Nardone Raffaele, Sebastianelli Luca, Versace Viviana, Brigo Francesco, Golaszewski Stefan, Pucks-Faes Elke, Saltuari Leopold, Trinka Eugen
Department of Neurology, Franz Tappeiner Hospital, Merano, Italy; Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Spinal Cord Injury and Tissue Regeneration Center, Salzburg, Austria; Karl Landsteiner Institut für Neurorehabilitation und Raumfahrtneurologie, Salzburg, Austria.
Department of Neurorehabilitation, Hospital of Vipiteno, Vipiteno, Italy; Research Unit for Neurorehabilitation South Tyrol, Bolzano, Italy.
Sleep Med. 2020 Jul;71:124-134. doi: 10.1016/j.sleep.2019.12.009. Epub 2019 Dec 24.
Transcranial magnetic stimulation (TMS) may offer a reliable means to characterize significant pathophysiologic and neurochemical aspects of restless legs syndrome (RLS). Namely, TMS has revealed specific patterns of changes in cortical excitability and plasticity, in particular dysfunctional inhibitory mechanisms and sensorimotor integration, which are thought to be part of the pathophysiological mechanisms of RLS rather than reflect a non-specific consequence of sleep architecture alteration. If delivered repetitively, TMS is able to transiently modulate the neural activity of the stimulated and connected areas. Some studies have begun to therapeutically use repetitive TMS (rTMS) to improve sensory and motor disturbances in RLS. High-frequency rTMS applied over the primary motor cortex or the supplementary motor cortex, as well as low-frequency rTMS over the primary somatosensory cortex, seem to have transient beneficial effects. However, further studies with larger patient samples, repeated sessions, an optimized rTMS setup, and clinical follow-up are needed in order to corroborate preliminary results. Thus, we performed a systematic search of all the studies that have used TMS and rTMS techniques in patients with RLS.
经颅磁刺激（TMS）可能为描述不宁腿综合征（RLS）的重要病理生理和神经化学方面提供一种可靠的方法。具体而言，TMS已揭示出皮质兴奋性和可塑性的特定变化模式，尤其是功能失调的抑制机制和感觉运动整合，这些被认为是RLS病理生理机制的一部分，而非反映睡眠结构改变的非特异性后果。如果重复给予TMS，它能够短暂调节受刺激和相连区域的神经活动。一些研究已开始治疗性地使用重复经颅磁刺激（rTMS）来改善RLS中的感觉和运动障碍。在初级运动皮层或辅助运动皮层施加高频rTMS，以及在初级体感皮层施加低频rTMS，似乎都有短暂的有益效果。然而，需要进一步开展更大样本量患者、重复疗程、优化rTMS设置以及临床随访的研究，以证实初步结果。因此，我们对所有在RLS患者中使用TMS和rTMS技术的研究进行了系统检索。
