Yoshihito Shigihara

PET Imaging–Based Evaluation of Hepatobiliary Transport in Humans with (15R)-11C-TIC-Me

It is well accepted that drug transporters play a pivotal role in hepatobiliary excretion of anionic drugs, in which drug–drug interactions and genetic polymorphisms are known to cause variations. However, PET probes for in vivo functional characterization of these transporters have not been established yet. We used PET to investigate hepatic uptake and subsequent canalicular efflux of 11C-labeled (15R)-16-m-tolyl-17,18,19,20-tetranorisocarbacyclin methyl ester [(15R)-11C-TIC-Me)] in healthy subjects. Methods: Serial PET scans of the abdominal region in healthy male subjects were obtained with or without the organic anion–transporting polypeptide (OATP) inhibitor rifampicin after intravenous injection of (15R)-11C-TIC-Me as a radiotracer. Venous blood samples and PET images were obtained at frequent intervals up to 30 min after administration of the PET tracer. Dynamic imaging data were evaluated by integration plots of data collected for 2–10 min and for 10–30 min after tracer administration for the determination of tissue uptake clearance and biliary efflux clearance, respectively. Results: After rapid hydrolysis in blood, the acid form—11C-labeled (15R)-16-m-tolyl-17,18,19,20-tetranorisocarbacyclin [(15R)-11C-TIC]—accumulated in the liver (37% of the dose by 17 min), and the radioactivity was then excreted into the bile (6.2% by 30 min). Rifampicin (600 mg by mouth), a potent OATP inhibitor, significantly reduced the radioactivity excreted into the bile (by 44%) by inhibiting both uptake (by 45%) and subsequent canalicular efflux (by 62%). (15R)-11C-TIC is an in vitro substrate of OATP1B1 and OATP1B3, and clinically relevant concentrations of rifampicin inhibited uptake by OATP1B1 and OATP1B3. These results demonstrated that in humans, (15R)-11C-TIC–associated radioactivity is excreted into the bile by organic anion transport systems. Conclusion: We demonstrated that PET image analysis with (15R)-11C-TIC-Me is useful for investigating variations in OATP function in the human hepatobiliary transport system.

Relationships between dietary habits and the prevalence of fatigue in medical students

OBJECTIVE Fatigue, which is a common complaint among medical students, is related to poor academic outcomes. Because impaired dietary habits, such as skipping breakfast and taking meals irregularly, are correlated with poor school performances, whether those dietary habits were associated with the prevalence of fatigue was determined in medical students. METHODS The study group consisted of 127 healthy second-year medical students attending Osaka City University Graduate School of Medicine. They completed a questionnaire dealing with fatigue (Japanese version of the Chalder Fatigue Scale), lifestyle, and academic performance. RESULTS On multivariate logistic regression analyses adjusted for age, gender, body mass index, and nocturnal sleeping hours, skipping breakfast (completely skipping breakfast everyday versus having breakfast everyday; odds ratio 7.81, 95% confidence interval 2.00-30.52, P = 0.003) and taking meals irregularly (completely irregular versus always regular; odds ratio 6.89, 95% confidence interval 1.20-39.55, P = 0.030) were positively correlated with the prevalence of fatigue. CONCLUSION Skipping breakfast and taking meals irregularly are associated with the prevalence of fatigue in medical students.

Effect of mental fatigue on the central nervous system: an electroencephalography study

BackgroundFatigue can be classified as mental and physical depending on its cause, and eachtype of fatigue has a multi-factorial nature. We examined the effect of mentalfatigue on the central nervous system using electroencephalography (EEG) in eighteenhealthy male volunteers.MethodsAfter enrollment, subjects were randomly assigned to two groups in a single-blinded,crossover fashion to perform two types of mental fatigue-inducing experiments. Eachexperiment consisted of four 30-min fatigue-inducing 0- or 2-back test sessions andtwo evaluation sessions performed just before and after the fatigue-inducingsessions. During the evaluation session, the participants were assessed using EEG.Eleven electrodes were attached to the head skin, from positions F3, Fz, F4, C3, Cz,C4, P3, Pz, P4, O1, and O2.ResultsIn the 2-back test, the beta power density on the Pz electrode and the alpha powerdensities on the P3 and O2 electrodes were decreased, and the theta power density onthe Cz electrode was increased after the fatigue-inducing mental task sessions. Inthe 0-back test, no electrodes were altered after the fatigue-inducing sessions.ConclusionsDifferent types of mental fatigue produced different kinds of alterations of thespontaneous EEG variables. Our findings provide new perspectives on the neuralmechanisms underlying mental fatigue.

