Transcranial Direct-Current Stimulation (tDCS) attenuates perceived temporal demand during simulated laparoscopic tasks

Abstract Intraoperative temporal demand (TD) precipitates technical skill deterioration in surgical novices and is associated with attenuated prefrontal cortex (PFC) activity. Transcranial direct-current stimulation (tDCS) may augment PFC activation, thereby reducing subjective stress and improving technical skill under TD. In this randomized double-blind trial, forty surgical novices performed time-pressured simulated laparoscopic tasks across three phases: before (“pre”), during (“online”), and after (“post”) either active or sham stimulation of the PFC. Primary outcomes were self-reported measures of surgery-specific workload. Objective measures of technical performance were also recorded. Intervention groups comprised similar baseline demographics and skill levels (p>0.05). Only active tDCS significantly reduced perceived TD (p=0.01), whereas perceived task complexity reduced with sham (p=0.02). Following intervention, the tDCS group were 5% and 7.5% more likely to complete peg-transfer and pattern-cutting tasks within time, respectively (p=0.273). Our findings suggest that non-invasive prefrontal stimulation may offset perceived temporal stress in surgery, facilitating improved technical performance.