Abstract
BACKGROUND: Surgeons learn to perform highly repetitive movements, improving their speed and precision. Simple movements elicit a synchronization of alpha frequency band (8–12 Hz) in the occipital area, reflecting the inhibition of irrelevant areas. Yet, there is limited evidence on alpha modulation by movement performance and task experience and demands for complex visuo-motor skills. In this study we evaluated the extent of the modulation of the electroencephalogram (EEG) power in the alpha frequency band (8–12 Hz) in the visual areas and its relationship with suture performance to quantify the attentional modulation in expert surgeons and medical students. The EEG based measurements might offer a relevant measure of attentional modulation, to evaluate the progression and outcomes of learning and training surgical programs. Two groups of expert surgeons and medical students performed 6 surgical exercises on a suture pad, under two different task demands. They performed an open suture technique under relaxed conditions and stressed conditions. We obtained the EEG alpha power spectra, using a 20-20 system EEG device while suturing as well as in a baseline, eyes-open, condition as well as the number as sutures as an index of performance.RESULTS: Surgical expertise resulted in twice the number of sutures and greater task demands increased suture performance by 20%. In contrast, alpha power in the occipital areas is greater in surgeons and medical students performing sutures, relative to the baseline, yet it is not modulated by expertise or task demands. Interestingly, the alpha power correlated positively with suture performance in surgeons, but not in the medical students.CONCLUSIONS: The modulation of the EEG alpha power is consistent with the inhibitory-attentional hypothesis of alpha rhythm in a complex visuo-motor task, suggesting that the attentional resources allocated to the visual areas are redistributed in the somatosensory and motor areas, in addition to the visual areas during the suture task relative to the baseline. Furthermore, the association of alpha power with suture performance suggests that, unlike medical students, experts have a gradual redistribution of the inhibitory-attentional resources linked to their suture performance.