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Neural synchrony via theta\u2010gamma phase\u2010amplitude coupling (PAC) in the prefrontal cortex facilitates cognitive control and is impaired in BD. This pilot study aimed to investigate the feasibility and efficacy of transcranial alternating current stimulation (tACS) in targeting the neural coordination (i.e., theta\u2010gamma PAC) of cognitive control in a double\u2010blind, randomized, controlled crossover trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Participants (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200918) with BD completed an emotional Go\/No\u2010Go task during six 5\u2010min stimulation blocks interleaved with 2\u2010min resting blocks. Participants received active\u2010 and sham\u2010stimulation 1\u2009week apart; sham comprised a ramp up\/down at the beginning and end of the block to mimic stimulation sensations. Tolerability was measured using a side effect questionnaire after active and sham stimulation. Behavioral measures of discriminability (\n                      <jats:italic>d<\/jats:italic>\n                      \u2032) and reaction time during the task, and EEG measures of theta\u2010power and theta\u2010gamma PAC during the interleaved resting states were compared for active versus sham.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Active did not differ from sham stimulation on any side effects (all\n                      <jats:italic>p<\/jats:italic>\n                      's\u2009&gt;\u20090.11). Effect sizes when comparing discriminability, theta\u2010power, and PAC across active versus sham were small but showed a consistent pattern of improvement in the active relative to the sham condition.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This pilot study showed that 30\u2010min tACS is tolerable to BD patients and demonstrated preliminary promise in enhancing affective cognitive control. Future studies should determine the optimal dosage to produce more substantial and enduring effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials: NCT05480124<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bdi.70142","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T08:16:13Z","timestamp":1782893773000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Enhancing Affective Cognitive Control in Bipolar Disorder Using Transcranial Alternating Current Stimulation: A Double\u2010Blind, Randomized, Sham\u2010Controlled Clinical Trial and Proof of Concept Study"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9607-014X","authenticated-orcid":false,"given":"Jacob D.","family":"Kraft","sequence":"first","affiliation":[{"name":"Department of Psychology University of South Dakota  Vermillion South Dakota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Locarno","sequence":"additional","affiliation":[{"name":"Department of Psychiatry &amp; Behavioral Health The Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4247-280X","authenticated-orcid":false,"given":"Takakuni","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Tulsa  Tulsa Oklahoma USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Riddle","sequence":"additional","affiliation":[{"name":"Department of Psychology Florida State University  Tallahassee Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soo\u2010Eun","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melvin G.","family":"McInnis","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavio","family":"Fr\u00f6hlich","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of North Caralina  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan F.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivy F.","family":"Tso","sequence":"additional","affiliation":[{"name":"Department of Psychiatry &amp; 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