• Beatrice P De Koninck, Daphnée Brazeau, Samuel Guay, Alberto Herrero Babiloni, and Louis De Beaumont.
• Sports and Trauma Applied Research Lab, Montreal Sacred Heart Hospital, CIUSSS North-Montreal-Island, Montreal, Quebec, Canada; University of Montreal, Montréal, Quebec, Canada. Electronic address: beatrice.pelletier-de.koninck@umontreal.ca.
• Neuromodulation. 2023 Dec 1; 26 (8): 154915841549-1584.

BackgroundTranscranial alternating current stimulation (tACS) has been one of numerous investigation methods used for their potential to modulate brain oscillations; however, such investigations have given contradictory results and a lack of standardization.ObjectivesIn this systematic review, we aimed to assess the potential of tACS to modulate alpha spectral power. The secondary outcome was the identification of tACS methodologic key parameters, adverse effects, and sensations.Materials And MethodsStudies in healthy adults who were receiving active and sham tACS intervention or any differential condition were included. The main outcome assessed was the increase/decrease of alpha spectral power through either electroencephalography or magnetoencephalography. Secondary outcomes were methodologic parameters, sensation reporting, and adverse effects. Risks of bias and the study quality were assessed with the Cochrane assessment tool.ResultsWe obtained 1429 references, and 20 met the selection criteria. A statistically significant alpha-power increase was observed in nine studies using continuous tACS stimulation and two using intermittent tACS stimulation set at a frequency within the alpha range. A statistically significant alpha-power increase was observed in three more studies using a stimulation frequency outside the alpha range. Heterogeneity among stimulation parameters was recognized. Reported adverse effects were mild. The implementation of double blind was identified as challenging using tACS, in part owing to electrical artifacts generated by stimulation on the recorded signal.ConclusionsMost assessed studies reported that tACS has the potential to modulate brain alpha power. The optimization of this noninvasive brain stimulation method is of interest mostly for its potential clinical applications with neurological conditions associated with perturbations in alpha brain activity. However, more research efforts are needed to standardize optimal parameters to achieve lasting modulation effects, develop methodologic alternatives to reduce experimental bias, and improve the quality of studies using tACS to modulate brain activity.Crown Copyright © 2022. Published by Elsevier Inc. All rights reserved.

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