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. 2021 May 13;15:100272. doi: 10.1016/j.bbih.2021.100272

Fig. 1.

Fig. 1

Schematic representation of adaptive and maladaptive sickness behavioral responses. Elevated cytokine levels, resulting from various potential triggers, including SARS-COV-2 virus, act as neuromodulators informing the hypothalamus about an inflammatory stressor. The hypothalamus orchestrates adaptive biological responses to restore homeostasis, engendering sickness behavior. Therefore, both an exaggerated systemic inflammation in a healthy brain (e.g., COVID-19-associated cytokine storm) or a susceptible brain confronted with a relatively mild inflammatory stimulus (e.g., urinary tract infection in the elderly) may be sufficient to result in a disproportionate cytokine-mediated neuroinflammation, leading to encephalopathy.