title: Frequency-modulated electromagnetic neural stimulation enhances cutaneous microvascular flow in patients with diabetic neuropathy.
abstract: OBJECTIVE
  The aim of this study was to investigate the effects of frequency modulated electromagnetic neural stimulation (FREMS), a recently developed safe and effective treatment of painful diabetic neuropathy, on cutaneous microvascular function.
  
  
  METHODS
  Thirty-one patients with painful neuropathy were enrolled in a randomised, double-blind, crossover FREMS vs. placebo study; each received two series of 10 treatments of either FREMS or placebo in random sequence within no more than 3 weeks. Patients were studied at baseline, end of FREMS and placebo series, and after 4 months of follow-up. Cutaneous blood flow was measured by laser doppler flowmetry and partial tissue tension of oxygen (TcPO2) and carbonic anhydride (TcPCO2) by oxymetry at the lower extremities in basal resting conditions and as incremental response after thermal stimulation.
  
  
  RESULTS
  Crossover analysis showed no consistent differences between FREMS and placebo. After 4-month follow-up, a 52% increase of cutaneous blood flow was observed in resting conditions (P=.0086 vs. baseline), while no differences were observed as incremental flow after warming; compared with baseline, no significant differences were observed for TcPO2 and TcPCO2, both in resting conditions and as incremental response to warm.
  
  
  CONCLUSIONS
  These results indicate that 10 treatments with FREMS may induce an enhancement of microvascular blood flow measurable at 4 months of follow-up. The findings of this study will need to be confirmed in a larger, adequately powered study (ClinicalTrial.gov Id: NCT00337324).
authors.affiliation: Department of Medicine, Diabetes and Endocrinology Unit, San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Via Olgettina, 60, 20132 Milan, Italy.
authors.forename: Morena
authors.initials: M
authors.lastname: Conti
authors.forename: Elena
authors.initials: E
authors.lastname: Peretti
authors.forename: Giuliana
authors.initials: G
authors.lastname: Cazzetta
authors.forename: Gabriella
authors.initials: G
authors.lastname: Galimberti
authors.forename: Cristiana
authors.initials: C
authors.lastname: Vermigli
authors.forename: Roberto
authors.initials: R
authors.lastname: Pola
authors.forename: Luciano
authors.initials: L
authors.lastname: Scionti
authors.forename: Emanuele
authors.initials: E
authors.lastname: Bosi
mesh_terms: D003929:Diabetic Neuropathies / Q000628:therapy*; D004574:Electromagnetic Fields; D005260:Female; D006801:Humans; D055909:Magnetic Field Therapy; D008297:Male; D008833:Microcirculation / Q000528:radiation effects*; D008875:Middle Aged; D009420:Nervous System / Q000528:radiation effects*