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.

中文翻译：

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经颅磁刺激在不安腿综合征中的作用：病理生理学见解和治疗方法。

经颅磁刺激（TMS）可能提供表征不安腿综合征（RLS）的重要病理生理和神经化学方面的可靠手段。也就是说，TMS揭示了皮质兴奋性和可塑性变化的特定模式，特别是功能障碍抑制机制和感觉运动整合，这被认为是RLS病理生理机制的一部分，而不是反映睡眠结构改变的非特异性结果。如果重复递送，TMS能够瞬时调节受刺激和相连区域的神经活动。一些研究已经开始治疗性地使用重复性TMS（rTMS）来改善RLS中的感觉和运动障碍。高频rTMS应用于主运动皮层或辅助运动皮层，以及初级体感皮层上的低频rTMS似乎具有短暂的有益作用。但是，为了证实初步结果，需要对更大的患者样本，重复的治疗，优化的rTMS设置以及临床随访进行进一步的研究。因此，我们对RLS患者使用TMS和rTMS技术的所有研究进行了系统的检索。