title: Induction of vascular endothelial growth factor release by transcutaneous frequency modulated neural stimulation in diabetic polyneuropathy.
abstract: BACKGROUND
  Pharmacological treatment for diabetic polyneuropathy (DP) has shown limited benefit; frequency-modulated electrical stimulation (FREMS) has shown positive results in pain control and nerve conduction velocity in DP.
  
  
  OBJECTIVE
  To investigate the effects of FREMS vs transcutaneous electrical nerve stimulation (TENS) on the release of vascular endothelial growth factor (VEGF) in Type 2 diabetic and in non-diabetic subjects.
  
  
  METHODS
  10 non-diabetic [mean age 37+/-5 yr; females (F)/males (M): 6/4] and 10 Type 2 diabetic subjects (mean age 52+/-6 yr; F/M: 5/5) with DP underwent TENS (for 10 min) followed by 30 min interval without electrical stimulation, and then FREMS (for 10 min) over the forearm volar surface. Blood samples for VEGF measurements were obtained from the contra-lateral arm every 2 min during TENS/FREMS application and every 10 min during the intervals.
  
  
  RESULTS
  We observed a significant rise in plasma VEGF during FREMS in both non-diabetic and diabetic subjects (maximal response 89.4+/-80.3 pg/ml and 48.5+/-18.3 pg/ml, respectively; p<0.01 vs basal) with a lower, but still significant response in diabetics. No changes in VEGF were observed during TENS application.
  
  
  CONCLUSIONS
  VEGF release during FREMS may help explain the positive effects on nerve conduction velocity in DP, possibly mediated by favorable effects on vasa nervorum microangiopathy.
authors.affiliation: Endocrinology and Diabetes Unit and LORENZ Research Center, Department of Medicine, Luigi Sacco Hospital (Vialba)-University of Milan, Milan, Italy. mauriziobevilacqua@fastwebnet.it
authors.forename: M
authors.initials: M
authors.lastname: Bevilacqua
authors.forename: L J
authors.initials: LJ
authors.lastname: Dominguez
authors.forename: M
authors.initials: M
authors.lastname: Barrella
authors.forename: M
authors.initials: M
authors.lastname: Barbagallo
mesh_terms: D000200:Action Potentials / Q000502:physiology; D000328:Adult; D003929:Diabetic Neuropathies / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000502:physiology; D009431:Neural Conduction / Q000502:physiology; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D059408:Pain Management; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D042461:Vascular Endothelial Growth Factor A / Q000097:blood / Q000378:metabolism*
chemical_list: D042461:Vascular Endothelial Growth Factor A