Spinal Division of Orthopedic and Traumatology Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.
Department of Orthopaedics and Traumatology, The University of Hong Kong, 12 Sandy Bay Road, Hong Kong, China.
Surg Endosc. 2021 Feb;35(2):584-592. doi: 10.1007/s00464-020-07419-5. Epub 2020 Feb 19.
Laparoscopic skill involves sensory processing and motor control, which is associated with high-level alpha oscillation of the brain. Neurofeedback (NF) has been reported effective in enhancing alpha oscillation. Our objectives were to assess the alpha oscillation during laparoscopic skills training, and to verify the usefulness of NF in improving the learning efficacy.
Sixty medical students without laparoscopic experience were recruited. Multi-channel electroencephalography (EEG) signals were recorded during training of peg transfer task. Training performance was assessed based on the task completion time. All subjects participated in the first experiment comprising eight training blocks and one testing block. Subjects were ranked based on performance: the top 20 subjects were classified as the good performance group and the bottom 20 subjects as the fair performance group. In the second experiment, the fair performance group were randomly divided into the NF and control groups. Spectral analysis of EEG signals was used to calculate alpha power and alpha band coherence. Training performance and EEG alpha powers were compared between the NF and control groups.
In the first experiment, the completion time was significantly faster in the good performance group (62.5 ± 2.8 s) compared with the fair performance group (75.0 ± 5.6 s) (P < 0.05). EEG oscillations showed strong alpha power and alpha coherence in the posterior electrode clusters in the good performance group. In the second experiment, the NF group showed much stronger alpha activity power and coherence compared with the control group. Furthermore, the NF training led to a significant performance improvement from 75.1 ± 5.9 s in the first experiment to 64.3 ± 4.9 s in the second experiment (P = 0.003).
The learning performance of laparoscopic skills varies among individuals. Subjects with good performance results had high alpha power and strong alpha coherence. The alpha enhancement NF increased alpha oscillations, leading to improved learning efficacy.
腹腔镜技能涉及感觉处理和运动控制，这与大脑的高级 alpha 振荡有关。神经反馈（NF）已被报道可有效增强 alpha 振荡。我们的目的是评估腹腔镜技能训练过程中的 alpha 振荡，并验证 NF 在提高学习效果方面的有用性。
招募了 60 名没有腹腔镜经验的医学生。在进行 peg 转移任务训练时，记录多通道脑电图（EEG）信号。根据任务完成时间评估培训绩效。所有受试者均参加了包含 8 个训练块和 1 个测试块的第一个实验。根据表现对受试者进行排名：前 20 名受试者被归类为表现良好组，后 20 名受试者被归类为表现一般组。在第二个实验中，表现一般组被随机分为 NF 组和对照组。使用 EEG 信号的频谱分析来计算 alpha 功率和 alpha 频带相干性。比较 NF 组和对照组的训练绩效和 EEG alpha 功率。
在第一个实验中，表现良好组（62.5±2.8 s）的完成时间明显快于表现一般组（75.0±5.6 s）（P<0.05）。表现良好组在后电极簇中表现出较强的 alpha 功率和 alpha 相干性。在第二个实验中，NF 组的 alpha 活动功率和相干性明显强于对照组。此外，与第一个实验中的 75.1±5.9 s 相比，NF 训练导致第二个实验中的表现显著提高，达到 64.3±4.9 s（P=0.003）。
腹腔镜技能的学习表现因人而异。表现良好的受试者具有较高的 alpha 功率和较强的 alpha 相干性。增强 alpha 的 NF 增加了 alpha 振荡，从而提高了学习效果。
