Investigating the impact of mental rehearsal on prefrontal and motor cortical haemodynamic responses in surgeons using optical neuroimaging
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Introduction: Inadequate exposure to real-life operating can impede timely acquisition of technical competence among surgical residents, and is a major challenge faced in the current training climate. Mental rehearsal (MR) -the cognitive rehearsal of a motor task without overt physical movement -has been shown to accelerate surgical skills learning. However, the neuroplastic effect of MR of a complex bimanual surgical task is unknown. The aim of this study is to use functional near-infrared spectroscopy (fNIRS) to assess the impact of MR on prefrontal and motor cortical activation during a laparoscopic knot tying task. Methods: 12 surgical residents performed a laparoscopic knot tying task before and after either mental rehearsal (MR, intervention group) or textbook reading (TR, control group). In both groups, fNIRS was used to measure changes in oxygenated haemoglobin concentration (HbO2) in the prefrontal (24 channels) and motor cortices (22 channels). Technical performance was measured using leak volume, objective performance score and task progression score. Results: MR led to a decrease in HbO2 (reduced activation) in the bilateral prefrontal cortex (PFC), and an increase in HbO2 (increased activation) in the left middle frontal gyrus, left precentral gyrus, and left postcentral gyrus. No discernible changes in activation were observed after TR in either the PFC or motor cortex. Moreover, smaller ΔHbO2 responses in the right PFC and greater ΔHbO2 responses in the left motor cortex were observed in the MR group compared with the TR group. Leak volume was significantly less following MR (p=0.019), but not after TR (p=0.347). Mean objective performance score was significantly higher following MR compared with TR (p=0.043). Conclusion: Mental rehearsal may enhance surgical skill acquisition and technical proficiency by reducing utilisation of attentional resources in the prefrontal cortex and improving neural efficiency in motor areas during a laparoscopic surgical task.
Date Issued
2024-10-21
Date Acceptance
2024-10-03
Citation
Frontiers in Human Neuroscience, 2024, 18
ISSN
1662-5161
Publisher
Frontiers Media S.A.
Journal / Book Title
Frontiers in Human Neuroscience
Volume
18
Copyright Statement
© 2024 Modi, Osborne-Grinter, Patel, Darzi,
Leff and Singh. This is an open-access article
distributed under the terms of the Creative
Commons Attribution License (CC BY). The
use, distribution or reproduction in other
forums is permitted, provided the original
author(s) and the copyright owner(s) are
credited and that the original publication in
this journal is cited, in accordance with
accepted academic practice. No use,
distribution or reproduction is permitted
which does not comply with these terms.
Leff and Singh. This is an open-access article
distributed under the terms of the Creative
Commons Attribution License (CC BY). The
use, distribution or reproduction in other
forums is permitted, provided the original
author(s) and the copyright owner(s) are
credited and that the original publication in
this journal is cited, in accordance with
accepted academic practice. No use,
distribution or reproduction is permitted
which does not comply with these terms.
License URL
Identifier
https://www.frontiersin.org/journals/human-neuroscience/articles/10.3389/fnhum.2024.1386005/abstract
Publication Status
Published
Article Number
1386005
Date Publish Online
2024-10-21