Brain Plasticity Related to Psychomotor Skills in Catheter-based Interventions

A fascinating property of the brain is its ability to reorganise as a result of experience. Practice-related change has been shown in grey and white matter as a result of for example juggling training, but tasks that require many interrelated skills such as very fine motor skills, mental rotation and tactile perception have not been examined yet. For Catheter-based interventions (e.g., Dotter treatments), where catheters are used to treat blood vessel disease, these skills are crucial: using the catheter, neither direct view nor direct access is granted. The only means to visualize the catheter’s position in the blood vessel are x-ray images, which are imperfect and susceptible to geometric illusions. In this research project, we will use three MRI methods to examine whether the structure of white and grey matter and the intrinsic functional connectivity change as a result of developing the psycho-motor skills necessary for catheterisation. Participants will be 40 undergraduate medical students (of which 20 age and gender-matched controls). On day one, MRI pre scans (T1-weighted, diffusion-weighted and resting state fMRI) will be performed and a number of cognitive tests are taken. On day two, the experimental group will watch an instruction video and practice the psycho-motor skills of catheterisation for two hours on a high-fidelity catheter-lab simulator. On day three, the experimental group practices again for two hours on the simulator and takes a procedural test. Finally, structural and functional post MRI scans are performed and the cognitive test battery is administered again. <br/

Mental rotation ability predicts the acquisition of basic endovascular skills

Abstract Due to the increasing complexity of diseases in the aging population and rapid progress in catheter-based technology, the demands on operators’ skills in conducting endovascular interventions (EI) has increased dramatically, putting more emphasis on training. However, it is not well understood which factors influence learning and performance. In the present study, we examined the ability of EI naïve medical students to acquire basic catheter skills and the role of pre-existing cognitive ability and manual dexterity in predicting performance. Nineteen medical students practised an internal carotid artery angiography during a three-day training on an endovascular simulator. Prior to the training they completed a battery of tests. Skill acquisition was assessed using quantitative and clinical performance measures; the outcome measures from the test battery were used to predict the learning rate. The quantitative metrics indicated that participants’ performance improved significantly across the training, but the clinical evaluation revealed that participants did not significantly improve on the more complex part of the procedure. Mental rotation ability (MRA) predicted quantitative, but not clinical performance. We suggest that MRA tests in combination with simulator sessions could be used to assess the trainee’s early competence level and tailor the training to individual needs