1000 Section - Bilateral Network Modulation via High-Intensity Transcranial Alternating Current Stimulation for Post-Stroke Cognitive Impairment: A Randomized Controlled Trial

Tuesday, May 19, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

YA

Yinan Ai, PhD

Senior Therapy Technician
The Third Affiliated Hospital of Sun Yat-sen University
Guangzhou, Guangdong, China (People's Republic)

Co-Author(s)

QC

Qinlin Cheng, MD

Therapy Technician
The Third Affiliated Hospital of Sun Yat-sen University
Guangzhou, Guangdong, China (People's Republic)
SZ

Shuxian Zhang, BS

Therapy Technician
The Third Affiliated Hospital of Sun Yat-sen University
Guangzhou, Guangdong, China (People's Republic)
LH

Li Huang, BS

Therapy Technician
The Third Affiliated Hospital of Sun Yat-sen University
Guangzhou, Guangdong, China (People's Republic)
FZ

Fang Zheng, BS

Student
The Third Affiliated Hospital of Sun Yat-sen University
Guangzhou, Guangdong, China (People's Republic)
HZ

Haiqing Zheng, PhD

Chief Physician
The Third Affiliated Hospital of Sun Yat-sen University
Guangzhou, Guangdong, China (People's Republic)
LZ

Liying Zhang, MD

Associate Professor
The Third Affiliated Hospital of Sun Yat-sen University
Guangzhou, Guangdong, China (People's Republic)
XH

Xiquan Hu, MD

Professor
The Third Affiliated Hospital of Sun Yat-sen University
Guangzhou, Guangdong, China (People's Republic)

Objectives : To evaluate the efficacy and neural mechanisms of a novel high-intensity (15 mA) transcranial alternating current stimulation (tACS) protocol, designed for broad bilateral coverage and deep current penetration, on cognitive function in patients with post-stroke cognitive impairment (PSCI).

Design: In a triple-blind, randomized controlled trial, 70 PSCI patients were allocated to receive either active tACS (77.5 Hz) or sham stimulation, alongside conventional rehabilitation, twice daily for two weeks. The primary outcome was the change in Montreal Cognitive Assessment (MoCA) score. Secondary outcomes included auditory digit span tests and functional near-infrared spectroscopy (fNIRS) measurements of hemodynamic responses.

Results: The tACS group demonstrated significantly greater improvements in MoCA scores and digit span performance than the sham group at both post-intervention and the 6-week follow-up (p< 0.05). fNIRS revealed that tACS specifically prevented the decline of functional connectivity in the right default mode network (DMN), which correlated with cognitive improvement. Task-based analysis indicated a normalization of brain activation, with a shift from left-lateralized to a more balanced, bilateral engagement of prefrontal and parietal regions after tACS.

Conclusion: High-intensity tACS is a safe and effective intervention for PSCI, with sustained benefits. Its effects are associated with the preservation of DMN connectivity and the induction of an optimized, bilateral brain activation pattern, supporting the therapeutic value of its spatially extensive and deep-targeting stimulation paradigm.