There is a significantly elevated incidence of epilepsy in Alzheimer's disease (AD). Moreover, there is neural hyperexcitation/synchronization in transgenic mice expressing abnormal levels or forms of amyloid precursor protein and its presumed, etiopathogenic product, amyloid- 1-42 (A). However, the underlying mechanisms of how A causes neuronal hyperexcitation remain unclear. Here, we report that exposure to pathologically relevant levels of A induces A form-dependent, concentration-dependent, and time-dependent neuronal hyperexcitation in primary cultures of mouse hippocampal neurons. Similarly, A exposure increases levels of nicotinic acetylcholine receptor (nAChR) ␣7 subunit protein on the cell surface and ␣7-nAChR function, but not ␣7 subunit mRNA, suggesting post-translational upregulation of functional ␣7-nAChRs. These effects are prevented upon coexposure to brefeldin A, an inhibitor of endoplasmic reticulum-to-Golgi protein transport, consistent with an effect on trafficking of ␣7 subunits and assembled ␣7-nAChRs to the cell surface. A exposure-induced ␣7-nAChR functional upregulation occurs before there is expression of neuronal hyperexcitation. Pharmacological inhibition using an ␣7-nAChR antagonist or genetic deletion of nAChR ␣7 subunits prevents induction and expression of neuronal hyperexcitation. Collectively, these results, confirmed in studies using slice cultures, indicate that functional activity and perhaps functional upregulation of ␣7-nAChRs are necessary for production of A-induced neuronal hyperexcitation and possibly AD pathogenesis. This novel mechanism involving ␣7-nAChRs in mediation of A effects provides potentially new therapeutic targets for treatment of AD.