The Effects of Unilateral Transcranial Direct Current Stimulation on Unimanual Laparoscopic Peg-Transfer Task

Abstract

Introduction: Efficient training methods are required for laparoscopic surgical skills training to reduce the time needed for proficiency. Transcranial direct current stimulation (tDCS) is widely used to enhance motor skill acquisition and can be used to supplement the training of laparoscopic surgical skill acquisition. The aim of this study was to investigate the effect of anodal tDCS over the primary motor cortex (M1) on the performance of a unimanual variant of the laparoscopic peg-transfer task. Methods: Fifteen healthy subjects participated in this randomized, double-blinded crossover study involving an anodal tDCS and a sham tDCS intervention separated by 48 hours. On each intervention day, subjects performed a unimanual variant of laparoscopic peg-transfer task in three sessions (baseline, tDCS, post-tDCS). The tDCS session consisted of 10 minutes of offline tDCS followed by 10 minutes of online tDCS. The scores based on the task completion time and the number of errors in each session were used as a primary outcome measure. A linear mixed-effects model was used for the analysis. Results: We found that the scores increased over sessions (p<0.001). However, we found no effects of stimulation (anodal tDCS vs. sham tDCS) and no interaction of stimulation and sessions. Conclusion: This study suggests that irrespective of the type of current stimulation (anodal and sham) over M1, there was an improvement in the performance of the unimanual peg-transfer task, implying that there was motor learning over time. The results would be useful in designing efficient training paradigms and further investigating the effects of tDCS on laparoscopic peg-transfer tasks.

M1 transcranial Direct Current Stimulation augments laparoscopic surgical skill acquisition

“…The few studies to date vary not only according to their methodological rigour but also by the site of neurostimulation, the tasks experimenters evaluated and the metrics that were used to quantify performance. For example, stimulation has largely been administered over the prefrontal cortex [18] [19], primary motor cortex [20][21] [22] or supplementary motor area (SMA; [21]), with most manually evaluating basic metrics of performance including the time to complete the task [19] [23] or a score related to the number of errors made [18] [20][21] [24]. However, research highlighting the need for more robust and objective metrics to quantify surgical performance has shown that the inclusion of biomechanical measures such as instrument movement e ciency, velocity, and positioning can provide a more complete description of surgical skill [25][26] [27].…”