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74 Modulation of the musclegutbrain axis by vitamin B 12 is also possible by acting on gut microbiota

At the imaging level, metabolic imaging modalities such as positron emission tomography (PET), functional magnetic resonance imaging (fMRI), and emerging techniques like magnetic resonance spectroscopic imaging (MRSI) are being employed for non-invasive assessment of tumor metabolic activity and mitochondrial function [141, 142]

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This does not mean zero drug reaches CNS targets, but it does mean the fraction is likely small and the pharmacokinetic profile is poorly characterized for that route