Search

Simulation-based training is an effective tool for acquiring practical skills, specifically to train new surgeons in a controlled and hazard-free environment, it is however important to measure participants cognitive load to decide whether they are ready to go into a real surgery. In the present study we measured performance on a surgery simulator of medical students and interns, while their brain activity was monitored by a mobile EEG device. 38 medical studentswere underwent 3 experiments undergoing a task with Simbionix simulator, while their brain activity was measured using a single-channel EEG device (Aurora by Neurosteer). On each experiment, participants performed 3 repeats of a simulator task using laparoscopic hands. The retention between tasks was different on each experiment, to examine changes in performance and cognitive load biomarkers that occur during the task or as a results of night sleep consolidation. The participants behavioral performance improved with trial repetition in all 3 experiments. In Exps. 1 & 2, the theta band activity significantly decreased with better individual performance, as exhibited by some of the behavioral measurements of the simulator. The novel VC9 biomarker (previously shown to correlate with cognitive load), exhibited a significant decrease with better individual performance shown by all behavioral measurements. In correspondence with previous research, theta decreased with lower cognitive load and higher performance and the novel biomarker, VC9, showed higher sensitivity to load changes. Together, these measurements might be for neuroimaging assessment of cognitive load while performing simulator laparoscopic tasks. This could potentially be expanded to evaluate efficacy of different medical simulations to provide more efficient training to medical staff and to measure cognitive and mental load in real laparoscopic surgeries.

Post-operative cognitive decline is a well-known phenomenon and of crucial importance especially in the elderly. General anesthesia can be accomplished by inhalation-based (volatile) or total intravenous anesthesia (TIVA). While their effects on post-operative symptoms have been investigated, little is known about their influence on brain functionalities during the surgery itself. To assess differences 17 patients were divided to receive either volatile anesthesia (n=9), or TIVA (n=8). The level of anesthesia was kept to be equal in both groups. A single bipolar EEG electrode (Neurosteer system) was placed on the participants foreheads. It presented real-time activity and collected their data during the surgery. The dependent variables included frequency bands (delta, theta, alpha, and beta), and three features (VC9, ST4, and A0) previously extracted with the device and provided by Neurosteer. All surgeries were uneventful, and all patients showed bispectral index (BIS) score less than 60. Feature activity under volatile anesthesia (in comparison to TIVA) was significantly lower for the delta, theta and alpha frequency bands and for the three features. Further analysis showed that the largest difference between anesthesia types was for feature A0. The EEG frequency bands and novel brain activity features provide evidence that volatile anesthesia further reduces components of brain activity in comparison to TIVA anesthesia. Specifically, A0, which previously showed a correlation with cognitive decline severity and cognitive load, exhibited the most prominent difference between anesthesia types. Together, this study suggests that measuring brain activity during anesthesia using sensitive features, enables revealing that different anesthesia types may affect brain activity differently, which could affect the recovery from anesthesia, and consequently reduce post-operative cognitive decline