Figure 2: Vagal afferent plasticity following neurotrauma. Neurotrauma is emerging as systemic phenomenon whereby multiple organ systems demonstrate post-injury pathophysiology. Vagal afferents remain anatomically intact after TBI and SCI, yet they demonstrate significant remodeling following injury. Systemic inflammation contributes to multi-organ compromise, including the gastrointestinal tract. Whether this systemic inflammation causes vagal afferent plasticity or the plasticity of the vagal afferents contributes to the systemic inflammation has yet to be determined. This dysregulation may exist in concert with, or independent of, alterations in the gut microbiome. F/B: Firmicutes/Bacteroidetes ratio; GI: gastrointestinal.NTS: Nucleus tractus solitarius; SCI: spinal cord injury; TBI: traumatic brain injury.