REVIEW article

Front. Aging Neurosci.

Sec. Cellular and Molecular Mechanisms of Brain-aging

Volume 17 - 2025 | doi: 10.3389/fnagi.2025.1604378

NMDA Receptors in Neurodegenerative Diseases: Mechanisms and Emerging Therapeutic Strategies

Provisionally accepted
Keyi  ZhangKeyi Zhang1*Ming  WenMing Wen2Xinyue  NanXinyue Nan1Shuaizhu  ZhaoShuaizhu Zhao1Hao  LiHao Li1Houze  ZhuHouze Zhu1Yanping  AiYanping Ai2
  • 1Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
  • 2Hankou Hospital, Wuhan, Hebei, China

The final, formatted version of the article will be published soon.

NMDA receptors (NMDARs) are widely distributed throughout the central nervous system (CNS) and play pivotal roles in normal physiological processes such as synaptic plasticity, learning, and memory. Substantial evidence indicates that NMDAR dysfunction, particularly excessive calcium influx, critically contributes to the pathogenesis of major neurodegenerative diseases, including Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (HD), and amyotrophic lateral sclerosis (ALS). Dysregulated glutamatergic signaling synergizes with pathological protein aggregation (e.g., Aβ, α-synuclein, mutant huntingtin) to drive neuronal loss. We systematically delineate NMDAR-related mechanisms underlying neurodegeneration, highlighting spatial-specific roles (e.g., synaptic NMDAR-mediated neuroprotection versus extrasynaptic NMDAR-mediated excitotoxicity) and crosstalk with mitochondrial dysfunction and oxidative stress. We critically evaluate current therapeutic strategies targeting NMDARs, including subunit-selective modulators, downstream effector modulation, and glutamate transporter modulation designed to restore NMDAR homeostasis. Consequently, NMDARs and their modulators represent promising therapeutic targets for these refractory conditions. This review comprehensively summarizes current research on the involvement of NMDARs and the glutamatergic system in neurodegenerative diseases. Furthermore, we discuss the clinical application of NMDAR-targeting agents and explore emerging therapeutic strategies focused on modulating NMDAR-related pathways. This article aims to provide a reference for elucidating the molecular mechanisms underlying these neurodegenerative disorders and to highlight potential avenues for future drug development.

Keywords: NMDA receptors (N-methyl-D-aspartate receptors), neurodegenerative disease, excitotoxicity, Glutamate, Alzheimer's disease (AD), Amytrophic lateral sclerosis

Received: 01 Apr 2025; Accepted: 30 Jun 2025.

Copyright: © 2025 Zhang, Wen, Nan, Zhao, Li, Zhu and Ai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Keyi Zhang, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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