There are technical challenges in recording EEG during procedures, as pain induces motor movements. More research is needed to determine the most sensitive approach to measure EEG signals within the context of pain in infancy.
IntroductionCognitive Load Theory (CLT) relates to the efficiency with which individuals manipulate the limited capacity of working memory load. Repeated training generally results in individual performance increase and cognitive load decrease, as measured by both behavioral and neuroimaging methods. One of the known biomarkers for cognitive load is frontal theta band, measured by an EEG. Simulation-based training is an effective tool for acquiring practical skills, specifically to train new surgeons in a controlled and hazard-free environment. Measuring the cognitive load of young surgeons undergoing such training can help to determine whether they are ready to take part in a real surgery. In this study, we measured the performance of medical students and interns in a surgery simulator, while their brain activity was monitored by a single-channel EEG.MethodsA total of 38 medical students and interns were divided into three groups and underwent three experiments examining their behavioral performances. The participants were performing a task while being monitored by the Simbionix LAP MENTOR™. Their brain activity was simultaneously measured using a single-channel EEG with novel signal processing (Aurora by Neurosteer®). Each experiment included three trials of a simulator task performed with laparoscopic hands. The time retention between the tasks was different in each experiment, in order to examine changes in performance and cognitive load biomarkers that occurred during the task or as a result of nighttime sleep consolidation.ResultsThe participants’ behavioral performance improved with trial repetition in all three experiments. In Experiments 1 and 2, delta band and the novel VC9 biomarker (previously shown to correlate with cognitive load) exhibited a significant decrease in activity with trial repetition. Additionally, delta, VC9, and, to some extent, theta activity decreased with better individual performance.DiscussionIn correspondence with previous research, EEG markers delta, VC9, and theta (partially) decreased with lower cognitive load and higher performance; the novel biomarker, VC9, showed higher sensitivity to lower cognitive load levels. Together, these measurements may be used for the neuroimaging assessment of cognitive load while performing simulator laparoscopic tasks. This can potentially be expanded to evaluate the efficacy of different medical simulations to provide more efficient training to medical staff and measure cognitive and mental loads in real laparoscopic surgeries.
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Background: Cognitive decline remains highly underdiagnosed in the community despite extensive efforts to find novel biomarkers to detect it. Finding objective screening tools for cognitive decline may improve early diagnosis of Alzheimer′s disease (AD) in the community. EEG biomarkers based on machine learning (ML) may offer a noninvasive low-coast approach for identifying cognitive decline with clinically useful accuracy. However, most of the studies use multi-electrode systems which are not vastly accessible. This study aims to evaluate the ability to extract cognitive decline biomarkers using a wearable single-channel EEG system with a short interactive cognitive assessment tool. Methods: Seniors in different clinical stages of cognitive decline (healthy to mild dementia, n=60) and young healthy participants (n=22) performed a cognitive assessment which included auditory detection and resting state tasks, while being recorded with a single-channel EEG (Aurora by Neurosteer®). Seniors′ MMSE scores were obtained by clinicians and used in allocating the groups (Healthy: MMSE>28; MCI-R: 28>MMSE>24; and MD: MMSE<24). Data analysis included standard frequency bands as well as three novel biomarkers, A0, ST4 and VC9, previously extracted from a different dataset to minimize overfitting risks. Results: Correlation between MMSE scores and reaction times was significant, validating the cognitive assessment tool. Individual MMSE scores correlated significantly with two of the EEG biomarkers: A0 and ST4. Furthermore, A0 and ST4 showed significant separation between groups of seniors with high vs. low MMSE scores, as well as the healthy young group. ST4 separated between the healthy groups (young and seniors) and the low MMSE (MD) group. Conversely, A0 differentiated between the healthy young group and all three groups of seniors. In the healthy young group, activity of Theta band and VC9 biomarker significantly increased with higher cognitive load, with both separating between the high cognitive load task and resting state. Furthermore, VC9 showed a finer separation between high and low cognitive load levels within the cognitive task. This was not shown in the senior groups, suggesting VC9 may be indicative to cognitive decline in the senior population. Conclusions: These results introduce novel biomarkers which potentially detect cognitive decline, obtained by a wearable single-channel EEG with a short interactive cognitive assessment. Such objective screening tools can be used on a large scale to detect cognitive decline and potentially allow early diagnosis of AD in every clinic.
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