FIGURE 5.

Several studies have shown that the dorsal brainstem can be affected or infected by SARS-CoV-2. This region is dense with nuclei that may be important for PASC. AP, area postrema, a circumventricular organ lacking a blood brain barrier, involved in nausea/vomiting; DRt, dorsal reticular nucleus, involved in inflammatory pain; DMV, dorsal motor nucleus of the vagus nerve, site of parasympathetic neurons and the main source of the vagal innervation of trunk organs; NAmb, nucleus ambiguus, contains soma of cholinergic preganglionic parasympathetic neurons that control heart rate; NTS, nucleus of the solitary tract, site of sensory vagus nerve soma that respond to detection of peripheral inflammation; VLM, ventrolateral medulla, involved in noradrenergic sympathetic nervous system signaling, autonomic control of blood pressure and breathing. Image adapted with permission from Sclocco et al. (2018). Original image courtesy of Dr. Zahra Mona Nasiriavanaki, Paulita Lara Mejia, and Dr. Roberta Sclocco.