Anodal transcutaneous spinal direct current stimulation (tsDCS) significantly improved RLS symptoms and sleep quality, likely through enhancing cortical inhibitory function and thereby reducing spinal neuronal excitability.
Active tsDCS produced significantly greater improvement in RLS symptom severity than sham stimulation over 2 weeks.
Active tsDCS produced significantly greater improvement in sleep quality compared to sham stimulation.
Active tsDCS significantly prolonged the cortical silent period in RLS patients after 14 days of treatment.
Active tsDCS significantly increased MEP amplitude after 15 minutes of rest during movement tasks.
Active tsDCS significantly reduced the paired H-reflex ratio (H2/H1) in the lower limbs of RLS patients.
No significant changes in any neurophysiological parameters were observed in the sham stimulation group.
The proposed mechanism of tsDCS benefit in RLS involves enhancement of cortical inhibitory function leading to reduced spinal neuronal excitability.
This research suggests that applying a mild electrical current to the spinal cord through the skin (called transcutaneous spinal direct current stimulation, or tsDCS) can significantly reduce the uncomfortable sensations and urge to move that characterize restless legs syndrome (RLS). In a randomized trial of 30 RLS patients treated over two weeks, those receiving active stimulation showed dramatically greater reductions in RLS symptom severity scores (an average improvement of about 12 points versus just over 1 point in the sham group) and meaningful improvements in sleep quality. The sham group received a procedure that mimicked the treatment but delivered no real stimulation, allowing the researchers to confirm that the benefits were due to the electrical stimulation itself. The study also used specialized nerve tests to understand how tsDCS affects the nervous system. After two weeks of active treatment, patients showed changes in brain and spinal cord activity that suggest the treatment works by boosting the brain's natural ability to inhibit or 'calm down' nerve signals, which in turn reduces overactivity in the spinal cord nerves — a pattern thought to underlie the uncomfortable sensations of RLS. Specifically, the researchers measured a longer 'cortical silent period' (a sign of stronger brain inhibition), increased muscle response signals, and a reduced spinal reflex ratio, all pointing to a shift toward less excitable nervous system activity. This research suggests that tsDCS could be a promising non-drug treatment option for people with RLS, particularly given its apparent ability to address an underlying neurological imbalance in the condition. The findings provide a potential explanation for why the treatment works, linking symptom improvement to measurable changes in how the brain and spinal cord communicate. Further studies with larger patient groups and longer follow-up will be needed to confirm these findings and establish the best treatment protocols.
Wang L, Hao W, Wang D, Li S, Su X, Liu C, et al.. (2026). Modulation of spinal and cortical neuronal excitability by transcutaneous spinal direct current stimulation in restless legs syndrome.. Sleep medicine. https://doi.org/10.1016/j.sleep.2026.108789