Post-stroke cognitive impairment is a common and severe complication of stroke, significantly affecting patients' daily life and rehabilitation. Although transcranial direct current stimulation combined with computerized cognitive training has shown potential for improvement, current studies still have key limitations. Most have used only simultaneous intervention protocols, without systematically comparing sequential combination strategies, making it difficult to determine the optimal clinical approach. The core objective of this study will be to address the existing research gap by comparing sequential intervention strategies and to resolve the key issue of identifying the optimal clinical approach. This study will use a single-center, double-blind, randomized controlled trial design. A total of 60 patients with post-stroke cognitive impairment will be randomly assigned in a 1:1:1:1 ratio to four groups: three intervention groups receiving computerized cognitive training combined with transcranial direct current stimulation at different timings (pre-training, concurrent, or post-training), and one sham control group. All interventions will be administered five times a week for two consecutive weeks. Follow-up assessments will be conducted at 4 and 12 weeks post-intervention. This trial will systematically evaluate the optimal timing strategies for combining tDCS and CCT in PSCI. The hypothesized mechanisms are: (1) synchronous stimulation enhancing cognitive processing efficiency through immediate synaptic changes, (2) pre-training stimulation promoting plasticity via long-term potentiation-like modifications, and (3) post-training stimulation consolidating training effects by modulating neuronal synchrony. High-sensitivity cerebral oxygenation parameters will be used to assess microcirculatory improvements, linking physiological changes to cognitive recovery. However, ceiling effects and test biases will potentially limit the accuracy of long-term results, while sample size and lack of stratification based on brain lesion characteristics may introduce heterogeneity. Future studies will need to incorporate multimodal neuroimaging for stratified analysis and should develop personalized interventions based on lesion severity, disease stage, and timing to address therapeutic challenges and advance precision rehabilitation. Trial registration: ChiCTR2500102565.[Chinese Clinical Trial Registry (ChiCTR), https://www.chictr.org.cn/] [Registered on May 16, 2025].

Alcohol use disorder (AUD) is a chronic relapsing condition requiring long-term pharmacotherapy. Because of their variable efficacy and poor adherence, newer neuromodulation approaches are being examined. Our study aimed to investigate the effect of adjunctive high-definition transcranial direct current stimulation (HD-tDCS) on craving, brain glutamate-glutamine (Glx) at the left dorsolateral prefrontal cortex (DLPFC) in AUD. A total of 50 individuals with AUD, randomized into 25 each to active and sham HD-tDCS groups were enrolled on the study. After detoxification, HD-tDCS was administered twice daily over 5 days for a total of 10 sessions. Each participant was started on oral naltrexone 50mg/day. Alcohol craving questionnaire-NOW (ACQ-NOW), obsessive compulsive drinking scale (OCDS), and brain Glx were measured at baseline and end of 10 sessions of high-definition transcranial direct current stimulation. The active HD-tDCS group showed significantly lower brain Glx at the left DLPFC at the end of 10 sessions from baseline compared with the sham HD-tDCS group. Craving did not show any significant between-group × time effects. Our study showed that the HD-tDCS could significantly change brain Glx at the left DLPFC in AUD. Change in craving did not correlate with change in Glx. Future studies should include a larger sample size, multivoxel assessment and a greater number of HD-tDCS sessions.

Brain stimulation in stuttering: Participant experiences with transcranial Direct Current Stimulation (tDCS).

Neural mechanisms of tDCS: Insights from an in-vivo rodent model across a range of electric field strengths.

Neurodevelopmental disorders comprise a heterogeneous group of conditions characterized by earlyonset impairments in cognitive, behavioral, emotional, and social functioning, that persist across the lifespan. Growing evidence on the neurobiological underpinnings of attention-deficit/hyperactivity disorder and autisms spectrum disorder has promoted the use of non-invasive brain stimulation as a complementary therapeutic approach. Repetitive transcranial magnetic stimulation and transcranial direct current stimulation can safely modulate cortical excitability and synaptic plasticity, targeting dysfunctional neural networks involved in executive control, attention, and socio-emotional processing. Findings from pediatric populations indicate that prefrontal stimulation, particularly of the dorsolateral prefrontal cortex, may improve executive functions and reduce core clinical symptoms. Both techniques show favorable safety and tolerability profiles in children and adolescents. However, variability in stimulation protocols and outcome measures highlights the need for large-scale, standardized clinical trials to establish optimal parameters and long-term efficacy.

Role of hippocampal subfield volumes in the efficacy of transcranial direct current stimulation for late-life depression: An exploratory pilot randomized clinical trial.

Recent advances and mechanistic insights of non-invasive brain stimulation in post-stroke dysphagia rehabilitation.

The effect of transcranial direct current stimulation on reading adaptation in adults who stutter.

Anodal HD-tDCS of vmPFC facilitates learning of monosemous and polysemous words: A computational modeling study.

Tracking remyelination in a model of multiple sclerosis: Visual evoked potentials reveal therapeutic effect from brain stimulation and exercise.

Effects of anodal cerebellar transcranial direct current stimulation on motor symptoms and cerebellar inhibition in Parkinson's disease: A sham-controlled cross-over study.

Increasing resilience to stress by home-based transcranial stimulation.

High-definition transcranial direct current stimulation enhances empathy-related cerebellar centrality in patients with schizophrenia.

Theory of mind in multiple sclerosis: Three-month follow-up effects after double-blind tDCS and video-training, a pilot study.

Temporal interference non-invasive deep brainstimulation: bibliometric, clinical translation and potential for neurorestoratology.

Effects of personalized vs. non-personalized neurostimulation protocols in improving speech and limb reaction times.

Appropriately Designed Studies are Needed to Assess Whether Transcranial Direct Current Stimulation Actually Improves Gait Performance in Older People.

Does transcranial direct current stimulation enhance sensorimotor recovery in chronic ankle instability? A systematic review and meta-analysis.

Response to "Considerations for Transcranial Direct Current Stimulation to Improve Gait Performance in the Elderly".

Anodal Transcranial Direct Current Stimulation as an Adjunct to Physiotherapy in Lacunar Stroke