Perception action cycle-related brain networks differentiate experts and novices: a combined EEG, fNIRS study during a complex surgical motor task

Abstract

Perception-action cycle-based motor learning theory postulates coupled action and perception for visuomotor learning. We hypothesized that perception-action-related brain connectivity will underpin visuomotor skill levels in a complex motor task based on this theory. We tested our hypothesis using multi-modal brain imaging on healthy human subjects (N=6 experts, N= 8 novice, all right-handed) during the performance of fundamentals of laparoscopic surgery (FLS) "suturing and intracorporeal knot-tying" task. We investigated dynamic directed brain networks using nonoverlapping sliding window-based spectral Granger causality (GC) from simultaneously acquired electroencephalogram (EEG), and functional near-infrared spectroscopy (fNIRS) signals. Our GC analysis on EEG signals showed the flow of information from the supplementary motor area complex (SMA) to the left primary motor cortex (LM1) that was statistically different (p <0.05) between the experts and novices. This result aligned with the perception action cycle theory where SMA is central to the orderly descent from the prefrontal to the motor cortex in Fuster's perception-action processing stages. The GC analysis of the fNIRS oxyhemoglobin signal revealed the connectivity from left to right primary motor cortex (LM1 to RM1) and LM1 to left prefrontal cortex (LPFC) that was significantly different (p <0.05) between the cohorts. Here, our preliminary results supported the involvement of perception-action-related directed brain connectivity in distinguishing the skill levels during a complex laparoscopic task that was measured with portable brain imaging during task performance. Future studies need to investigate the fusion of the EEG and fNIRS networks for the causal brain-behavior analysis of complex motor skill acquisition.