(57) Spinal Cord Stimulation (SCS) treatment of Restless Leg's Syndrome (RLS): A single-center retrospective cohort experience

Introduction: Restless legs syndrome (RLS) is a sleep-related movement disorder that currently affects 5-10% of the population.1 RLS is characterized an uncontrollable urge to move often accompanied by painful sensations that primarily onset during sleep. These symptoms can drastically alter patients’ qualities of life by disturbing sleep, hindering daytime functions, and impairing mood. While medical treatment remains standard of care, neuromodulation has emerged as a potential therapeutic. Spinal cord stimulation (SCS) has shown promise as a neuromodulatory therapeutic in RLS in small cohort observational studies.2 This study retrospectively evaluated the impact of SCS on RLS and sleep symptoms and suggests future trials of SCS in primary idiopathic RLS.

Methods: Patients who received SCS for any reason that also had a comorbid diagnosis of RLS were identified retrospectively. These patients were contacted via telephone to conduct the survey of their RLS symptoms. RLS diagnosis was confirmed through the Cambridge Hopkins RLS questionnaire (CH-RLSQ13) and International Restless Leg Syndrome Scale (IRLS 10). Sleep quality and impairment was measured using Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep v4 Sleep Disturbance short form 8 and PROMIS Sleep Related Impairment short form 8. These scores were recorded pre, peri, and post SCS. The results of the RLS symptom and sleep scores were analyzed using A within-subject analysis of variance (ANOVA).

Results: Eleven patients were identified and surveyed, with a mean age of 62.1 9.9 and a white (9, 82.9%) and female (10, 90.9%) preponderance . Post-SCS, the IRLS summed score significantly decreased from 30.00  4.09 to 23.78  5.65 (p=0.028), with significant decreases in the need to move, severity of condition, and discomfort in arms and legs questions of the IRLS score. All individual questions of the PROMIS Sleep Disturbance form were statistically significant. No significant differences were found in the PROMIS Impairment Score.

Conclusion: RLS seriously effects patient quality of life through sleep impairment, leading to fatigue and daytime sleepiness. This study retrospectively demonstrates significant benefit of SCS symptoms and sleep quality in RLS patients. Further prospective trials are necessary to determine the safety, feasibility, and efficacy of SCS in primary idiopathic RLS.