Virus infection of neurons leads to different outcomes ranging from latent and noncytolytic infection to cell death. Viruses kill neurons directly by inducing either apoptosis or necrosis or indirectly as a result of the host immune response. Sindbis virus (SV) is an alphavirus that induces apoptotic cell death both in vitro and in vivo. However, apoptotic changes are not always evident in neurons induced to die by alphavirus infection. Time lapse imaging revealed that SV-infected primary cortical neurons exhibited both apoptotic and necrotic morphological features and that uninfected neurons in the cultures also died. Antagonists of the N-methyl-Daspartate (NMDA) subtype of glutamate receptors protected neurons from SV-induced death without affecting virus replication or SV-induced apoptotic cell death. These results provide evidence that SV infection activates neurotoxic pathways that result in aberrant NMDA receptor stimulation and damage to infected and uninfected neurons.Neuronal death is a tightly regulated process that is necessary for proper development of the nervous system. However, neuronal death that is inappropriate, either in timing or extent, is also involved in production of disease associated with neurodegeneration, stroke, and trauma (50). Similar to cell death in other tissues, neuronal death can be characterized as either apoptotic or necrotic. Apoptotic cell death, a caspase-dependent programmed cell death, is important for the elimination of unnecessary or potentially harmful cells and involves nuclear and cytoplasmic condensation, intranucleosomal DNA cleavage, and blebbing of the cell into membrane-bound apoptotic bodies. Necrotic, or lytic, cell death occurs following intense cellular injury and is associated with swelling of the cell body, increases in cellular volume, changes in plasma membrane permeability, and release of cellular contents into the extracellular space. The types of morphological changes that occur during neuronal death depend on the developmental state of the neuron and on the cell death stimulus (34, 50).Sindbis virus (SV) is an enveloped, single-stranded, positivesense RNA alphavirus related to eastern, western, and Venezuelan equine encephalitis viruses, important causes of acute mosquito-borne encephalitis in the Americas (55). SV causes fever, rash, and arthritis in humans but causes an age-dependent encephalitis in mice and serves as a model for studying viral encephalitis and neuronal damage caused by the encephalitic alphaviruses (18). SV induces apoptotic cell death in vitro and in vivo (35-37, 45, 60), but characteristic apoptotic changes are not always evident in neurons induced to die by alphavirus infection (17,19,24,51). As determined by caspase-3 activation, terminal deoxynucleotidyltransferase-mediated dUTP nick end labeling positivity, and morphological changes, apoptotic neurons are present in the hippocampi of infected animals (24; T. Kimura and D. E. Griffin, submitted for publication). However, swollen neurons without condensed apoptotic nuclei ca...