SynthesisJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2023
Pharmacological responsiveness of periodic limb movements in patients with restless legs syndrome: a systematic review and meta-analysis.
Synthesis in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 11 citations in OpenAlex.
- Pathophysiology and pharmacological management for sleep problems in Parkinson's disease.Journal of Parkinson's disease · 2026Review
- Secondary Restless Legs Syndrome during psychopharmacological treatment: real-world evidence from a multinational pharmacovigilance program.The international journal of neuropsychopharmacology · 2026Article
- When the legs speak for the lungs.Sleep · 2026Article
- Periodic limb movements in Parkinson's disease: a critical review of pathophysiology and a framework for clinical management.NPJ Parkinson's disease · 2026Review
- Acute effects of tonic motor activation (TOMAC) on sleep in adults with medication-refractory restless legs syndrome.Sleep advances : a journal of the Sleep Research Society · 2026Article
- Neural Correlates of Restless Legs Syndrome (RLS) Based on Electroencephalogram (EEG)-A Mechanistic Review.International journal of molecular sciences · 2025Review
- Sleep and circadian disturbances in children with neurodevelopmental disorders.Nature reviews. Neurology · 2025Review
- Review of the role of the endogenous opioid and melanocortin systems in the restless legs syndrome.Brain : a journal of neurology · 2024Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesPeriodic limb movements during sleep (PLMS) are a frequent finding in restless legs syndrome, but their impact on sleep is still debated, as well the indication for treatment. We systematically reviewed the available literature to describe which drug categories are effective in suppressing PLMS, assessing their efficacy through a meta-analysis, when this was possible.
methodsThe review protocol was preregistered on PROSPERO (CRD42021175848), and the systematic search was conducted on and EMBASE (last searched on March 2020). We included original human studies, which assessed PLMS modification on drug treatment with a full-night polysomnography, through surface electrodes on each tibialis anterior muscle. When at least 4 studies were available on the same drug or drug category, we performed a random-effect model meta-analysis.
resultsDopamine agonists like pramipexole and ropinirole resulted the most effective, followed by l-dopa and other dopamine agonists. Alpha2delta ligands are moderately effective as well opioids, despite available data on these drugs are much more limited than those on dopaminergic agents. Valproate and carbamazepine did not show a significant effect on PLMS. Clonazepam showed contradictory results. Perampanel and dypiridamole showed promising but still insufficient data. The same applies to iron supplementation.
conclusionsDopaminergic agents are the most powerful suppressors of PLMS. However, most therapeutic trials in restless legs syndrome do not report objective polysomnographic findings, there is a lack of uniformity in presenting results on PLMS. Longitudinal polysomnographic interventional studies, using well-defined and unanimous scoring criteria and endpoints on PLMS are needed. CITATION: Riccardi S, Ferri R, Garbazza C, Miano S, Manconi M. Pharmacological responsiveness of periodic limb movements in patients with restless legs syndrome: a systematic review and meta-analysis.
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Registered trials
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.