Effect of brain alpha oscillation on the performance in laparoscopic skills simulator training

Background Laparoscopic skill involves sensory processing and motor control, which is associated with high-level alpha oscillation of the brain. Neurofeedback (NF) has been reported effective in enhancing alpha oscillation. Our objectives were to assess the alpha oscillation during laparoscopic skills training, and to verify the usefulness of NF in improving the learning efficacy. Methods Sixty medical students without laparoscopic experience were recruited. Multi-channel electroencephalography (EEG) signals were recorded during training of peg transfer task. Training performance was assessed based on the task completion time. All subjects participated in the first experiment comprising eight training blocks and one testing block. Subjects were ranked based on performance: the top 20 subjects were classified as the good performance group and the bottom 20 subjects as the fair performance group. In the second experiment, the fair performance group were randomly divided into the NF and control groups. Spectral analysis of EEG signals was used to calculate alpha power and alpha band coherence. Training performance and EEG alpha powers were compared between the NF and control groups. Results In the first experiment, the completion time was significantly faster in the good performance group (62.5 +/- 2.8 s) compared with the fair performance group (75.0 +/- 5.6 s) (P < 0.05). EEG oscillations showed strong alpha power and alpha coherence in the posterior electrode clusters in the good performance group. In the second experiment, the NF group showed much stronger alpha activity power and coherence compared with the control group. Furthermore, the NF training led to a significant performance improvement from 75.1 +/- 5.9 s in the first experiment to 64.3 +/- 4.9 s in the second experiment (P = 0.003). Conclusions The learning performance of laparoscopic skills varies among individuals. Subjects with good performance results had high alpha power and strong alpha coherence. The alpha enhancement NF increased alpha oscillations, leading to improved learning efficacy.