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Fetal Magnetoencephalography and Evoked Potentials

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Using the SARA (SQUID Array for Reproductive Analysis) system, we have performed many fetal MEG (fMEG) studies, most of which, were recorded from a "normal" patient population. We have developed different protocols based on simple auditory processing, sound discrimination related stimuli, and visual stimulation. We have also developed a combination of recording parameters using auditory and visual stimuli and spontaneous brain activity for a multimodal approach to the investigation of fetal health. It is clear from our studies that, in order to improve the fetal neurological testing, a combination of comprehensive assessment protocols is necessary including multiple recordings of auditory evoked responses (AER), visual evoked responses (VER), and spontaneous brain activity. This protocol can be referred to as SNAP (SARA Neurological Assessment Protocol) and can be used to evaluate the neurological status of the fetus and newborn. However, for further advancement of the field, we must determine how applicable fMEG is for clinically relevant studies. In addition we will improve our data analysis repertoire by implementing a more rigorous assessment of the statistical significance of the fetal responses and further verification of the fetal responses by application of advanced source reconstruction technique. We also plan to fully develop a comprehensive neurological test protocol for fetuses at high risk for neurological impairment due to certain maternal risk factors and/or fetal diagnostic findings. Furthermore, we will apply the same protocol to fetuses with known neurological anomalies. The specific aims are as follows: 1. Improvement of extraction and validation of fetal/neonatal auditory and visual evoked responses and spontaneous brain activity acquired through MEG. a) Development of a standard statistical test for fetal evoked responses b) Verification of fetal AER, VER and spontaneous activity by beamformer approaches c) Automatic Detection of spontaneous fetal brain activity d) State determination in fetal MEG recording. 2. Perform MEG to assess neurological status of: fetuses and neonates at increased risk for neurological damage due to maternal high risk conditions that correlate with placental insufficiency and fetal chronic hypoxia and intrinsic (fetal) conditions. Relevance: In this proposal our goal is to further the development of techniques to improve validation procedure for auditory and visual evoked responses and fetal spontaneous brain activity.

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