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Peripheral Autonomic Neuropathy

When a stimulus causes backward nerve transmission, vasodilation of the innervated blood vessels occurs; this is the axon reflex, also referred to as the flare response. An impaired axon reflex indicates peripheral neuropathy. In practical terms, when skin is heated (by using the moorVMS-HEAT) or iontophoresed (by using the MIC2) with acetylcholine over a well defined area, microvascular blood flow also increases in the surrounding skin (as well as at the site stimulated). Laser Doppler monitoring (moorVMS-LDF) is used to assess the magnitude and time course of the vasodilation, and additional information on the flare area can be obtained with laser Doppler (moorLDI2) and Speckle imaging (moorFLPI-2).

Equipment recommendations

The moorFLPI-2 with high speed and spatial resolution is the system of choice, coupled with MIC2 iontophoresis and ION6 chambers + CAP.

What's next?

Contact us to discuss your specific needs and to request your copy of our free Application Note which includes a detailed experimental method and practical suggestions. We also offer no obligation on-site visits so you can test the equipment in your facility.


Ahluwalia P, McGill J I, Church M K. Nedocromil sodium inhibits histamine-induced itch and flare in human skin. British Journal of Pharmacology. 2001, 132, 613-616.

Bickel A; Kramer H H; Hilz M J; Birklein F; Neundorfer B, and Schmelz M. Assessment of the neurogenic flare reaction in small-fiber neuropathies. Neurology 2002; 59, 917-919.

Caselli A, Rich J, Hanane T, Uccioli L, and Veves A. Role of C-nociceptive fibers in the nerve axon reflex-related vasodilation in diabetes. Neurology 2003: 60, 297-300.

Krishnan STM and Rayman G. The LDIflare: A novel test of C-fiber function demonstrates early neuropathy in type 2 diabetes. Diabetes Care 27:2930–2935, 2004.

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