Bilateral high-frequency noninvasive peroneal nerve stimulation evokes tonic leg muscle activation for sleep-compatible reduction of restless legs syndrome symptoms
- S-Med
- Jul 31
- 1 min read
Together, these results suggest that NPNS activates afferent peroneal nerve fibers to evoke increases in TA muscle tone, thereby reducing RLS symptoms while maintaining compatibility with sleep. NPNS and voluntary leg movements both lead to leg muscle activation and relief of RLS symptoms, suggesting a similar mechanism of action. However, NPNS confers 2 clinically significant advantages. First, NPNS can be used at bedtime without interfering with sleep onset (Table 2), whereas voluntary leg movements are incompatible with sleep. Second, NPNS remains similarly efficacious for severe RLS, in contrast to leg movements.
NPNS activates leg muscles and thus is fundamentally different from technologies that rely on sensory counter stimulation. Mechanical vibration devices activate mechanoreceptors in the dermis but do not directly activate nerves whereas NPNS directly activates the peroneal nerve with sufficient potency to evoke muscle activity. The relatively weak signals triggered by mechanical vibration may explain why this approach does not reduce RLS symptom severity whereas NPNS reduces RLS symptom severity to a clinically significant degree. Trans-cutaneous electrical stimulation devices use sensory counter stimulation and in some forms can induce abrupt muscle twitches but do not result in tonic increases in muscle activity In summary, NPNS uniquely delivers nerve stimulation to evoke tonic muscle activity while remaining compatible with sleep.
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