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Synaptic versus extrasynaptic NMDA receptor signalling: implications for neurodegenerative disorders
Open accessAbstract
There is a long-standing paradox that NMDA (N-methyl-D-aspartate) receptors (NMDARs) can both promote neuronal health and kill neurons. Recent studies show that NMDAR-induced responses depend on the receptor location: stimulation of synaptic NMDARs, acting primarily through nuclear Ca(2+) signalling, leads to the build-up of a neuroprotective 'shield', whereas stimulation of extrasynaptic NMDARs promotes cell death. These differences result from the activation of distinct genomic programmes and from opposing actions on intracellular signalling pathways. Perturbations in the balance between synaptic and extrasynaptic NMDAR activity contribute to neuronal dysfunction in acute ischaemia and Huntington's disease, and could be a common theme in the aetiology of neurodegenerative diseases. Neuroprotective therapies should aim to both enhance the effect of synaptic activity and disrupt extrasynaptic NMDAR-dependent death signalling.
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“research suggests that synaptic NMDAR transmission promotes cell survival and that extra-synaptic NMDARs promote cell death through p38MAPK inhibition and activation, respectively [25].”
From Ketamine in neuropsychiatric disorders: an update (2024) · cites this paper as [25]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Augmented release of glutamate from astrocytes has been shown to be decrease brain-derived neurotrophic factor and increase excitotoxicity (Hardingham and Bading, 2010).”
From Inflammation in Fear- and Anxiety-Based Disorders: PTSD, GAD, and Beyond (2017) · cites this paper as Hardingham and Bading, 2010
Experimental — accuracy not yet measuredIn the citing paper
“PI3K/AKT and RAS/ERK signaling pathways also control processes associated with neural excitotoxicity and cell survival [191].”
From The ASD Living Biology: from cell proliferation to clinical phenotype (2019) · cites this paper as [191]
In the citing paper
“While redox state modulates NMDAR function, activation of synaptic NMDARs strengthens neuronal antioxidant defense mechanisms (Hardingham and Bading, 2010).”
From Redox dysregulation, neuroinflammation, and NMDA receptor hypofunction: A “central hub” in schizophrenia pathophysiology? (2016) · cites this paper as Hardingham and Bading, 2010
In the citing paper
“Interestingly, synaptic NMDAR activation boosts GSH, thioredoxin, and peroxiredoxin systems via calcium-mediated signaling involving activation of CREB and inhibition of FOXO (Hardingham and Bading, 2010; Papadia et al., 2008).”
From Redox dysregulation, neuroinflammation, and NMDA receptor hypofunction: A “central hub” in schizophrenia pathophysiology? (2016) · cites this paper as Hardingham and Bading, 2010
In the citing paper
“Moreover, GABAergic interneuron-specific deletion of Grin1 has been show to lead to increased ROS levels which are exacerbated by post-weaning social isolation, in association with down-regulation of peroxisome proliferative activated receptor-γ, coactivator 1α (PPARGC1A, also known as PGC-1α), a regulator of mitochondrial energy metabolism and antioxidant defences 78 .”
From Linking early-life NMDAR hypofunction and oxidative stress in schizophrenia pathogenesis (2016) · cites this paper as [78]
In the citing paper
“Both immunohistochemical and electrophysiological studies have confirmed the existence of extra-synaptic NMDARs, which are not located in the post-synaptic density 68, and are primarily comprised of GluN2B-containing heterotetramers 28, 29.”
From Mechanisms of ketamine action as an antidepressant (2018) · cites this paper as [68]
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“, 2013), extrasynaptic iGluRs, which are predominantly NMDARs, may be scattered on other parts of the neuron (Benke et al., 1993; Hardingham and Bading, 2010) and do not have privileged access to presynaptic glutamate (Köhr, 2006).”
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Activity‐dependent regulation of NMDA receptors in substantia nigra dopaminergic neurones
Wild, A. R., Jones, S., & Gibb, A. J. (2013) · The Journal of Physiology · doi:10.1113/jphysiol.2013.267310 · Cited by 13
“Elevated intracellular [Ca2+] can activate signalling pathways coupled to cell death (Hardingham & Bading, 2010; Surmeier et al. 2010), has a detrimental effect on mitochondrial function (Duchen et al. 2008) and enhances the toxic effects of a high cytosolic dopamine concentration (Mosharov et al.…”
BackgroundMethodInfluentialNmda Receptor Antagonists for Depression: Critical Considerations
Serafini, G., Gonda, X., Rihmer, Z., Pompili, M., Girardi, P., Nasrallah, H. A., & Amore, M. (2015) · Annals of Clinical Psychiatry · doi:10.1177/104012371502700308 · Cited by 15
“24 Glutamatergic abnormalities may result from the imbalance between synaptic and extrasynaptic NMDAR activity.”
