Brain-in-the-Loop Learning Using fNIR and Simulated Virtual Reality Surgical Tasks: Hemodynamic and Behavioral Effects

Functional near infrared spectroscopy (fNIR) is a noninvasive, portable optical imaging tool to monitor changes in hemodynamic responses (i.e., oxygenated hemoglobin (HbO)) within the prefrontal cortex (PFC) in response to sensory, motor or cognitive activation. We used fNIR for monitoring PFC activation during learning of simulated laparoscopic surgical tasks throughout 4 days of training and testing. Blocked (BLK) and random (RND) practice orders were used to test the practice schedule effect on behavioral, hemodynamic responses and relative neural efficiency (EFFrel-neural) measures during transfer. Left and right PFC for both tasks showed significant differences with RND using less HbO than BLK. Cognitive workload showed RND exhibiting high EFFrel-neural across the PFC for the coordination task while the more difficult cholecystectomy task showed EFFrel-neural differences only in the left PFC. Use of brain activation, behavioral and EFFrel-neural measures can provide a more accurate depiction of the generalization or transfer of learning.