The Efficacy of Transcranial Direct Current Stimulation in Enhancing Surgical Skill Acquisition: A Preliminary Meta-Analysis of Randomized Controlled Trials

• Main Authors: Chao-Ming Hung, Bing-Yan Zeng, Bing-Syuan Zeng, Cheuk-Kwan Sun, Yu-Shian Cheng, Kuan-Pin Su, Yi-Cheng Wu, Tien-Yu Chen, Pao-Yen Lin, Chih-Sung Liang, Chih-Wei Hsu, Che-Sheng Chu, Yen-Wen Chen, Ming-Kung Wu, Ping-Tao Tseng
• Format: Article
• Language: English
• Published: MDPI AG 2021-05-01
• Series: Brain Sciences
• Subjects: surgical skill; resident training; meta-analysis; tDCS; neuromodulation
• Online Access: https://www.mdpi.com/2076-3425/11/6/707

The application of transcranial direct current stimulation (tDCS) to targeted cortices has been found to improve in skill acquisition; however, these beneficial effects remained unclear in fine and complicated skill. The aim of the current meta-analysis was to investigate the association between tDCS application and the efficacy of surgical performance during surgical skill training. We included randomized controlled trials (RCTs) investigating the efficacy of tDCS in enhancing surgical skill acquisition. This meta-analysis was conducted under a random-effect model. Six RCTs with 198 participants were included. The main result revealed that tDCS was associated with significantly better improvement in surgical performance than the sham control (Hedges’ <i>g</i> = 0.659, 95% confidence intervals (95%CIs) = 0.383 to 0.935, <i>p</i> < 0.001). The subgroups of tDCS over the bilateral prefrontal cortex (Hedges’ <i>g</i> = 0.900, 95%CIs = 0.419 to 1.382, <i>p</i> < 0.001) and the primary motor cortex (Hedges’ <i>g</i> = 0.599, 95%CIs = 0.245 to 0.953, <i>p</i> = 0.001) were both associated with significantly better improvements in surgical performance. The tDCS application was not associated with significant differences in error scores or rates of local discomfort compared with a sham control. This meta-analysis supported the rationale for the tDCS application in surgical training programs to improve surgical skill acquisition.