Theta-gamma tACS modulates attention network synchronization, not isolated network performance.

As the brain ages, oscillatory changes disrupt neuronal communication, contributing to cognitive decline in key areas such as parts of the attention network system. This study explores the effects of multi-session low-intensity transcranial Alternating Current Stimulation (tACS) on the efficiency of the alerting, orienting, and executive control networks in older adults. Using a 16-session theta-gamma tACS protocol targeting the prefrontal cortex, we examined its impact on Attention Network Task (ANT) performance of 76 participants aged 55 to 84 in a randomized, double-blind, sham-controlled design. To account for the influence of brain state, both active and sham tACS groups underwent cognitive n-back training during stimulation. Despite no significant modulations in attention network efficiencies, generalized linear mixed-effect modeling revealed that active tACS negatively influenced overall reaction time (RT) improvements, resulting in poorer ANT performance compared to the sham group. Additionally, active tACS disrupted network correlations post-intervention, particularly affecting the alerting network's interactions with the orienting and executive networks. These findings provide further evidence for the involvement of theta-gamma coupling in attention processes, though without network-specific effects. The results underscore the potential of frequency-specific neurostimulation to modulate cognitive functions but also emphasize the need for caution, as such interventions may inadvertently impair brain network dynamics.