A method of post-
stroke treatment at delayed timepoints with 
sigma receptor agonists. Sigma receptors are promising targets for 
neuroprotection following 
ischemia. One of the key components in the demise of neurons following 
ischemic injury is the disruption of 
intracellular calcium homeostasis. The 
sigma receptor agonist, DTG, was shown to depress [Ca2+]i elevations observed in response to 
ischemia induced by 
sodium azide and 
glucose deprivation. Two 
sigma receptor antagonists, metaphit and BD-1047, were shown to blunt the ability of DTG to inhibit 
ischemia-evoked increases in [Ca2+]i. DTG inhibition of ischemia-induced increases in [Ca2+]i was mimicked by the sigma-1 
receptor-selective agonists, carbetapentane, (+)-pentazocine and PRE-084, but not by the sigma-2 selective 
agonist, ibogaine, showing that activation of sigma-1 receptors is responsible for the effects. Activation of sigma receptors can ameliorate [Ca2+]i dysregulation associated with ischemia in 
cortical neurons, providing neuroprotective properties. The effects of 1,3-di-o-tolyguanidine (DTG), a high affinity sigma 
receptor agonist, as a potential treatment for decreasing infarct area at 
delayed time points was further examined in rats. DTG treatment significantly reduced infarct area in both cortical / striatal and cortical / hippocampal regions by >80%, relative to control rats. These findings were confirmed by immunohistochemical experiments using the neuronal marker, mouse anti-neuronal nuclei 
monoclonal antibody (NeuN), which showed that application of DTG significantly increased the number of viable neurons in these regions. Furthermore, DTG blocked the 
inflammatory response evoked by MCAO, as indicated by decreases in the number of reactive astrocytes and activated 
microglia / macrophages detected by 
immunostaining for 
glial fibrillary acidic protein (GFAP) and binding of isolectin IB4, respectively. Thus, the sigma 
receptor-selective agonist, DTG, can enhance neuronal survival when administered 24 hr after an 
ischemic stroke. In addition, the 
efficacy of sigma receptors for 
stroke treatment at 
delayed time points is likely the result of combined neuroprotective and anti-inflammatory properties of these receptors.