Pain Med. 2023 Oct 13;24(Supplement_2):S18-S23. doi: 10.1093/pm/pnad089. PMID: 37833049.

3.For refractory RLS, TOMAC (peroneal nerve stim)enabled substantial opioid dose reduction without increased RLS symptoms. These results suggest that TOMAC has the potential to reduce the risk profile associated with opioid therapy for refractory RLS.

Buchfuhrer MJ, Roy A, Rodriguez S, Charlesworth JD. Adjunctive tonic motor activation enables opioid reduction for refractory restless legs syndrome: a prospective, open-label, single-arm clinical trial. BMC Neurol. 2023 Nov 21;23(1):415. doi: 10.1186/s12883-023-03462-6. PMID: 37990163; PMCID: PMC10662398.

[RLSLearner]

Yep, depending on your patience and budget and availability they all seem to be of use for some people, for some time. And this -

Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014–2018)

Repetitive Transcranial Magnetic Stimulation for the Treatment of Restless Legs Syndrome

or

Transcranial Direct Current Stimulation (tDCS): A Beginner’s Guide for Design and Implementation

even

Deep brain stimulation improves restless legs syndrome in patients with Parkinson disease

[SueJohnson in reply to RLSLearner]

NightWalkers Fall 2023 a publication of the RLS.org said TMS may help some as shown by 2 small studies but it has never been demonstrated in a large study and it is not very practical as it requires many sessions and is almost never covered by insurance per Dr William Ondo one of the authors of the Mayo Algorithm

[RLSLearner in reply to SueJohnson]

TMS is not great - but vs something horrendous may be worth considering? Here in Australia there seem to be more clinics opening up providing it more specifically for depression and getting insurance coverage. Yes it requires going in 5 days a week for 20-30min for 8 weeks. But with the increase in brain/electronic interfacing coming ie expect your ear buds to have sensors in them reading your brain waves very soon, maybe they will have take home devices - like they do with vagal nerve stimulators. Lots of money is getting put into the commercial research and hopefully some of that will spill over into medical applications. If 2% of the population need treatment for RLS that is a lot of customers. Big pharma has struggled to capitalise on it maybe big tech will?

[Goldy700]

I have a “Chi Machine upon which you rest your ankles and it has a 3 speed wave motion which activates your vagus nerve. When you finish the session after 10 mins or so you experience a pleasant wave which goes to your head. My friend and husband also experience this. I find this effective in stoping the RLS for a time / often enough to get to sleep. There are quite a few different brands on the market - l