Hannah Palmer, Morgan L Cox, Zhi-De Deng, Amanda Watts, Lysianne Beynel, Jonathan R Young, Sarah H Lisanby, John Migaly and Lawrence G Appelbaum
Duke University, USA
National Institute of Mental Health - NIH, USA
Posters & Accepted Abstracts: J Neurol Neurophysiol
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that delivers constant, low voltage electrical current to the cortex. This approach has been shown to create changes in cortical excitability leading to greater learning when paired with manual skill training. Laparoscopic surgery requires mastery of bimanual motor skills in order to obtain board certification. Training to proficiency can take extensive time and practice. Therefore, use of tDCS in laparoscopic technical skill training could lead to accelerated motor learning in less time. To test this hypothesis, sixty participants were randomized to active or sham tDCS between two different stimulation configurations: bilateral motor cortex (bM1) and supplementary motor area (SMA). Training included repetition of the Fundamentals of Laparoscopic Surgery (FLS) peg-transfer task over six, 20-min sessions and completion of pre- and post testing sessions of one repetition each. Videos were recorded and scored accounting for errors such as bad transfers and dropping the object outside the field-of-view. Linear mixed effects models were tested comparing the active configurations to sham. A significant main effect of session was observed with increased learning in all groups. Moreover, bM1 stimulation demonstrated significantly greater learning than sham (p<0.03) leading to faster skill acquisition. SMA stimulation produced greater average learning though this condition did not differ significantly from sham. In conclusion, laparoscopic technical skills were enhanced using active bM1 stimulation, demonstrating the potential for noninvasive brain stimulation to aid in learning of manual technical skills in surgery.
Hannah Palmer has completed her MS in Biomedical Sciences from Duke University School of Medicine. She is currently a Clinical Trials Specialist at Duke University in the Department of Psychiatry and Behavioral Sciences. She conducts research within the division of Brain Stimulation and Neurophysiology using various brain stimulation techniques such as Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS) with both clinical populations and healthy volunteers.
E-mail: hlp14@duke.edu