Diabetic peripheral neuropathy (DPN) occurs due to long standing hyperglycemia and associated metabolic derangements. Cognitive impairment is a common complication in diabetes mellitus. It is associated with a faster rate of cognitive decline.

This research aims to

• determine the effect of non-invasive Vagus nerve stimulation on cognitive functions in diabetic peripheral neuropathy.
• investigate the correlation between cognitive function and severity of diabetic neuropathy.
• investigate the correlation between cognitive function and quality of life in diabetic peripheral neuropathy.

Inclusion Criteria:

• patients with diabetic polyneuropathy
• Female patients.
• age ranges from 40 to 55 years old.
• Duration of diabetic illness started since at least three years.
• Patients with mild to moderate neuropathy according to Toronto clinical neuropathy score
• Patients with cognitive function ranges from 24 - 15 score according to Mini mental state examination
• Patients with HbA1c ranges from seven to nine score.
• Ambulant patients with or without walking aids.
• Medically and psychologically stable patients without cardiac problems, confirmed by Electro Cardiogram (ECG).
• able to understand instructions.

Exclusion Criteria:

• Type I diabetes mellitus.
• Severe visual, verbal or acoustic impairments.
• Sever cognitive dysfunctions or that caused by other cause rather than diabetes mellitus.
• Polyneuropathy caused by other cause rather than diabetes mellitus.
• Other neurological problem as stroke.
• Cardiovascular problems.
• Metallic implants
• Illiterate patients.
• Uncooperative patients.

Diabetic polyneuropathy female patients