Brain network effects related to physical and virtual surgical training revealed by Granger causality

this study investigates the difference in effective connectivity among novice medical students trained on physical and virtual simulators to perform the Fundamental laparoscopic surgery (FLS) pattern cutting task (PC). We propose using dynamic spectral Granger causality (GC) in the frequency band of [0.01-0.07]Hz to measure the effect of surgical training on effective brain connectivity. To obtain the dynamics relationship between the cortical regions, we propose to use the short-time Fourier transform (STFT) method. FLS pattern cutting is a complex bimanual task requiring fine motor skills and increased brain activity. With this in mind, we have used high resolution functional near-infrared spectroscopy to leverage its high temporal resolution for capturing the change in hemodynamics (HbO2) in 14 healthy subjects. Analysis of variance (ANOVA) found a statistically significant difference in "LPMC granger causes RPMC" (LPMC→ RPMC) in the subject trained on these two simulator in the first 40 sec of the task. We showed that the directed brain connectivity was affected by the type of surgical simulator used for training the medical students.