Background and Purpose-We characterized the differential effects of glycine at different levels in the induction of postischemic long-term potentiation, as well as in the neuronal damage induced by focal ischemia. Methods-Whole-cell patch clamp recordings were obtained from rat hippocampal slice preparations. In vitro ischemia and postischemic long-term potentiation were induced by oxygen and glucose deprivation. In vivo ischemia was induced by transient middle cerebral artery occlusion. Results-In both in vitro and in vivo ischemia models, glycine at low level exerts deleterious effects in postischemic long-term potentiation and ischemic neuronal injury by modulation of the N-methyl-D-aspartate receptor coagonist site; whereas glycine at high level exerts neuroprotective effects by activation of glycine receptor and subsequent differential regulation of N-methyl-D-aspartate receptor subunit components. Conclusions-Our results provide a molecular basis for the dual roles of glycine in ischemic injury through distinct mechanisms, and they suggest that glycine receptors could be a potential target for clinical treatment of stroke. (Stroke. 2012;43:2212-2220.)Key Words: glycine Ⅲ ischemia Ⅲ electrophysiology Ⅲ middle cerebral artery occlusion Ⅲ N-methyl-D Ⅲ aspartate receptor A pathological form of plasticity, named postischemic long-term potentiation (i-LTP), was observed in glutamatereceptor-mediated neurotransmission after stroke. [1][2][3] There is evidence that i-LTP in the hippocampus may exert a detrimental effect via facilitation of excitotoxic damage. 3 This long-term enhancement in AMPA-and NMDA-receptor-mediated excitatory responses was mainly attributable to overstimulation of glutamatergic neurotransmission by excessively released extracellular glutamate in the postischemic brain. Given that overexcitation of neurons caused by stroke disturbs the balance between excitation and inhibition, restoring this balance via intervention with additional inhibition seems to be a potential and practical strategy.Ischemia elicits the rapid release of various amino acid neurotransmitters, including glycine. 4,5 Glycine is a 2-faceted bioactive molecule in the central nervous system. 6 Glycine is a strychnine-insensitive coagonist for N-methyl-D-aspartate receptors (NMDAR) and is essential for activation of NMDARs. [7][8][9] And yet, glycine is one of the main inhibitory neurotransmitters in the central nervous system. 10 Over the past decade, accumulating evidence has suggested that functional glycine receptors are present throughout all regions in the hippocampus, and they play an important role in regulating excitability and plasticity. These strychnine-sensitive glycine receptors (GlyR), if located postsynaptically, are mostly in extrasynaptic sites. 11 Because GlyRs activation induces Cl Ϫ flux and neuronal hyperpolarization, and thus suppresses neuronal excitability, we sought to determine whether and how activation of extrasynaptic GlyRs could help restore excitation-inhibition balance and activity-dependent p...