Evidence map›Paper›PMID 27856776›Full record

ArticleNeurology2016

Practice guideline summary: Treatment of restless legs syndrome in adults: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology.

John W Winkelman, Melissa J Armstrong, Richard P Allen, K Ray Chaudhuri, William Ondo, Claudia Trenkwalder, Phyllis C Zee, Gary S Gronseth, David Gloss, Theresa Zesiewicz

Erratum issuedAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 88 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
88citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

88 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Treatment of restless legs syndrome and periodic limb movement disorder: an American Academy of Sleep Medicine clinical practice guideline.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025
    Guideline
  2. Putative Animal Models of Restless Legs Syndrome: A Systematic Review and Evaluation of Their Face and Construct Validity.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2023
    Pooled it
  3. Restless Legs Syndrome in Chronic Kidney Disease- a Systematic Review.Tremor and other hyperkinetic movements (New York, N.Y.) · 2023
    Pooled it
  4. Pooled it
  5. Iron for the treatment of restless legs syndrome.The Cochrane database of systematic reviews · 2019
    Pooled it
  6. Trial
  7. Trial
  8. Article
  9. Article
  10. Retirement of Guidelines.Neurology · 2026
    Article
  11. Article
  12. The evolving treatment landscape of restless legs syndrome.Therapeutic advances in neurological disorders · 2026
    Review
  13. Review
  14. Article
  15. Article
  16. Sleep-related movement disorders in children: recent updates.World journal of pediatrics : WJP · 2025
    Review
  17. Article
  18. Review
  19. Review
  20. Article

28 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

John W WinkelmanFrom Harvard Medical School and Massachusetts General Hospital (J.W.W.), Boston; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Department of Neurology (R.P.A.), Johns Hopkins University, Baltimore, MD; King's College and King's College Hospital (K.R.C.), London; Methodist Neurological Institute (W.O.), Houston, TX; Department of Neurology (C.T.), University Medical Center, Göttingen, Germany; Northwestern University Feinberg School of Medicine (P.C.Z.), Chicago, IL; University of Kansas Medical Center (G.S.G.), Kansas City; CAMC Neurology Section (D.G.), Charleston, WV; and Department of Neurology (T.Z.), University of South Florida, James A Haley Veterans Administration Hospital, Tampa.
Melissa J ArmstrongFrom Harvard Medical School and Massachusetts General Hospital (J.W.W.), Boston; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Department of Neurology (R.P.A.), Johns Hopkins University, Baltimore, MD; King's College and King's College Hospital (K.R.C.), London; Methodist Neurological Institute (W.O.), Houston, TX; Department of Neurology (C.T.), University Medical Center, Göttingen, Germany; Northwestern University Feinberg School of Medicine (P.C.Z.), Chicago, IL; University of Kansas Medical Center (G.S.G.), Kansas City; CAMC Neurology Section (D.G.), Charleston, WV; and Department of Neurology (T.Z.), University of South Florida, James A Haley Veterans Administration Hospital, Tampa.
Richard P AllenFrom Harvard Medical School and Massachusetts General Hospital (J.W.W.), Boston; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Department of Neurology (R.P.A.), Johns Hopkins University, Baltimore, MD; King's College and King's College Hospital (K.R.C.), London; Methodist Neurological Institute (W.O.), Houston, TX; Department of Neurology (C.T.), University Medical Center, Göttingen, Germany; Northwestern University Feinberg School of Medicine (P.C.Z.), Chicago, IL; University of Kansas Medical Center (G.S.G.), Kansas City; CAMC Neurology Section (D.G.), Charleston, WV; and Department of Neurology (T.Z.), University of South Florida, James A Haley Veterans Administration Hospital, Tampa.
K Ray ChaudhuriFrom Harvard Medical School and Massachusetts General Hospital (J.W.W.), Boston; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Department of Neurology (R.P.A.), Johns Hopkins University, Baltimore, MD; King's College and King's College Hospital (K.R.C.), London; Methodist Neurological Institute (W.O.), Houston, TX; Department of Neurology (C.T.), University Medical Center, Göttingen, Germany; Northwestern University Feinberg School of Medicine (P.C.Z.), Chicago, IL; University of Kansas Medical Center (G.S.G.), Kansas City; CAMC Neurology Section (D.G.), Charleston, WV; and Department of Neurology (T.Z.), University of South Florida, James A Haley Veterans Administration Hospital, Tampa.
William OndoFrom Harvard Medical School and Massachusetts General Hospital (J.W.W.), Boston; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Department of Neurology (R.P.A.), Johns Hopkins University, Baltimore, MD; King's College and King's College Hospital (K.R.C.), London; Methodist Neurological Institute (W.O.), Houston, TX; Department of Neurology (C.T.), University Medical Center, Göttingen, Germany; Northwestern University Feinberg School of Medicine (P.C.Z.), Chicago, IL; University of Kansas Medical Center (G.S.G.), Kansas City; CAMC Neurology Section (D.G.), Charleston, WV; and Department of Neurology (T.Z.), University of South Florida, James A Haley Veterans Administration Hospital, Tampa.
Claudia TrenkwalderFrom Harvard Medical School and Massachusetts General Hospital (J.W.W.), Boston; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Department of Neurology (R.P.A.), Johns Hopkins University, Baltimore, MD; King's College and King's College Hospital (K.R.C.), London; Methodist Neurological Institute (W.O.), Houston, TX; Department of Neurology (C.T.), University Medical Center, Göttingen, Germany; Northwestern University Feinberg School of Medicine (P.C.Z.), Chicago, IL; University of Kansas Medical Center (G.S.G.), Kansas City; CAMC Neurology Section (D.G.), Charleston, WV; and Department of Neurology (T.Z.), University of South Florida, James A Haley Veterans Administration Hospital, Tampa.
Phyllis C ZeeFrom Harvard Medical School and Massachusetts General Hospital (J.W.W.), Boston; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Department of Neurology (R.P.A.), Johns Hopkins University, Baltimore, MD; King's College and King's College Hospital (K.R.C.), London; Methodist Neurological Institute (W.O.), Houston, TX; Department of Neurology (C.T.), University Medical Center, Göttingen, Germany; Northwestern University Feinberg School of Medicine (P.C.Z.), Chicago, IL; University of Kansas Medical Center (G.S.G.), Kansas City; CAMC Neurology Section (D.G.), Charleston, WV; and Department of Neurology (T.Z.), University of South Florida, James A Haley Veterans Administration Hospital, Tampa.
Gary S GronsethFrom Harvard Medical School and Massachusetts General Hospital (J.W.W.), Boston; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Department of Neurology (R.P.A.), Johns Hopkins University, Baltimore, MD; King's College and King's College Hospital (K.R.C.), London; Methodist Neurological Institute (W.O.), Houston, TX; Department of Neurology (C.T.), University Medical Center, Göttingen, Germany; Northwestern University Feinberg School of Medicine (P.C.Z.), Chicago, IL; University of Kansas Medical Center (G.S.G.), Kansas City; CAMC Neurology Section (D.G.), Charleston, WV; and Department of Neurology (T.Z.), University of South Florida, James A Haley Veterans Administration Hospital, Tampa.
David GlossFrom Harvard Medical School and Massachusetts General Hospital (J.W.W.), Boston; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Department of Neurology (R.P.A.), Johns Hopkins University, Baltimore, MD; King's College and King's College Hospital (K.R.C.), London; Methodist Neurological Institute (W.O.), Houston, TX; Department of Neurology (C.T.), University Medical Center, Göttingen, Germany; Northwestern University Feinberg School of Medicine (P.C.Z.), Chicago, IL; University of Kansas Medical Center (G.S.G.), Kansas City; CAMC Neurology Section (D.G.), Charleston, WV; and Department of Neurology (T.Z.), University of South Florida, James A Haley Veterans Administration Hospital, Tampa.
Theresa ZesiewiczFrom Harvard Medical School and Massachusetts General Hospital (J.W.W.), Boston; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Department of Neurology (R.P.A.), Johns Hopkins University, Baltimore, MD; King's College and King's College Hospital (K.R.C.), London; Methodist Neurological Institute (W.O.), Houston, TX; Department of Neurology (C.T.), University Medical Center, Göttingen, Germany; Northwestern University Feinberg School of Medicine (P.C.Z.), Chicago, IL; University of Kansas Medical Center (G.S.G.), Kansas City; CAMC Neurology Section (D.G.), Charleston, WV; and Department of Neurology (T.Z.), University of South Florida, James A Haley Veterans Administration Hospital, Tampa.

