Knowledge, attitudes, and practices of Chinese neurologists toward transcranial direct current stimulation

To assess the knowledge, attitudes, and practices (KAP) of Chinese neurologists regarding transcranial direct current stimulation (tDCS) and explore the interrelationships among these dimensions using path analysis. A multicenter cross-sectional study was conducted in October 2022 across multiple hospitals in China. A total of 351 neurologists were included. Among the respondents, 170 (48.43%) were male and 181 (51.57%) were female. Most had access to tDCS equipment (91.17%). The mean scores (± SD) for knowledge, attitude, and practice were 6.42 ± 1.49 (out of 10), 20.97 ± 4.33 (out of 32), and 11.95 ± 3.43 (out of 20), respectively. There were weak positive correlations among knowledge, attitude, and practice scores, with a moderate correlation observed between attitude and practice (all P < 0.001). Path analysis showed that knowledge directly influenced attitude (β = 0.275, P = 0.019), which in turn directly impacted practice (β = 0.563, P = 0.012). Knowledge also indirectly affected practice through attitude (β = 0.155, P = 0.016), although it had no significant direct effect on practice (β = 0.044, P = 0.504). Neurologists in China show moderate knowledge and positive attitudes toward tDCS, but its clinical use remains limited. Attitude was independently associated with practice, while knowledge showed no independent direct association after adjustment. Knowledge may influence practice indirectly through shaping attitudes. These findings suggest that efforts to improve clinicians’ attitudes, alongside educational support, may be essential for facilitating the appropriate clinical adoption of tDCS and other emerging neuromodulation techniques.