Browsing by Subject "Electroencephalogram"
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Item Augmenting mental imagery for robotic surgery using neurofeedback: results of a randomized controlled trial(Springer Nature, 2023) Anton, Nicholas E.; Ziliak, Meredith C.; Stefanidis, Dimitrios; Surgery, School of MedicineBackground: Mental imagery (MI) can enhance surgical skills. Research has shown that through brain-computer interface (BCI), it is possible to provide feedback on MI strength. We hypothesized that adding BCI to MI training would enhance robotic skill acquisition compared with controls. Methods: Surgical novices were recruited. At baseline, participants completed the Mental Imagery Questionnaire (MIQ) and the Vandenburg Mental Rotation Test (MRT). Students also performed several tasks on a robotic simulator. Participants were stratified based on MIQ and robotic skill and randomized into three groups: controls, MI, and MI and BCI training. All participants completed five 2-h training sessions. One hour was devoted to practicing robotic skill on the simulator. Additionally, controls completed crosswords for one hour, the MI group completed MI training and crosswords for one hour, and the MI + BCI group completed MI training and MI-related BCI training. Following training, participants completed the same baseline assessments. A Kruskal-Wallis test was used to determine differences between groups. Mann-Whitney U tests were performed to determine specific differences between groups. Results: Twenty-seven undergraduates participated. There were post-test differences on the MRT and knot tying task. Sub-analyses revealed that the MI + BCI group significantly outperformed the other groups on knot tying. There were no appreciable differences between the control and MI groups on any measures. Conclusions: Augmenting MI training with BCI led to significantly enhanced MI and robotic skill acquisition than traditional MI or robotic training methods. To optimize surgical skill acquisition in robotic and other surgical skills curricula, educators should consider utilizing MI with BCI training.Item Cohort study into the neural correlates of postoperative delirium: the role of connectivity and slow-wave activity(Elsevier, 2020-07) Tanabe, Sean; Mohanty, Rosaleena; Lindroth, Heidi; Casey, Cameron; Ballweg, Tyler; Farahbakhsh, Zahra; Krause, Bryan; Prabhakaran, Vivek; Banks, Matthew I.; Sanders, Robert D.; Medicine, School of MedicineBackground: Delirium frequently affects older patients, increasing morbidity and mortality; however, the pathogenesis is poorly understood. Herein, we tested the cognitive disintegration model, which proposes that a breakdown in frontoparietal connectivity, provoked by increased slow-wave activity (SWA), causes delirium. Methods: We recruited 70 surgical patients to have preoperative and postoperative cognitive testing, EEG, blood biomarkers, and preoperative MRI. To provide evidence for causality, any putative mechanism had to differentiate on the diagnosis of delirium; change proportionally to delirium severity; and correlate with a known precipitant for delirium, inflammation. Analyses were adjusted for multiple corrections (MCs) where appropriate. Results: In the preoperative period, subjects who subsequently incurred postoperative delirium had higher alpha power, increased alpha band connectivity (MC P<0.05), but impaired structural connectivity (increased radial diffusivity; MC P<0.05) on diffusion tensor imaging. These connectivity effects were correlated (r2=0.491; P=0.0012). Postoperatively, local SWA over frontal cortex was insufficient to cause delirium. Rather, delirium was associated with increased SWA involving occipitoparietal and frontal cortex, with an accompanying breakdown in functional connectivity. Changes in connectivity correlated with SWA (r2=0.257; P<0.0001), delirium severity rating (r2=0.195; P<0.001), interleukin 10 (r2=0.152; P=0.008), and monocyte chemoattractant protein 1 (r2=0.253; P<0.001). Conclusions: Whilst frontal SWA occurs in all postoperative patients, delirium results when SWA progresses to involve posterior brain regions, with an associated reduction in connectivity in most subjects. Modifying SWA and connectivity may offer a novel therapeutic approach for delirium.Item Disturbed resting state EEG synchronization in bipolar disorder: A graph-theoretic analysis(Elsevier, 2013-03-22) Kim, Dae-Jin; Bolbecker, Amanda R.; Howell, Josselyn; Rass, Olga; Sporns, Olaf; Hetrick, William P.; Breier, Alan; O'Donnell, Brian F.; Psychiatry, School of MedicineDisruption of functional connectivity may be a key feature of bipolar disorder (BD) which reflects disturbances of synchronization and oscillations within brain networks. We investigated whether the resting electroencephalogram (EEG) in patients with BD showed altered synchronization or network properties. Resting-state EEG was recorded in 57 BD type-I patients and 87 healthy control subjects. Functional connectivity between pairs of EEG channels was measured using synchronization likelihood (SL) for 5 frequency bands (δ, θ, α, β, and γ). Graph-theoretic analysis was applied to SL over the electrode array to assess network properties. BD patients showed a decrease of mean synchronization in the alpha band, and the decreases were greatest in fronto-central and centro-parietal connections. In addition, the clustering coefficient and global efficiency were decreased in BD patients, whereas the characteristic path length increased. We also found that the normalized characteristic path length and small-worldness were significantly correlated with depression scores in BD patients. These results suggest that BD patients show impaired neural synchronization at rest and a disruption of resting-state functional connectivity.Item Sensor-based indicators of performance changes between sessions during robotic surgery training(Elsevier, 2021) Wu, Chuhao; Cha, Jackie; Sulek, Jay; Sundaram, Chandru P.; Wachs, Juan; Proctor, Robert W.; Yu, Denny; Urology, School of MedicineTraining of surgeons is essential for safe and effective usage of robotic surgery, yet current assessment tools for learning progression are limited. The objective of this study was to measure changes in trainees’ cognitive and behavioral states as they progressed in a robotic surgeon training curriculum at a medical institution. Seven surgical trainees in urology who had no formal robotic training experience participated in the simulation curriculum. They performed 12 robotic skills exercises with varying levels of difficulty repetitively in separate sessions. EEG (electroencephalogram) activity and eye movements were measured throughout to calculate three metrics: engagement index (indicator of task engagement), pupil diameter (indicator of mental workload) and gaze entropy (indicator of randomness in gaze pattern). Performance scores (completion of task goals) and mental workload ratings (NASA-Task Load Index) were collected after each exercise. Changes in performance scores between training sessions were calculated. Analysis of variance, repeated measures correlation, and machine learning classification were used to diagnose how cognitive and behavioral states associate with performance increases or decreases between sessions. The changes in performance were correlated with changes in engagement index (rrm = −.25, p < .001) and gaze entropy (rrm = −.37, p < .001). Changes in cognitive and behavioral states were able to predict training outcomes with 72.5% accuracy. Findings suggest that cognitive and behavioral metrics correlate with changes in performance between sessions. These measures can complement current feedback tools used by medical educators and learners for skills assessment in robotic surgery training.