Department of Electronics and Telecommunications, University of Florence, Via S Marta 3, 50139 Florence, Italy.
Med Eng Phys. 2010 May;32(4):407-13. doi: 10.1016/j.medengphy.2010.02.004. Epub 2010 Mar 6.
Synchronized oscillation of smooth muscle cells tension in arterioles is the main control system of microvascular skin blood flow. An important autogenic vasomotion activity is recognized in 0.1Hz oscillations through power spectrum analysis of laser Doppler flowmetry. Severe dysautonomia in diabetic neuropathy is correlated with loss of 0.1Hz vasomotor activity, hence with impaired blood microcirculation. FREMS is a novel transcutaneous electrotherapy characterized by sequences of electrical stimuli of high voltage and low pulse duration which vary both in frequency and duration. We have evaluated the changes in laser Doppler flow in the volar part of the forearm before, during and after FREMS. Normal controls (n=10, 6 females, age range 21-39 years) demonstrated significant 0.1Hz vasomotion power spectra at baseline conditions associated with large oscillations of adrenergic cutaneous sweat activity sampled from the hand; people with diabetes type 2 and severe dysautonomia (n=10, 5 females, age range 63-75 years) displayed a significant decrease of 0.1Hz vasomotion power spectra. During FREMS application we observed an increase (p<0.05) of 0.1Hz vasomotion power spectra only in the diabetic group, despite persistence of adrenergic cutaneous sweat activity suppression in this group. However, after the application of the stimuli, the relative energy values around the 0.1Hz peak remained significantly higher than preapplication values in the diabetic group (p<0.05). From these findings, we suggest that FREMS is able to synchronize smooth cell activity, inducing and increasing 0.1Hz vasomotion, independently from the autonomic nervous system.
微血管皮肤血流的主要控制系统是小动脉中平滑肌细胞张力的同步振荡。通过激光多普勒流量metry 的功率谱分析，识别到 0.1Hz 振荡中的重要自主血管运动活动。糖尿病性神经病中的严重自主神经功能障碍与 0.1Hz 血管运动活动的丧失相关，因此与血液微循环受损相关。FREMS 是一种新型的经皮电疗，其特征在于高压和低脉冲持续时间的电刺激序列，其频率和持续时间均变化。我们已经评估了 FREMS 之前、期间和之后前臂掌侧的激光多普勒流量的变化。正常对照组（n=10，女性 6 名，年龄范围 21-39 岁）在基线条件下表现出明显的 0.1Hz 血管运动功率谱，与从手部采样的肾上腺素能皮肤汗活动的大振荡相关；2 型糖尿病和严重自主神经功能障碍的患者（n=10，女性 5 名，年龄范围 63-75 岁）显示出明显降低的 0.1Hz 血管运动功率谱。在 FREMS 应用期间，我们仅在糖尿病组中观察到 0.1Hz 血管运动功率谱的增加（p<0.05），尽管在该组中肾上腺素能皮肤汗活动的抑制持续存在。然而，在刺激应用后，糖尿病组中围绕 0.1Hz 峰值的相对能量值仍显著高于应用前的值（p<0.05）。从这些发现中，我们认为 FREMS 能够同步平滑肌细胞活动，诱导和增加 0.1Hz 血管运动，而与自主神经系统无关。
