Electroencephalography correlates of transcranial direct-current stimulation enhanced surgical skill learning: A replication and extension study

Ciechanski, Patrick; Kirton, Adam; Wilson, Bethan; Williams, Chad C.; Anderson, Sarah; Cheng, Adam; Lopushinsky, Steven R.; Hecker, Kent G.

doi:10.1016/j.brainres.2019.146445

Cited by 28 publications

(48 citation statements)

References 41 publications

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“…For example, tDCS has been used to enhance performance in high cognitive load environments in the military 85,86 and surgery. 87,88 In these aforementioned applications, if fNIRS is combined with tDCS, a powerful tool could be established to elucidate the physiological impact of tDCS in the real-world settings and would be a step forward to transition the conventional neurophysiological studies from the laboratory to naturalistic environments.…”

Section: Future Considerationsmentioning

confidence: 99%

Systematic review of combined functional near-infrared spectroscopy and transcranial direct-current stimulation studies

et al. 2020

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Significance: Combining transcranial direct-current stimulation (tDCS) with functional nearinfrared spectroscopy (fNIRS) is a recent approach to exploring brain activation evoked by neurostimulation. Aim: To critically evaluate studies combining tDCS and fNIRS and provide a consolidated overview of cortical hemodynamic responses to neurostimulation. Approach: Key terms were searched in three databases (MEDLINE, EMBASE, and PsycINFO) with cross-referencing and works from Google Scholar also evaluated. All studies reporting on fNIRS-derived hemoglobin changes evoked by tDCS were included. Results: Literature searches revealed 474 articles, of which 28 were included for final review (22 in healthy individuals: 9 involving rest and 13 with tasks; 6 in the clinical setting). At rest, an overall increase in cortical activation was observed in fNIRS responses at the site of stimulation, with evidence suggesting nonstimulated brain regions are also similarly affected. Conversely, during tasks, reduced cortical activation was observed during online stimulation. Offline and poststimulation effects were less consistent, as is the impact on clinical populations and their symptom correlation. Conclusion: This review explores the methodological frameworks for fNIRS-tDCS evaluations and summarizes hemodynamic responses associated with tDCS in all populations. Our findings provide further evidence of the impact of tDCS on neuronal activation within functionally connected networks.

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Section: Future Considerationsmentioning

confidence: 99%

Systematic review of combined functional near-infrared spectroscopy and transcranial direct-current stimulation studies

et al. 2020

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“…In an fNIRS study, Choe et al (2016) showed that the performance improvement in pilot training due to tDCS is related to DLPFC and M1 region HbO. In EEG/MEG studies, strong correlations were observed between changes in beta band power (Sugata et al, 2018), alpha and gamma band power (Ciechanski et al, 2019), and motor learning performance.…”

Section: Suggested Neuroimaging Biomarkers For Motor Performance Undementioning

confidence: 98%

“…While in healthy participants, low beta event-related desynchronization (ERD) reduced after individual alpha frequency tACS ( Berntsen et al, 2019 ). However, beta power increased during surgical motor tasks after tDCS ( Ciechanski et al, 2019 ). Dutta et al (2014) observed the slope of slow cortical potentials (SCPs) of ankle flexions decreased after tDCS.…”

Section: Eegmentioning

confidence: 99%

The Effects of Transcranial Electrical Stimulation on Human Motor Functions: A Comprehensive Review of Functional Neuroimaging Studies

et al. 2020

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Transcranial electrical stimulation (tES) is a promising tool to enhance human motor skills. However, the underlying physiological mechanisms are not fully understood. On the other hand, neuroimaging modalities provide powerful tools to map some of the neurophysiological biomarkers associated with tES. Here, a comprehensive review was undertaken to summarize the neuroimaging evidence of how tES affects human motor skills. A literature search has been done on the PubMed database, and 46 relative articles were selected. After reviewing these articles, we conclude that neuroimaging techniques are feasible to be coupled with tES and offer valuable information of cortical excitability, connectivity, and oscillations regarding the effects of tES on human motor behavior. The biomarkers derived from neuroimaging could also indicate the motor performance under tES conditions. This approach could advance the understanding of tES effects on motor skill and shed light on a new generation of adaptive stimulation models.

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“…Correlating this to surgical technical tasks, there are currently three published studies investigating the impact of tDCS in laparoscopic skills tasks and simulated neurosurgical resection tasks in medical students. Compared with sham, tDCS improved performance in pattern‐cutting scores during a laparoscopic skills task (207·6 versus 186·0; P = 0·022), and there were significant improvements in resection efficiency during the neurosurgical task.…”

Section: Neuroenhancement By Neurostimulationmentioning

confidence: 99%

“…All studies have compared tDCS with sham stimulation to ensure that effects are not simply placebo in nature, but should be evaluated against traditional training approaches including team‐based scenarios and human factors sessions. Encouragingly, greater technical performance can be demonstrated in aspects of surgery in a simulated environment. It is not known whether these benefits will translate into faster achievement of technical competence in trainees or better clinical outcomes in practice.…”

Section: Neuroenhancement By Neurostimulationmentioning

confidence: 99%

Neuroenhancement in surgeons: benefits, risks and ethical dilemmas

Patel

Ashcroft

Darzi

et al. 2020

British Journal of Surgery

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Background Surgeons traditionally aim to reduce mistakes in healthcare through repeated training and advancement of surgical technology. Recently, performance‐enhancing interventions such as neurostimulation are emerging which may offset errors in surgical practice. Methods Use of transcranial direct‐current stimulation (tDCS), a novel neuroenhancement technique that has been applied to surgeons to improve surgical technical performance, was reviewed. Evidence supporting tDCS improvements in motor and cognitive performance outside of the field of surgery was assessed and correlated with emerging research investigating tDCS in the surgical setting and potential applications to wider aspects of healthcare. Ethical considerations and future implications of using tDCS in surgical training and perioperatively are also discussed. Results Outside of surgery, tDCS studies demonstrate improved motor performance with regards to reaction time, task completion, strength and fatigue, while also suggesting enhanced cognitive function through multitasking, vigilance and attention assessments. In surgery, current research has demonstrated improved performance in open knot‐tying, laparoscopic and robotic skills while also offsetting subjective temporal demands. However, a number of ethical issues arise from the potential application of tDCS in surgery in the form of safety, coercion, distributive justice and fairness, all of which must be considered prior to implementation. Conclusion Neuroenhancement may improve motor and cognitive skills in healthcare professions with impact on patient safety. Implementation will require accurate protocols and regulations to balance benefits with the associated ethical dilemmas, and to direct safe use for clinicians and patients.

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Electroencephalography correlates of transcranial direct-current stimulation enhanced surgical skill learning: A replication and extension study

Cited by 28 publications

References 41 publications

Systematic review of combined functional near-infrared spectroscopy and transcranial direct-current stimulation studies

Systematic review of combined functional near-infrared spectroscopy and transcranial direct-current stimulation studies

The Effects of Transcranial Electrical Stimulation on Human Motor Functions: A Comprehensive Review of Functional Neuroimaging Studies

Neuroenhancement in surgeons: benefits, risks and ethical dilemmas

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