Fetal EEG

1. Fetal EEG was a focus of clinical research in 1970ies and mid 1990ies, but never made it to the bedside mostly due to technological limitations and lack of evidence that it contributed useful clinical information during labour process. In 2007, I discovered and patented that changes in fetal electrocortical activity predict severe acidemia during labour and thereby the risk for brain injury with sufficient lead-time to intervene by inducing labour or performing cesarian section. We validated this finding in several fetal sheep studies over the past ten years and created an automated algorithm for unsupervised monitoring and detection of EEG-FHR pattern pathognomonic of adaptive brain shut-down as an early response to incipient acidemia. I am leading the translation of this technology to the bedside.

a. Frasch MG et al. (2011). Monitoring Fetal Electrocortical Activity during Labour for Predicting Worsening Acidemia: A Prospective Study in the Ovine Fetus Near Term. PLoS ONE. 6(7): e22100. PMID: 21789218.

b. Xu A et al. (2014). Adaptive brain shut-down counteracts neuroinflammation in the near-term ovine fetus. Front. Neurol. doi: 10.3389/fneur.2014.00110. PMID: 26149280.

c. Frasch, MG (2014). Putative role of AMPK in fetal adaptive brain shut-down: linking metabolism and inflammation in the brain. Front. Neurol. doi: 10.3389/fneur.2014.00150. PMID: 25157238.

d. Wang X et al. (2014). Online Detection of Fetal Acidemia during Labour by Testing Synchronization of EEG and Heart Rate. PLoS One. doi: 10.1371/journal.pone.0108119. PMID: 25268842.

e. Frasch, MG et al. Adaptive shut-down of EEG activity predicts early onset of critical acidemia in the near-term ovine fetus. Physiol Rep. 2015 Jul;3(7). pii: e12435. doi: 10.14814/phy2.12435.


2. In a series of complex experiments in juvenile pig followed by innovative nonlinear analyses of EEG complexity, I provided the proof-of-principle that cortico-cortical communication derived from EEG can be used to gauge the presence and degree of thalamocortical communication under varying degrees of propofol sedation comparing it to the directly recorded EThG, an excellent model of modulating thalamic gating via reticulothalamic-cortical pathways.

a. Frasch MG, Walter B, Friedrich H, Hoyer D, Eiselt M, Bauer R. Detecting the signature of reticulothalamocortical communication in cerebrocortical electrical activity. Clin Neurophysiol. 2007 Sep; 118(9):1969-79. PMID: 17604691.

b. Frasch MG, Walter B, Brodhun M, Friedrich H, Eiselt M, Bauer R. Stereotactic approach and electrophysiological characterization of thalamic reticular and dorsolateral nuclei of the juvenile domestic pig (sus scrofa domesticus). Acta Neurobiol Exp (Wars). 2006; 66(1):43-54. PMID: 16617676.