Researchers at Johns Hopkins University have found that gentle electrical stimulation of the cerebellum significantly improves the transition from virtual reality training to real-world tasks in robotic surgery, and in medical and technical training. It shows potential advances in the method.

People who received a mild electrical current to the back of the head learned to operate a robotic surgical tool in virtual reality and subsequently operated the robotic surgical tool in a real environment much more easily than those who did not receive such stimulation. A new study shows that.

The study results provide the first glimpse of how stimulating a specific part of the brain, called the cerebellum, could help medical professionals apply what they learn in virtual reality to the real operating room. It’s a much-needed transition in a field that is increasingly reliant on digital simulation training. “It’s important to remember that this is the case,” said author Jeremy D. Brown, a robotics engineer at Johns Hopkins University.

“Training in virtual reality is not the same as training in a real environment. Previous research has shown that skills learned in simulation can be difficult to transfer to the real world.” , said Mr. Brown of John C. Kennedy. Malone Associate Professor of Mechanical Engineering. “Although it is very difficult to claim statistical accuracy, the participants in the study concluded that when they received this stimulation, they were able to more easily transfer skills from virtual reality to the real world. ”

This work was published today (December 20th). Nature scientific report.

Participants drove surgical needles through three small holes, first in a virtual simulation and then in a real-life scenario using the da Vinci Research Kit, an open-source research robot. Researchers say the exercise mimics the movements required during surgery on abdominal organs.

Participants received a subtle flow of electricity through electrodes or small pads placed on their scalp to stimulate the cerebellum of the brain. Half of the group received a steady flow of electricity throughout the test, while the remaining participants received only a short stimulation at the beginning and nothing at all for the rest of the test.

Those who received steady flow showed significant improvements in dexterity. None of them had prior training in surgery or robotics.

“The unstimulated group had a little more trouble applying the skills they learned in virtual reality to the real robot, especially the most complex movements that involve rapid movements,” said Johns Hopkins University roboticist and former robotics engineer. , said Guido Caccianiga, now of Max. Planck Institute for Intelligent Systems, which designed and led the experiment; “The group that received brain stimulation did better at those tasks.”

Non-invasive brain stimulation is a method of influencing specific parts of the brain from outside the body, and scientists say they have shown how it can aid motor learning in rehabilitation therapy. Ta. Co-author Gabriela Cantarello, a former assistant professor of physical therapy and rehabilitation, said the research team is looking at how surgeons can stimulate their brains to acquire skills they might need in real-world situations. He said he was taking research to a new level by testing whether it could help. at Johns Hopkins University.

“It’s really great to be able to use this setup to actually influence behavior and really quantify every little aspect of people’s movements, deviations, and errors,” Cantarello said.

Study participants undergoing non-invasive brain stimulation sit at the console of a surgical robot and use a virtual reality simulation of needle-stroke practice. Credit: Guido Caccianiga/Johns Hopkins University.

Robotic surgical systems offer significant benefits to clinicians by improving human skills. It helps surgeons minimize hand tremors and enhance vision for detailed and precise work.

In addition to impacting the way future surgeons learn new skills, this type of brain stimulation also holds promise for skill acquisition in other industries that rely on virtual reality training, particularly in the field of robotics.

Even outside of virtual reality, this stimulation is likely to help people learn more generally, the researchers said.

“What if we could prove that if you stimulate your brain, you can learn new skills in half the time?” Caccianiga said. “This will significantly reduce costs because we can train people more quickly. We will have more resources to train more surgeons and engineers who will be working frequently with these technologies in the future. You can save.”

Reference: “Anodal cerebellar t-DCS influences skill learning and transfer in robotic surgical training tasks” by Guido Caccianiga, Ronan A. Mooney, Pablo A. Celnik, Gabriela L. Cantarero, and Jeremy D. Brown, 2023 December 20th, scientific report.
DOI: 10.1038/s41598-023-47404-1

Other authors include Ronan A. Mooney of the Johns Hopkins University School of Medicine and Pablo A. Selnik of the Shirley Ryan Ability Lab.