UNASSIGNED: A literature search of PubMed and Embase was conducted to identify neuroimaging studies using fNIRS and neurostimulation in surgeons performing simulated tasks.
UNASSIGNED: Novice surgeons exhibit greater haemodynamic responses across the pre-frontal cortex than experts during simple surgical tasks, whilst expert surgical performance is characterized by relative prefrontal attenuation and upregulation of activation foci across other regions such as the supplementary motor area. The association between PFC activation and mental workload follows an inverted-U shaped curve, activation increasing then attenuating past a critical inflection point at which demands outstrip cognitive capacity Neuroimages are sensitive to the impact of laparoscopic and robotic tools on cognitive workload, helping inform the development of training programs which target neural learning curves. FNIRS differs in comparison to current tools to assess proficiency by depicting a cognitive state during surgery, enabling the development of cognitive benchmarks of expertise. Finally, neurostimulation using transcranial direct-current-stimulation may accelerate skill acquisition and enhance technical performance.
UNASSIGNED: FNIRS can inform the development of surgical training programs which modulate stress responses, cognitive learning curves, and motor skill performance. Improved data processing with machine learning offers the possibility of live feedback regarding surgeons\' cognitive states during operative procedures.
■对PubMed和Embase进行了文献检索,以确定在执行模拟任务的外科医生中使用fNIRS和神经刺激的神经影像学研究。
在简单的手术任务中,新手外科医生在前额叶皮层表现出比专家更大的血液动力学反应,而专家手术表现的特征是相对前额叶衰减和激活病灶在其他区域如补充运动区域的上调。PFC激活与心理负荷之间的关联遵循倒U形曲线,激活增加,然后衰减超过一个关键的拐点,在该拐点处需求超过认知能力。神经影像对腹腔镜和机器人工具对认知工作量的影响敏感。帮助为针对神经学习曲线的训练计划的开发提供信息。FNIRS与当前通过描述手术过程中的认知状态来评估熟练程度的工具相比有所不同。促进专业知识认知基准的发展。最后,使用经颅直流电刺激的神经刺激可以加速技能获取并提高技术表现。
■FNIRS可以为调节应激反应的外科训练计划的发展提供信息,认知学习曲线,和运动技能表现。改进的机器学习数据处理提供了关于手术期间外科医生认知状态的实时反馈的可能性。