REVIEW article
Front. Psychiatry
Sec. Neurostimulation
This article is part of the Research TopicCognitive, Affective, and Neurophysiological State-Dependency in Non-Invasive Brain Stimulation: Implications for Individualized Protocol DesignView all 3 articles
Neuromodulation and Rehabilitation of Post-Stroke Cognitive Impairment: Challenges and Prospects
Provisionally accepted
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
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It is essential to recognize the significant daily impact that post-stroke cognitive impairment (PSCI) has on patients and their families. Neuromodulation strategies have been increasingly applied in the clinical management of PSCI. This review outlines the mechanisms and brain function detection approaches through which neuromodulation promotes cognitive enhancement in stroke patients. For cognitive recovery, transcranial magnetic stimulation, transcranial electrical stimulation, vagus nerve stimulation, and brain-computer interfaces have shown promising results in clinical and preclinical studies. However, their efficacy remains unproven in large-scale pivotal trials. Preliminary clinical trials have shown that photobiomodulation enhances cognitive performance, but further investigation is required into the issue of skull attenuation of light. Transcranial ultrasound stimulation, a novel technology that overcomes the limitation of requiring deep electrode implantation for focal deep brain stimulation, still lacks scientific evidence. Chemogenetics and optogenetics provide methods for monitoring, disrupting, and regulating neural circuits after a stroke. To enhance the effectiveness of neuromodulation, it is recommended to implement multi-target stimulation, strengthen active participation in rehabilitation, and leverage cognitive-motor interactions to promote holistic recovery after stroke. Finally, we propose that neuromodulation will evolve toward brain-machine interaction neuromodulation, using artificial intelligence to develop a closed-loop strategy encompassing stimulation, detection, optimization, and re-stimulation.
Keywords: Brain-computer interface, Genetic-based neuromodulation, Neuroimaging, Neuromodulation, post-stroke cognitive impairment, Transcranial electrical stimulation, Transcranial Magnetic Stimulation
Received: 12 Feb 2026; Accepted: 12 Feb 2026.
Copyright: © 2026 Shang, Choi, Zhan, Wu and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dongsheng Xu
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