{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T05:25:50Z","timestamp":1792301150259,"version":"4.4.0"},"reference-count":98,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,4,11]],"date-time":"2021-04-11T00:00:00Z","timestamp":1618099200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Swedish Research Council","award":["2018-02862"],"award-info":[{"award-number":["2018-02862"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>This qualitative review on rotavirus infection and its complications in the central nervous system (CNS) aims to understand the gut\u2013brain mechanisms that give rise to CNS driven symptoms such as vomiting, fever, feelings of sickness, convulsions, encephalitis, and encephalopathy. There is substantial evidence to indicate the involvement of the gut\u2013brain axis in symptoms such as vomiting and diarrhea. The underlying mechanisms are, however, not rotavirus specific, they represent evolutionarily conserved survival mechanisms for protection against pathogen entry and invasion. The reviewed studies show that rotavirus can exert effects on the CNS trough nervous gut\u2013brain communication, via the release of mediators, such as the rotavirus enterotoxin NSP4, which stimulates neighboring enterochromaffin cells in the intestine to release serotonin and activate both enteric neurons and vagal afferents to the brain. Another route to CNS effects is presented through systemic spread via lymphatic pathways, and there are indications that rotavirus RNA can, in some cases where the blood brain barrier is weakened, enter the brain and have direct CNS effects. CNS effects can also be induced indirectly as a consequence of systemic elevation of toxins, cytokines, and\/or other messenger molecules. Nevertheless, there is still no definitive or consistent evidence for the underlying mechanisms of rotavirus-induced CNS complications and more in-depth studies are required in the future.<\/jats:p>","DOI":"10.3390\/v13040658","type":"journal-article","created":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T21:47:33Z","timestamp":1618264053000},"page":"658","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Understanding the Central Nervous System Symptoms of Rotavirus: A Qualitative Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4512-3795","authenticated-orcid":false,"given":"Arash","family":"Hellysaz","sequence":"first","affiliation":[{"name":"Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Link\u00f6ping University, 58183 Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Hagbom","sequence":"additional","affiliation":[{"name":"Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Link\u00f6ping University, 58183 Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S96","DOI":"10.1093\/cid\/civ1013","article-title":"Global, Regional, and National Estimates of Rotavirus Mortality in Children <5 Years of Age, 2000\u20132013","volume":"62","author":"Tate","year":"2016","journal-title":"Clin. 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