Alpha‐ tACS Improves Executive Function and Alpha Power Spectral Density in Patients With Post‐Stroke Cognitive Impairment

Background This study aims to evaluate the efficacy of alpha‐frequency transcranial alternating current stimulation (alpha‐tACS) in treating post‐stroke cognitive impairment (PSCI) and its effects on electroencephalographic activity. Methods Forty PSCI patients were randomly assigned to receive either active alpha‐tACS (10 Hz, 2 mA over bilateral DLPFC) or sham stimulation for 4 weeks, combined with standard therapy. Cognitive function was assessed using MoCA and TMT‐A/B, complemented by resting‐state EEG. ROC analysis was employed to evaluate alpha power spectral density (PSD). Results Following the 4‐week intervention, the alpha‐tACS group demonstrated significantly greater improvements in MoCA scores and TMT‐A completion times compared to the sham group ( p < 0.05). Alpha power spectral density (PSD) increases were significantly more pronounced in the alpha‐tACS group across all electrodes. Additionally, this group exhibited significantly greater reductions in whole‐brain DAR and DTABR values ( p FDR < 0.05). Correlation analysis revealed significant positive associations between TMT‐A improvements and alpha PSD changes at multiple electrodes (F3, F4, F7, F8, C3, C4, P4, T4, O2, FZ, CZ, PZ; p FDR < 0.05). Regression analysis identified P3 electrode PSD difference as a significant predictor ( p = 0.01), with ROC analysis showing AUC values of 0.685 (T1 comparison) and 0.797 (T1–T0 comparison). Conclusion Alpha‐tACS effectively enhances alpha oscillations and improves executive functions in PSCI patients, supporting its potential as a promising neuromodulatory intervention for cognitive rehabilitation.