Digital Dementia in Neurosurgery

Digital dementia—a term coined recently by Manfred Spitzer—refers to early stages of dementia-like cognitive impairment due to excessive use of digital devices.[1] The ever-growing infiltration of digital technology in practice has transformed neurosurgery. Neurosurgical diagnostics, intraoperative navigation, and patient outcome all have become much more refined. This may further result in the emergence of an unforeseen adverse effect: deterioration of cognitive skills of the neurosurgeon himself or herself—a notion now coined “digital dementia.”

Neurosurgery requires correct decision-making, memory, and problem-solving at the highest level; in this respect, reliance on technology provides ground for apprehension regarding deterioration in cognitive functionality. Although digital technologies optimize workflow, thus improving patient safety, excessive usage impairs memorization, reduces spatial reasoning, and impacts problem-solving capacity. Being conversant with this problem and acquiring strategies to effectively neutralize this effect are a matter of essence in the modern neurosurgeon maintaining such cognitive and technical competencies as expected.

Digital dementia is underlined by changes within neuroplasticity brought upon by the avoidance of engagement of complex mental challenges.[2] It has even been suggested that overuse of digital technology for information retrieval weakens hippocampal activation, disrupting memory consolidation, and executive functions. Indeed, frequent multitasking and excessive screen time have been associated with attention deficits and reduced working memory capacity, which is important in neurosurgical practice. Additionally, excessive screen exposure has been associated with perpetuating a stress response related to cognitive fatigue, further exacerbating cognitive decline over time.[3] [4]

Contemporary neurosurgery heavily relies on several digital tools, which include the following: (1) neuronavigation systems, which allow more precise tumor resections and also reduce the necessity to memorize anatomy; (2) electronic medical records make patient care easier but at the same time might result in information overload and a reduction of attention toward the patient; (3) surgical robotics and AI-assisted platforms have increased precision at the cost of a possible decline in manual dexterity and problem-solving when overutilized; and (4) telemedicine and remote consultations will increase access and augment patient care but possibly at the cost of reduced hands-on clinical exposure to trainees.

While these have positive benefits for patient outcomes, overreliance on them will have the potential effect of eroding important cognitive and technical skills in neurosurgeons. Overly frequent reliance on these digital assistants and automated decision-making systems carries with it the risk of creating a dependency that will result in the loss of independent critical thinking and problem-solving skills.

Neurosurgical education and practice demand constant learning, flexibility, and creative decision-making. Digital dementia due to overreliance carries risks such as the following:

• Memory decline: One will stop trusting their memory of anatomy and surgical techniques, instead relying on navigation systems.

• Reduced problem-solving skills: The overdependence on AI for diagnostics instead of making an independent clinical diagnosis.

• Attention deficits: Continuously using electronic devices would lead to decreased attention toward patients and surgical procedures.

• Decreased tactile skill: Reduced digital dexterity as a consequence of the more extensive use of robotic-assisted surgery and digital interfaces.

• Information overload: Increased administrative burden because of extensive documentation and management of digital data leads to exhaustion and decreased clinical productivity.

The prevention of digital dementia in neurosurgery will be possible through various ways including the following:

• Cognitive training: Neurosurgeons should be subjected to training in memory and problem-solving to promote the agility of their minds.

• Hands-on training: Stress the cadaveric dissections added to manual skill development, not just digital tools.

• Screen time management: Minimize nonessential screen time to develop mindfulness for better concentration.

• Prudent integration of technology: Use digital tools as adjuncts, not replacements for traditional cognitive and surgical skills.

• Neurosurgical simulation with limited reliance on digital tools: Structured analog-based exercises to enhance tactile feedback and spatial orientation.

• Digital detox programs: These enable periodic respites from gadgets to restore the balance of cognition and reduce stress-related fatigue.

Greater reliance on technology in neurosurgery creates a potential digital dementia problem. While the use of digital tools is considered beneficial, a balance between technological assistance and cognitive engagement is required. Neurosurgeons should move toward strategies that preserve their cognitive function and surgical competencies for the best patient care in the digital era. The institutions and training programs should be fully aware of the cognitive risks from digital dependence and institute interventions to minimize its impact.

Conflict of Interest

None declared.

• References

• 1 Ali Z, Janarthanan J, Mohan P. Understanding digital dementia and cognitive impact in the current era of the internet: a review. Cureus 2024; 16 (09) e70029
• 2 Korte M. The impact of the digital revolution on human brain and behavior: where do we stand?. Dialogues Clin Neurosci 2020; 22 (02) 101-111
• 3 Loh KK, Kanai R. How has the internet reshaped human cognition?. Neuroscientist 2016; 22 (05) 506-520
• 4 Hoehe MR, Thibaut F. Going digital: how technology use may influence human brains and behavior. Dialogues Clin Neurosci 2020; 22 (02) 93-97

Publication History

Article published online:
21 April 2025