Neuronal dendrites are vulnerable to injury under diverse pathological conditions. However, the underlying mechanisms for dendritic Na ؉ overload and the selective dendritic injury remain poorly understood. Our current study demonstrates that activation of NHE-1 (Na ؉ /H ؉ exchanger isoform 1) in dendrites presents a major pathway for Na ؉ overload. Neuronal dendrites exhibited higher pH i regulation rates than soma as a result of a larger surface area/volume ratio. Neuronal dendrites are vulnerable to injury under diverse pathological conditions, including cerebral ischemia, epilepsy, and Alzheimer disease (1, 2). The hallmark of dendritic injury is the formation of focal swelling or beads along the length of the dendritic arbor (3). However, the underlying mechanisms for this selective dendritic injury remain poorly understood. The initial NMDA or kainite-mediated swelling in dendrites of cultured neurons depends on intracellular accumulation of Na ϩ and Cl Ϫ but not Ca 2ϩ (4). On the other hand, excessive Ca 2ϩ entry plays a role in the long lasting structural damage and delayed recovery in hippocampal slices in response to NMDA (4, 5). A correlation between dendritic bead formation and ATP reduction/mitochondrial dysfunction has been demonstrated in cultured hippocampal neurons following glutamate exposure (6). However, the relationship between selective dendritic damage, loss of Na ϩ and Ca 2ϩ homeostasis, and mitochondrial dysfunction following ischemia remains to be defined.NHE-1 (Na ϩ /H ϩ exchanger isoform 1) is a plasma membrane protein present in virtually all mammalian cells and plays a central role in intracellular pH (pH i ) and cell volume regulation (7). NHE-1 activity is directly activated by intracellular acidification and/or by protein phosphorylation mediated by ERK-p90 ribosomal S6 kinase (p90 RSK ) 2 in ischemic neurons (8). Excessive NHE-1 activation results in intracellular Na ϩ accumulation, which subsequently promotes Ca 2ϩ entry via reversal of Na ϩ /Ca 2ϩ exchange (NCX rev ) and plays an important role in myocardium ischemia/reperfusion injury (9). We recently reported that NHE-1 activity in the soma of neurons and astrocytes is stimulated following ischemia, and inhibition of NHE-1 activity is neuroprotective (8, 10). In addition, inhibition of NHE-1 either pharmacologically or by genetic knockdown reduces infarction at 24 h following in vivo focal ischemia (11). However, it remains unexplored whether concurrent activation of NHE-1 and NCX rev contributes to the selective vulnerability of postsynaptic neuronal dendrites to ischemic damage.In the current study, we demonstrated that neurons exhibited robust NHE-1-dependent pH i regulation in their dendrites as a result of their large surface area/volume ratio. Further, in vitro ischemia (oxygen glucose deprivation and reoxygenation, * This work was supported, in whole or in part, by National Institutes of Health Grants RO1NS48216 (to D. S.), R01 GM071434 (to J. T.), MS RG-4054-A-8 (to S.-Y. C.), P30 HD03352 (to the Waisman Center), and...