Statement of Significance
RLS, medication-refractory RLS, difficult-to-treat
RESTLESS LEGS SYNDROME
Tonic motor activation (TOMAC) is a novel wearable therapeutic device that reduces restless legs syndrome (RLS) symptoms. Previous research has demonstrated the short-term efficacy of TOMAC for the treatment of primary moderate-to-severe medication-refractory RLS. This paper presents results from an extension study showing that longer-duration TOMAC treatment over 28–32 weeks provides robust and durable benefits at very low risk to a difficult-to-treat population in need of new therapeutic options. Future research should be directed at understanding the mechanism for why long-term TOMAC use results in reduced RLS symptom frequency and investigating whether TOMAC has similar benefits earlier in the continuum of care, such as for medication-naïve RLS.