Effect of Frequency Rhythmic Electrical Modulation System (FREMS) on 0.1 Hz microvascular skin blood flow in dysautonomic diabetic (type 2) neuropathy

Synchronized oscillation of smooth muscle cells tension in arterioles is the main control system of microcirculation. An important autogenic vasomotion activity is recognized in the 0.1 Hz oscillations observed by means of power spectrum analysis of laser doppler flowmetry. Severe dysautonomia in diabetic neuropathy is correlated with the loss of 0.1 Hz vasomotion activity. FREMS is a novel transcutaneous electrotherapy characterized by sequences of high voltage and short width electrical pulses which vary both in frequency and width, but not in voltage. We have evaluated the changes in laser doppler flow in the volar part of the forearm before, during and after FREMS. During FREMS application we observed an increase (p < 0.05) of 0.1 Hz power spectra, despite the suppression of adrenergic cutaneous sweat activity. From these findings, we suggest that FREMS is able to synchronize the smooth cells activity, inducing and increasing 0.1 Hz vasomotion activity, independently from the adrenergic influence.