Funding

Cortical GABA in MDD and Primary Insomnia with Magnetic Resonance SpectroscopyR01MH095792 · NIMH · MASSACHUSETTS GENERAL HOSPITAL · PI WINKELMAN, JOHN W · 2012 to 2016
$2.1M
NIMH NIH HHS R01 MH095792
6 · The paper itself

Abstract

objectiveTo make evidence-based recommendations regarding restless legs syndrome (RLS) management in adults.

methodsArticles were classified per the 2004 American Academy of Neurology evidence rating scheme. Recommendations were tied to evidence strength. RESULTS AND RECOMMENDATIONS: In moderate to severe primary RLS, clinicians should consider prescribing medication to reduce RLS symptoms. Strong evidence supports pramipexole, rotigotine, cabergoline, and gabapentin enacarbil use (Level A); moderate evidence supports ropinirole, pregabalin, and IV ferric carboxymaltose use (Level B). Clinicians may consider prescribing levodopa (Level C). Few head-to-head comparisons exist to suggest agents preferentially. Cabergoline is rarely used (cardiac valvulopathy risks). Augmentation risks with dopaminergic agents should be considered. When treating periodic limb movements of sleep, clinicians should consider prescribing ropinirole (Level A) or pramipexole, rotigotine, cabergoline, or pregabalin (Level B). For subjective sleep measures, clinicians should consider prescribing cabergoline or gabapentin enacarbil (Level A), or ropinirole, pramipexole, rotigotine, or pregabalin (Level B). For patients failing other treatments for RLS symptoms, clinicians may consider prescribing prolonged-release oxycodone/naloxone where available (Level C). In patients with RLS with ferritin ≤75 μg/L, clinicians should consider prescribing ferrous sulfate with vitamin C (Level B). When nonpharmacologic approaches are desired, clinicians should consider prescribing pneumatic compression (Level B) and may consider prescribing near-infrared spectroscopy or transcranial magnetic stimulation (Level C). Clinicians may consider prescribing vibrating pads to improve subjective sleep (Level C). In patients on hemodialysis with secondary RLS, clinicians should consider prescribing vitamin C and E supplementation (Level B) and may consider prescribing ropinirole, levodopa, or exercise (Level C).

Indexed as

Practice Guidelines as TopicAdultDopamine AgentsDopamine AgonistsHumansRestless Legs SyndromeSocieties, MedicalTetrahydronaphthalenesThiophenesDopamine AgentsDopamine AgonistsrotigotineTetrahydronaphthalenesThiophenes

Identifiers

PMID27856776
PMCPMC5206998

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.