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Functional brain connectivity related to surgical skill dexterity in physical and virtual simulation environments
Nemani, Arun Kamat, Anil Gao, Yuanyuan Yücel, Meryem A. Gee, Denise Cooper, Clairice Schwaitzberg, Steven D. Intes, Xavier R. Dutta, Anirban De, Suvranu
Nemani, Arun
Kamat, Anil
Gao, Yuanyuan
Yücel, Meryem A.
Gee, Denise
Cooper, Clairice
Schwaitzberg, Steven D.
Intes, Xavier R.
Dutta, Anirban
De, Suvranu
Citations
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Time Period
Advisors
Original Date
Digitization Date
Issue Date
2021-03-21
Type
Article
Genre
Keywords
Functional connectivity,Functional near-infrared spectroscopy,Motor skills,Fundamentals of laparoscopic surgery
Subjects (LCSH)
Citation
Arun Nemani, Anil Kamat, Yuanyuan Gao, Meryem A. Yucel, Denise Gee, Clairice Cooper, Steven D. Schwaitzberg, Xavier Intes, Anirban Dutta, and Suvranu De "Functional brain connectivity related to surgical skill dexterity in physical and virtual simulation environments," Neurophotonics 8(1), 015008 (3 March 2021). https://doi.org/10.1117/1.NPh.8.1.015008
Abstract
Significance: Surgical simulators, both virtual and physical, are increasingly used as training tools for teaching and assessing surgical technical skills. However, the metrics used for assessment in these simulation environments are often subjective and inconsistent.
Aim: We propose functional activation metrics, derived from brain imaging measurements, to objectively assess the correspondence between brain activation with surgical motor skills for subjects with varying degrees of surgical skill.
Approach: Cortical activation based on changes in the oxygenated hemoglobin (HbO) of 36 subjects was measured using functional near-infrared spectroscopy at the prefrontal cortex (PFC), primary motor cortex, and supplementary motor area (SMA) due to their association with motor skill learning. Inter-regional functional connectivity metrics, namely, wavelet coherence (WCO) and wavelet phase coherence were derived from HbO changes to correlate brain activity to surgical motor skill levels objectively.
Results: One-way multivariate analysis of variance found a statistically significant difference in the inter-regional WCO metrics for physical simulator based on Wilk’s Λ for expert versus novice, F ( 10,1 ) = 7495.5, p < 0.01. Partial eta squared effect size for the inter-regional WCO metrics was found to be highest between the central prefrontal cortex (CPFC) and SMA, CPFC-SMA (η2 = 0.257). Two-tailed Mann–Whitney U tests with a 95% confidence interval showed baseline equivalence and a statistically significant (p < 0.001) difference in the CPFC-SMA WPCO metrics for the physical simulator training group (0.960 ± 0.045) versus the untrained control group (0.735 ± 0.177) following training for 10 consecutive days in addition to the pretest and posttest days.
Conclusion: We show that brain functional connectivity WCO metric corresponds to surgical motor skills in the laparoscopic physical simulators. Functional connectivity between the CPFC and the SMA is lower for subjects that exhibit expert surgical motor skills than untrained subjects in laparoscopic physical simulators.
Table of Contents
Description
Publisher
SPIE
Journal
Neurophotonics
Book Title
Series
Digital Collection
Finding Aid URL
Use and Reproduction
Archival Collection
PubMed ID
ISSN
2329-423X
2329-4248
2329-4248