Inta, I. M., Vogt, M. A., Vogel, A. S., Bettendorf, M., Gass, P., & Inta, D. (2015) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-015-0649-2 · Cited by 14
“The contrasting effects on cell death mediated via NMDAR were shown to depend on the activation of different intracellular signaling cascades [23].”
BackgroundArmstead, W. M., Riley, J., Yarovoi, S. V., Higazi, A. A., & Cines, D. B. (2016) · Stroke · doi:10.1161/strokeaha.116.012678 · Cited by 14
“sustained levels of activation of extrasynaptic NMDA-Rs may promote cell death.(33,34) This, in turn, may depend on the expres-”
BackgroundThe regulatory effect of electro-acupuncture on the expression of NMDA receptors in a SCI rat model
Tu, W., Chen, W., Xia, W., He, R., Hu, J., Jiang, M. C., & Jiang, S.-H. (2017) · Life Sciences · doi:10.1016/j.lfs.2017.04.004 · Cited by 14
Lautz, J. D., Gniffke, E. P., Brown, E., Immendorf, K. B., Mendel, R. D., & Smith, S. E. P. (2019) · Scientific Reports · doi:10.1038/s41598-019-46690-y · Cited by 12
Karanikas, E. (2025) · Psychopharmacology Bulletin · doi:10.64719/pb.4419 · Cited by 14
Ahmed, H., Zheng, M., Smart, K. A., Fang, H., Zhang, L., Emery, P. R., Gao, H., Ropchan, J. R., Haider, A., Tamagnan, G. D., et al. (2022) · Journal of Nuclear Medicine · doi:10.2967/jnumed.122.263977 · Cited by 13
“The GluN1/2B receptors are associated with several neuropatholo-gies, such as Alzheimer ’ s disease, Parkinson ’ s disease, depression, schizophrenia, and stroke, among others ( 2 – 5 ).”
BackgroundLiu, Y., Zhao, H., Li, Q., Cui, H.-W., & Huang, G. (2022) · Aging and Disease · doi:10.14336/ad.2022.1211 · Cited by 15
“GluN2A and GluN2B can be detected in both synaptic and extrasynaptic NMDARs in the adult brain, with GluN2A mainly located in synaptic NMDARs and GluN2B mainly in extrasynaptic NMDARs [38].”
BackgroundDrugs with glutamate-based mechanisms of action in psychiatry
Chrobak, A., & Siwek, M. (2024) · Pharmacological Reports · doi:10.1007/s43440-024-00656-8 · Cited by 11
“However, in pathological circumstances, excessive influxes of Ca 2+ in neuronal deterioration or death [17].”
Terry-Lorenzo, R. T., Fan, R. H., Khin, N. A., & Singh, J. B. (2024) · The International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyae066 · Cited by 14
Shangguan, T., Xu, J., Weng, X., & Lin, H. T. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1504123 · Cited by 14
“This dysregulation enables glutamate to bind to extra synaptic N-methyl-D-aspartate (NMDA) receptors, thereby inhibiting growth factors and induces excitotoxicity, and contributing to the development of depression (63).”
Kimura, J., Nemoto, K., Degawa, M., Yokosuka, A., Mimaki, Y., Shimizu, K., Oku, N., & Ohizumi, Y. (2014) · Biological and Pharmaceutical Bulletin · doi:10.1248/bpb.b14-00177 · Cited by 13
Novel rapid-acting antidepressants: molecular and cellular signaling mechanisms
Thomas, A. M., & Duman, R. S. (2017) · Neuronal Signaling · doi:10.1042/ns20170010 · Cited by 14
“In addition to activating in response to different patterns of glutamate release, GluN2B subunits transmit a different set of intracellular signals than GluN2A subunits and may be most prevalent at a different part of the postsynaptic neurone [37].”
