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Energy metabolism and cortical spreading depression susceptibility Cortical spreading depression (CSD) is a neurophysiological phenomenon characterized by the strong depolarization of regional neurons or glial cells, spreading along the cortex to neighboring regions at a rate of 35 mm/min, ultimately leading to inhibition of neural activity (9)

gain-of-function mutations in voltage-gated sodium channel genes increase neuronal excitability and are associated with PDPN

The end product of this reaction (AGE), in turn, induce oxidative stress and accelerate the Maillard reactions ultimately leading to inflammation and the propagation of tissue damage [30, 31, 32]

Such SARS-CoV-2 antigen persistence in infected tissues could possibly trigger immune perturbations that may contribute to the development of PASC