Frontal theta brain activity varies as a function of surgical experience and task error

Objective Investigations into surgical expertise have almost exclusively focused on overt behavioral characteristics with little consideration of the underlying neural processes. Recent advances in neuroimaging technologies, for example, wireless, wearable scalp-recorded electroencephalography (EEG)...

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Main Authors: Faisal Mushtaq, Mark A Mon-Williams, Michael Manogue, Ahmed Mohammed Balkhoyor, Muhammad Awais, Shekhar Biyani, Alexandre Schaefer, Matt Craddock, Olivia Jones
Format: Article
Language:English
Published: BMJ Publishing Group 2020-12-01
Series:BMJ Surgery, Interventions, & Health Technologies
Online Access:https://sit.bmj.com/content/2/1/e000040.full
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author Faisal Mushtaq
Mark A Mon-Williams
Michael Manogue
Ahmed Mohammed Balkhoyor
Muhammad Awais
Shekhar Biyani
Alexandre Schaefer
Matt Craddock
Olivia Jones
author_facet Faisal Mushtaq
Mark A Mon-Williams
Michael Manogue
Ahmed Mohammed Balkhoyor
Muhammad Awais
Shekhar Biyani
Alexandre Schaefer
Matt Craddock
Olivia Jones
author_sort Faisal Mushtaq
collection DOAJ
description Objective Investigations into surgical expertise have almost exclusively focused on overt behavioral characteristics with little consideration of the underlying neural processes. Recent advances in neuroimaging technologies, for example, wireless, wearable scalp-recorded electroencephalography (EEG), allow an insight into the neural processes governing performance. We used scalp-recorded EEG to examine whether surgical expertise and task performance could be differentiated according to an oscillatory brain activity signal known as frontal theta—a putative biomarker for cognitive control processes.Design, setting, and participants Behavioral and EEG data were acquired from dental surgery trainees with 1 year (n=25) and 4 years of experience (n=20) while they performed low and high difficulty drilling tasks on a virtual reality surgical simulator. EEG power in the 4–7 Hz range in frontal electrodes (indexing frontal theta) was examined as a function of experience, task difficulty and error rate.Results Frontal theta power was greater for novices relative to experts (p=0.001), but did not vary according to task difficulty (p=0.15) and there was no Experience × Difficulty interaction (p=0.87). Brain–behavior correlations revealed a significant negative relationship between frontal theta and error in the experienced group for the difficult task (r=−0.594, p=0.0058), but no such relationship emerged for novices.Conclusion We find frontal theta power differentiates between surgical experiences but correlates only with error rates for experienced surgeons while performing difficult tasks. These results provide a novel perspective on the relationship between expertise and surgical performance.
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spelling doaj-art-53ced06c80ee416ba0b1f95773fa92b42024-11-20T14:00:09ZengBMJ Publishing GroupBMJ Surgery, Interventions, & Health Technologies2631-49402020-12-012110.1136/bmjsit-2020-000040Frontal theta brain activity varies as a function of surgical experience and task errorFaisal Mushtaq0Mark A Mon-Williams1Michael Manogue2Ahmed Mohammed Balkhoyor3Muhammad Awais4Shekhar Biyani5Alexandre Schaefer6Matt Craddock7Olivia Jones8School of Psychology, University of Leeds, Leeds, UKSchool of Psychology, University of Leeds, Leeds, UKSchool of Dentistry, University of Leeds, Leeds, UKSchool of Dentistry, University of Leeds, Leeds, UKSchool of Psychology, University of Leeds, Leeds, UKUrology, St James University Hospital, Leeds, UKDepartment of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Selangor, MalaysiaSchool of Psychology, Lincoln University, Lincoln, UKSchool of Psychology, University of Leeds, Leeds, UKObjective Investigations into surgical expertise have almost exclusively focused on overt behavioral characteristics with little consideration of the underlying neural processes. Recent advances in neuroimaging technologies, for example, wireless, wearable scalp-recorded electroencephalography (EEG), allow an insight into the neural processes governing performance. We used scalp-recorded EEG to examine whether surgical expertise and task performance could be differentiated according to an oscillatory brain activity signal known as frontal theta—a putative biomarker for cognitive control processes.Design, setting, and participants Behavioral and EEG data were acquired from dental surgery trainees with 1 year (n=25) and 4 years of experience (n=20) while they performed low and high difficulty drilling tasks on a virtual reality surgical simulator. EEG power in the 4–7 Hz range in frontal electrodes (indexing frontal theta) was examined as a function of experience, task difficulty and error rate.Results Frontal theta power was greater for novices relative to experts (p=0.001), but did not vary according to task difficulty (p=0.15) and there was no Experience × Difficulty interaction (p=0.87). Brain–behavior correlations revealed a significant negative relationship between frontal theta and error in the experienced group for the difficult task (r=−0.594, p=0.0058), but no such relationship emerged for novices.Conclusion We find frontal theta power differentiates between surgical experiences but correlates only with error rates for experienced surgeons while performing difficult tasks. These results provide a novel perspective on the relationship between expertise and surgical performance.https://sit.bmj.com/content/2/1/e000040.full
spellingShingle Faisal Mushtaq
Mark A Mon-Williams
Michael Manogue
Ahmed Mohammed Balkhoyor
Muhammad Awais
Shekhar Biyani
Alexandre Schaefer
Matt Craddock
Olivia Jones
Frontal theta brain activity varies as a function of surgical experience and task error
BMJ Surgery, Interventions, & Health Technologies
title Frontal theta brain activity varies as a function of surgical experience and task error
title_full Frontal theta brain activity varies as a function of surgical experience and task error
title_fullStr Frontal theta brain activity varies as a function of surgical experience and task error
title_full_unstemmed Frontal theta brain activity varies as a function of surgical experience and task error
title_short Frontal theta brain activity varies as a function of surgical experience and task error
title_sort frontal theta brain activity varies as a function of surgical experience and task error
url https://sit.bmj.com/content/2/1/e000040.full
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