Introduction-Error monitoring and correction is one of the executive functions and is important for effective goal directed behavior. Deficient executive functioning, including reduced error monitoring ability, is one of the typical features of such neurodevelopmental disorders as autism, probably related to perseverative responding, stereotyped repetitive behaviors, and an inability to accurately monitor ongoing behavior. Our prior studies of behavioral and event-related potential (ERP) measures during performance on visual oddball tasks in high-functioning autistic (HFA) children showed that despite only minor differences in reaction times HFA children committed significantly more errors.

Introduction Preoccupation with drug and drug-related items is a typical characteristic of cocaine addicted individuals. It has been shown in multiple accounts that prolonged drug use has a profound effect on the EEG recordings of drug addicts when compared to controls during cue reactivity tests. Cue reactivity refers to a phenomenon in which individuals with a history of drug abuse exhibit excessive psychophysiological responses to cues associated with their drug of choice. One of the aims of this pilot study was to determine the presence of an attentional bias to preferentially process drug-related cues using evoked and induced gamma reactivity measures in cocaine addicts before and after biobehavioral treatment based on neurofeedback. Another aim was to show that central SMR amplitude increase and frontal theta control is possible in an experimental outpatient drug users group over 12 neurofeedback sessions. Method Ten current cocaine abusers participated in this pilot research study using neurofeedback combined with Motivational Interviewing sessions. Eight of them completed all planned pre- and post –neurofeedback cue reactivity tests with event-related EEG recording and clinical evaluations. Cue reactivity test represented a visual oddball task with images from the International Affective Picture System and drug-related pictures. Evoked and induced gamma responses to target and non-target drug cues were analyzed using wavelet analysis. Results Outpatient subjects with cocaine addiction completed the biobehavioral intervention and successfully increased SMR while keeping theta practically unchanged in 12 sessions of neurofeedback training. The addition of Motivational Interviewing helped retain patients in the study. Clinical evaluations immediately after completion of the treatment showed decreased self-reports on depression and stress scores, and urine tests collaborated reports of decreased use of cocaine and marijuana. Effects of neurofeedback resulted in a lower EEG gamma reactivity to drug-related images in a post-neurofeedback cue reactivity test. In particular, evoked gamma showed decreases in power to non-target and to a lesser extent target drug-related cues at all topographies (left, right, frontal, parietal, medial, inferior); while induced gamma power decreased globally to both target and non-target drug cues. Our findings supported our hypothesis that gamma band cue reactivity measures are sufficiently sensitive functional outcomes of neurofeedback treatment. Both evoked and induced gamma measures were found capable to detect changes in responsiveness to both target and non-target drug cues. Conclusion Our study emphasizes the utility of cognitive neuroscience methods based on EEG gamma band measures for the assessment of the functional outcomes of neurofeedback-based biobehavioral interventions for cocaine use disorders. This approach may have significant potential for identifying both physiological and clinical markers of treatment progress. The results confirmed our prediction that ...

The purpose of this study is to determine the pumping performance of Revision 7 of the Ension pediatric cardiopulmonary assist system (pCAS) when used with cannulae for venoarterial (VA) or venovenous (VV) extracorporeal membrane oxygenation (ECMO). It was hypothesized that the pCAS could deliver flow rates within recommended ranges needed to provide adequate cardiopulmonary support for neonates and infants. Rev 7 pCAS pumping performance was evaluated with the pCAS incorporated into an ECMO circuit connected to an instrumented pediatric mock circulation with cannulae combinations commonly used clinically for VA ECMO or dual lumen cannulae for VV ECMO. The pCAS motor speed was operated from 0 to 4500 rpm while the pCAS pumped blood analog solutions representing a clinically relevant range of viscosity. Maximum flow rates were inversely related to viscosity and were directly proportional to cannulae size. At 4500 rpm, maximum pCAS flow for the VA ECMO configuration was 2.14 L/min for the lowest viscosity and largest cannula combination and 0.72 L/ min for the highest viscosity and the smallest cannulae combination. At a flow of 0.5 L/min, the pressure drop across the pCAS ranged from 121 to 323 mmHg depending on viscosity and cannulae combination. For the VV ECMO configuration at 4500 rpm, the maximum pCAS flow was 1.21 L/min for the lowest viscosity and largest cannula and 0.58 L/min for the highest viscosity and smallest cannula. For a flow of 0.5 L/min, the pressure drop across the pCAS ranged from 82 to 407 mmHg depending on the viscosity and cannula. Possible transition to turbulent flow (Re > 2100 at cannula inlet) was found at the higher flow rates achieved with the lower viscosity test fluid for all cannulae tested. In conclusion, across the range of pump speeds and fluid viscosities evaluated, the pCAS can generate the flow rates recommended to provide adequate cardiopulmonary support for neonates and infants with commonly used clinical cannulae combinations, thus confirming the hypotheses.

Extracorporeal membrane oxygenation (ECMO) is often used to provide cardiopulmonary support for infants experiencing severe levels of cardiac or respiratory failure. In patients with two ventricles and no intra-atrial communication, ECMO is often complicated by limited venous return to the circuit and marked left atrial hypertension. This condition may be treated by performing an atrial septostomy to create an intentional atrial septal defect (ASD). A pediatric mock circulation with a conduit connecting the left and right atrium was used to examine the size of ASD that would relieve left atrial hypertension and restore acceptable hemodynamics in a 4 to 5 kg infant. After creation of left ventricular failure and subsequent institution of ECMO, the ASD was opened in a graded fashion while the resulting hemodynamic changes were recorded. An ASD equivalent to a 6.3 mm diameter hole decreased the left atrial pressure 30 mmHg to an acceptable level with a net left-to-right shunt of 393 ml/min. Further opening of the ASD resulted in additional hemodynamic improvement, but was eventually limited in further effect. This study demonstrates that a mock circulation can be used to investigate the size of an ASD necessary to effect sufficient clinical improvement in a two-ventricle infant on ECMO.