Two types of mental fatigue affect spontaneous oscillatory brain activities in different ways

BackgroundFatigue has a multi-factorial nature. We examined the effects of two types of mental fatigue on spontaneous oscillatory brain activity using magnetoencephalography (MEG).MethodsParticipants were randomly assigned to two groups in a single-blinded, crossover fashion to perform two types of mental fatigue-inducing experiments. Each experiment consisted of a 30-min fatigue-inducing 0- or 2-back test session and two evaluation sessions performed just before and after the fatigue-inducing mental task session.ResultsAfter the 0-back test, decreased alpha power was indicated in the right angular gyrus and increased levels in the left middle and superior temporal gyrus, left postcentral gyrus, right superior frontal gyrus, left inferior frontal gyrus, and right medial frontal gyrus. After the 2-back test, decreased alpha power was indicated in the right middle and superior frontal gyrus and increased levels in the left inferior parietal and superior parietal lobules, right parahippocampal gyrus, right uncus, left postcentral gyrus, left middle frontal gyrus, and right inferior frontal gyrus. For beta power, increased power following the 0-back test was indicated in the left middle temporal gyrus, left superior frontal gyrus, left cingulate gyrus, and left precentral gyrus. After the 2-back test, decreased power was suggested in the left superior frontal gyrus and increased levels in the left middle temporal gyrus and left inferior parietal lobule. Some of these brain regions might be associated with task performance during the fatigue-inducing trials.ConclusionsTwo types of mental fatigue may produce different alterations of the spontaneous oscillatory MEG activities. Our findings would provide new perspectives on the neural mechanisms underlying mental fatigue.

Imaging of Gastrointestinal Absorption and Biodistribution of an Orally Administered Probe Using Positron Emission Tomography in Humans

The purpose of this study was to establish a method for imaging the process of gastrointestinal (GI) absorption and subsequent biodistribution in the human body after oral drug administration, using positron emission tomography (PET) with 2‐[18F]fluoro‐2‐deoxy‐D‐glucose ([18F]FDG). First, we developed a method to deliver the radiotracer safely into the stomach using soft gelatin capsules to avoid any significant exposure to the pharyngoesophageal region. Second, we performed pharmacokinetic (PK) analyses on time–radioactivity profiles in GI tissues and blood to calculate the gastric emptying and intestinal elimination rate constants and to estimate the fluid volume in the lumen of the small intestine from PET image analysis. This is the first study involving oral administration of a PET probe in humans, and the results demonstrate the high potential of PET technology to investigate the GI absorption and PK profiles of drugs in humans.

Neural effects of prolonged mental fatigue: A magnetoencephalography study

Mental fatigue, manifest as a reduced efficiency for mental work load, is prevalent in modern society. It is important to understand the neural mechanisms of mental fatigue and to develop appropriate methods for evaluating mental fatigue. In this study we quantified the effect of a long-duration mental fatigue-inducing task on neural activity. We used magnetoencephalography (MEG) to examine the time course change of neural activity over the long duration of the task trials. Nine healthy male volunteers participated in this study. They performed two mental fatigue-inducing tasks on separate days. The order of task presentation was randomized in a single-blinded, crossover fashion. Each task consisted of 25-min mental fatigue-inducing 0- or 2-back task session for three times. Subjective rating of mental fatigue sensation and electrocardiogram, and resting state MEG measurements were performed just before and after each task session. MEG data were analyzed using narrow-band adaptive spatial filtering methods. Alpha band (8-13 Hz) power in the visual cortex decreased after performing the mental fatigue-inducing tasks, and the decrease of alpha power was greater when they performed 2-back task trials. The decrease in alpha power was positively associated with the self-reported level of mental fatigue sensation and sympathetic nerve activity level. These results demonstrate that performing the prolonged mental fatigue-inducing task causes overactivation of the visual cortex, manifest as decreased alpha power in this brain region. Our results increase understanding of the neural mechanisms of mental fatigue and can be used to develop new quantitative methods to assess mental fatigue.

Fatigue-Associated Alterations of Cognitive Function and Electroencephalographic Power Densities

Fatigue is a common problem in modern society. We attempted to identify moderate- to long-term fatigue-related alterations in the central nervous system using cognitive tasks and electroencephalography (EEG) measures. The study group consisted of 17 healthy male participants. After saliva samples were collected to measure copy number of human herpesvirus (HHV)-6 DNA to assess the level of moderate- to long-term fatigue, subjects were evaluated using EEG, with their eyes open for 2 min, then closed for 1 min sitting quietly. Thereafter, they completed cognitive task trials to evaluate simple selective attention for 3 min (Task 1) and conflict-controlling selective attention for 6 min (Task 2, which included Stroop trials). The percent error of Task 2 for Stroop trials was positively associated with the copy number of saliva HHV-6 DNA, although the simple selective attention measures in Task 1 did not differ significantly. EEG power densities (especially the alpha power density) during the eye-closed condition were negatively associated with the saliva HHV-6 DNA level. Impaired high-level information processing such as that required for conflict-controlling selective attention in the central nervous system may be a characteristic feature of moderate- to long-term fatigue.