Parrish, R. R., Codadu, N. K., Racca, C., & Trevelyan, A. J. (2018) · Journal of Neurophysiology · doi:10.1152/jn.00287.2018 · Cited by 13
Jacobi, A. A., Halawani, S. M., Lynch, D. R., & Lin, H. (2018) · Neuroscience Letters · doi:10.1016/j.neulet.2018.10.055 · Cited by 12
Leyrer‐Jackson, J. M., Olive, M. F., & Gipson, C. D. (2019) · Methods in molecular biology · doi:10.1007/978-1-4939-9077-1_9 · Cited by 14
Young, D. (2020) · Frontiers in Neurology · doi:10.3389/fneur.2020.00635 · Cited by 13
GluA3 autoantibodies induce alterations in dendritic spine and behavior in mice
Scheggia, D., Stanic, J., Italia, M., Greca, F. L., Zianni, E., Benussi, A., Borroni, B., Luca, M. D., & Gardoni, F. (2021) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2021.07.001 · Cited by 13
“2E,F) were not altered by the treatment with anti-GluA3 IgG thus suggesting no alteration of the main signaling pathways associated to the activation of synaptic glutamate receptors (Hardingham and Bading, 2010).”
Dong, H., Yang, X., & Sun, Z. (2021) · Cognitive Neurodynamics · doi:10.1007/s11571-021-09705-x · Cited by 13
Alfaro‐Ruiz, R., Aguado, C., Martín‐Belmonte, A., Moreno‐Martínez, A. E., Merchán‐Rubira, J., Hernández, F., Ávila, J., Fukazawa, Y., & Luján, R. (2022) · Brain Pathology · doi:10.1111/bpa.13115 · Cited by 14
“NMDARs are not only found at synaptic sites but also at extrasynaptic locations [21].”
BackgroundInfluentialBansal, Y., Fee, C., Misquitta, K. A., Codeluppi-Arrowsmith, S. A., Sibille, E. L., Berman, R., Coric, V., Sanacora, G., & Banasr, M. (2023) · Complex Psychiatry · doi:10.1159/000529534 · Cited by 12
Yamagata, Y., Kaneko, K., Kase, D., Ishihara, H., Nairn, A. C., Obata, K., & Imoto, K. (2013) · Brain Research · doi:10.1016/j.brainres.2013.02.015 · Cited by 13
“…plasticity, and learning and memory through phosphorylation of various substrates, such as transcription factors, cytoskeletal proteins, regulatory enzymes and kinases in postmitotic neurons (Hardingham and Bading, 2010; Subramaniam and Unsicker, 2006; Sweatt, 2004; Thomas and Huganir, 2004).”
BackgroundYamamoto, T., Mencarelli, M. A., Marco, C. D., Mucciolo, M., Vascotto, M., Balestri, P., Gérard, M., Mathieu‐Dramard, M., Andrieux, J., Breuning, M. H., et al. (2014) · European Journal of Medical Genetics · doi:10.1016/j.ejmg.2014.02.001 · Cited by 13
Sun, Y., Chen, Y., Zhan, L., Zhang, L., Hu, J. H., & Gao, Z. (2015) · Reviews in the Neurosciences · doi:10.1515/revneuro-2015-0037 · Cited by 13
“It is generally accepted that synaptic and extrasynaptic NMDARs have opposite effects on neuronal survival and death (Hardingham and Bading, 2010).”
BackgroundTian, M., Xu, J., Lei, G., Lombroso, P. J., Jackson, M. F., & MacDonald, J. F. (2016) · Scientific Reports · doi:10.1038/srep36684 · Cited by 13
Ambroziak, W., Fourie, C., & Montgomery, J. M. (2018) · Hippocampus · doi:10.1002/hipo.22995 · Cited by 13
Okamoto, S., Prikhodko, O., Piña-Crespo, J., Adame, A., McKercher, S. R., Brill, L. M., Nakanishi, N., Oh, C.-K., Nakamura, T., Masliah, E., et al. (2019) · Neurobiology of Disease · doi:10.1016/j.nbd.2019.03.029 · Cited by 13
“Moreover, activation of eNMDARs is known to be associated with synaptic pathology, whereas their inhibition by drugs like the aminoadamantanes can protect from synapse loss (Hardingham and Bading, 2010; Okamoto et al., 2009; Parsons and Raymond, 2014; Takahashi et al., 2015; Talantova et al., 2013).”
