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Each mechanism is not necessary pathogenetic, but it can be deemed as essential building unit within a common stimulus of adequate intensity able to breach the threshold for inducing the emetic cycles in susceptible patients ( Several pathophysiologic mechanisms have been postulated, such as autonomic abnormalities, hypothalamic-pituitary-adrenal (HPA) activation, genetic abnormalities, neuronal hyperexcitability, and gastric dysmotility

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Its less useful if your only goal is to assign causality to one pathway with high confidence

[DOI] [PubMed] [Google Scholar] 72.Sarmiento A., Diaz-Castro J., Pulido-Moran M., Kajarabille N., Guisado R., Ochoa J.J