Central inhibition regulates motor output during physical fatigue

Central fatigue refers to a progressive decline in the ability to activate muscles voluntarily. Although the existence of central inhibition of the motor area via visual feedback during physical fatigue was noted in a behavioral study, neural evidence has not been presented. The central mechanism to regulate physical fatigue was examined using a magnetoencephalographic (MEG) system. The study group consisted of eight healthy participants. They were randomly assigned to two groups in a crossover fashion to perform fatigue-inducing physical task sessions, in which they performed repetitive grips of a dominant hand at maximal voluntary contraction levels every second without using Ramachandrans mirror box to see the dominant hand or with using the mirror box to see the mirror reflection of the non-dominant hand to perceive that the fatigued dominant hand was not fatigued. Before and after each session, imagery of maximum grips of the dominant hand was performed for the evaluation with MEG. Beta-band event-related desynchronization (ERD) level of motor readiness magnetic field in the sensorimotor area in the contralateral hemisphere to the handgrips was not altered after the fatigue-inducing session without or with the mirror box. In contrast, the ERD level of motor movement-evoked magnetic field in the contralateral sensorimotor area was reduced after the fatigue-inducing session without the mirror box, although it was not altered after the session with the mirror box. We identified neural evidence of the central inhibition and showed that the visual feedback system is involved in the central mechanism regulating motor output.

Less efficient and costly processes of frontal cortex in childhood chronic fatigue syndrome

The ability to divide ones attention deteriorates in patients with childhood chronic fatigue syndrome (CCFS). We conducted a study using a dual verbal task to assess allocation of attentional resources to two simultaneous activities (picking out vowels and reading for story comprehension) and functional magnetic resonance imaging. Patients exhibited a much larger area of activation, recruiting additional frontal areas. The right middle frontal gyrus (MFG), which is included in the dorsolateral prefrontal cortex, of CCFS patients was specifically activated in both the single and dual tasks; this activation level was positively correlated with motivation scores for the tasks and accuracy of story comprehension. In addition, in patients, the dorsal anterior cingulate gyrus (dACC) and left MFG were activated only in the dual task, and activation levels of the dACC and left MFG were positively associated with the motivation and fatigue scores, respectively. Patients with CCFS exhibited a wider area of activated frontal regions related to attentional resources in order to increase their poorer task performance with massive mental effort. This is likely to be less efficient and costly in terms of energy requirements. It seems to be related to the pathophysiology of patients with CCFS and to cause a vicious cycle of further increases in fatigue.

Gustatory imagery reveals functional connectivity from the prefrontal to insular cortices traced with magnetoencephalography.

Our experience and prejudice concerning food play an important role in modulating gustatory information processing; gustatory memory stored in the central nervous system influences gustatory information arising from the peripheral nervous system. We have elucidated the mechanism of the “top-down” modulation of taste perception in humans using functional magnetic resonance imaging (fMRI) and demonstrated that gustatory imagery is mediated by the prefrontal (PFC) and insular cortices (IC). However, the temporal order of activation of these brain regions during gustatory imagery is still an open issue. To explore the source of “top-down” signals during gustatory imagery tasks, we analyzed the temporal activation patterns of activated regions in the cerebral cortex using another non-invasive brain imaging technique, magnetoencephalography (MEG). Gustatory imagery tasks were presented by words (Letter G-V) or pictures (Picture G-V) of foods/beverages, and participants were requested to recall their taste. In the Letter G-V session, 7/9 (77.8%) participants showed activation in the IC with a latency of 401.7±34.7 ms (n = 7) from the onset of word exhibition. In 5/7 (71.4%) participants who exhibited IC activation, the PFC was activated prior to the IC at a latency of 315.2±56.5 ms (n = 5), which was significantly shorter than the latency to the IC activation. In the Picture G-V session, the IC was activated in 6/9 (66.7%) participants, and only 1/9 (11.1%) participants showed activation in the PFC. There was no significant dominance between the right and left IC or PFC during gustatory imagery. These results support those from our previous fMRI study in that the Letter G-V session rather than the Picture G-V session effectively activates the PFC and IC and strengthen the hypothesis that the PFC mediates “top-down” control of retrieving gustatory information from the storage of long-term memories and in turn activates the IC.