BackgroundSalek, A. B., Edler, M., McBride, J. P., & Baucum, A. J. (2019) · Journal of Neurochemistry · doi:10.1111/jnc.14831 · Cited by 13
Manisha, C., Ayyamperumal, S., Selvaraj, J., Nanjan, C. M. J., Joghee, N. M., Clement, J. P., & Justin, A. (2020) · Medical Hypotheses · doi:10.1016/j.mehy.2020.109794 · Cited by 13
Dong, L.-D., Chen, J., Li, F., Gao, F., Wu, J., Miao, Y., & Wang, Z. (2013) · Neural Plasticity · doi:10.1155/2013/670254 · Cited by 13
Polyamines as Snake Toxins and Their Probable Pharmacological Functions in Envenomation
Aird, S. D., Villar‐Briones, A., Roy, M. C., & Mikheyev, A. S. (2016) · Toxins · doi:10.3390/toxins8100279 · Cited by 13
“Hardingham and Bading [101] report that neuronal NMDARs comprise two populations: synaptic receptors, which are neuroprotective, and extrasynaptic receptors that promote excitotoxicity and neuronal death.”
BackgroundKosheleva, L., Koshelev, D., Lagunas‐Rangel, F. A., Levit, S., Rabinovitch, A., & Schiöth, H. B. (2025) · Pharmacological Reviews · doi:10.1016/j.pharmr.2025.100044 · Cited by 12
“Glutamate N-Methyl-D-Aspartate receptors (NMDARs) activate by binding both glycine and glutamate, with the concomitant depolarization of the cell membrane (Hardingham and Bading, 2010).”
Calpain-1 and Calpain-2 in the Brain: What Have We Learned from 45 Years of Research?
Baudry, M., & Bi, X. (2025) · Cells · doi:10.3390/cells14171301 · Cited by 12
“Activation of synaptic NMDA receptors has been shown to be neuroprotective by stimulating the Akt survival pathway, while activation of extrasynaptic NMDA receptors is linked to a neurodegenerative pathway [108,109].”
Pharmacology of ketamine and esketamine as rapid-acting antidepressants
Pavlidi, P., Megalokonomou, A., Sofron, A., Kokras, N., & Dalla, C. (2021) · Psychiatriki · doi:10.22365/jpsych.2021.050 · Cited by 12
León, B. E., Peyton, L., Essa, H., Wieden, T., Marion, N., Childers, W. E., Abou-Gharbia, M. A., & Choi, D. (2023) · Neuropharmacology · doi:10.1016/j.neuropharm.2023.109515 · Cited by 12
Jos, S., Poulose, R., Kambaru, A., Gogoi, H., Nanjaiah, N. D., Padmanabhan, B., Mehta, B., & Padavattan, S. (2024) · Journal of Molecular Biology · doi:10.1016/j.jmb.2024.168445 · Cited by 12
Metadata
- Authors
- Hardingham, G. E., & Bading, H.
- Affiliations
- University of Edinburgh (GB)
- Heidelberg University (DE)
- Corresponding author
- Hardingham, Giles E.
- Bading, Hilmar
- Venue
- Nature Reviews Neuroscience
- Published
- 2010-09-15
- Volume
- 11
- Issue
- 10
- Pages
- 682-696
- ISSN
- 1471-003X (ISSN-L)
- 1471-0048
- PMC
- PMC2948541
- OpenAlex
- W1966556202
- Cited by
- 1,644
- References
- 167
- Citations by year
- 2026: 83 · 2025: 109 · 2024: 100 · 2023: 111 · 2022: 93 · 2021: 125 · 2020: 112 · 2019: 92 · 2018: 98 · 2017: 99 · 2016: 117 · 2015: 103 · 2014: 128 · 2013: 111 · 2012: 87
- FWCI
- 7.95
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Nature reviews. Neuroscience (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, other-oa)
- Funders
- Alexander von Humboldt-Stiftung
- Wellcome Trust (94018, 087491, 088156)
- Deutsche Forschungsgemeinschaft
- Medical Research Council
- Biotechnology and Biological Sciences Research Council
- Topics
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neuropharmacology Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Amino Acid Enzymes and Metabolism
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Keywords
- NMDA receptor, synaptic NMDA receptors, extrasynaptic NMDA receptors, neuroprotection, neuronal cell death, intracellular signaling, ischemia, Huntington's disease, neurodegenerative diseases, neuroprotective therapy
- MeSH terms
- Animals, Humans, Synapses, Signal Transduction, Gene Expression, Receptors, N-Methyl-D-Aspartate, Cell Death, Oxidative Stress, Neuroprotective Agents, Neurodegenerative Diseases
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